Chronic
migraine affects 2 % of the population and has substantial impact on quality of life and considerable burden on healthcare resources. 50-80 % patients with chronic
migraine have excessive consumption of
analgesic medications. Withdrawal of
analgesics is often advised before commencing preventive treatments. However, some
headache experts recommend preventive treatments alongside
analgesic withdrawal. 434 patients with chronic
migraine attending the Hull
Headache Clinic who received
OnabotulinumtoxinA as preventive treatment were stratified to those with or without
analgesic overuse. Data was collected through a dedicated
headache diary and analysed for
headache and
migraine days reduction and for an increment in
headache-free days in the month post treatment. The data shows no difference in the therapeutic outcome in patients with or without
analgesic overuse with substantial reduction in
headache and
migraine days and an increment in
headache-free days in both groups in a real-life clinical setting.
OnabotulinumtoxinA is equally effective in patients with chronic
migraine with or without
analgesic overuse.