Prognosis
In general, the prognosis for patients with MOH is favourable. One systematic review found that 66% to 100% of patients were free of medication overuse at 2-6 months, and 60% to 83% at 1 year, with the best outcomes for those who had withdrawal therapy combined with preventative medication.[102]
However, it also found that approximately 10% to 40% of patients experience relapse within 5 years after withdrawal, with most relapses occurring during the first year.
Predictive factors that increase the risk of relapse of MOH include:[10]
The presence of both migraine and tension-type headache as underlying headache disorders
Longer duration of regular acute medication intake
A higher number of acute treatments
Overuse of opioids
Lack of improvement after 2 months of withdrawal
Smoking and/or alcohol consumption
Poor sleep
High levels of bodily pain.
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