Table 3

- Treatment strategies for patients with MOH.

  • A- Education of the general population and healthcare providers with general practitioners intervention

  • B- Management strategies for MOH:

  • C- Abrupt withdrawal: treatment of choice for triptans, ergots, simple and combination analgesics, and NSAIDs

  • D- Gradual withdrawal: best for the overuse of opioids, barbiturates, and benzodiazepines

  • E- Outpatient management is recommended for committed, motivated patients, taking non-opioid and non-barbiturate medications, and who do not have any comorbidities. Inpatient care management is usually considered because of failed outpatient management, overuse of barbiturates, opioids or benzodiazepines, or those with medical or psychiatric comorbidities, and with severe withdrawal symptoms such as vomiting

  • F- Valproate, nabilone, onabotulinumtoxin A, topiramate, and amitriptyline are used as prophylactic management