Evaluation of the Comparative Effectiveness of Three Therapeutic Drug Regimens in the Treatment of Medication Overuse Headache in the Patients with Headache

Background and Aim: Medication overuse headache (MOH) is the second leading cause of chronic headaches. This study aimed to compare the efficacy of three medication regimens in the treatment of MOH in the patients referring to the neurology clinic of Imam Khomeini Hospital in Urmia in 2018. Material and Methods: This was a randomized clinical trial. Participants in this study selected from MOH patients referring to neurology clinic of Imam Khomeini Hospital in Urmia from Feb to Aug 2018. Our study included 60 patients. Patients were randomly assigned to one of the following 3 groups; prednisolone, celecoxib or a combination of both medications. The duration of treatment was 15 days for all the patients. At the end of the study period, the patients provided the information in regard to the severity, duration, and the number of headache days. Results: The mean duration of headache was 3.55 ± 1.58 months. Gender had no significant relationship with age and the duration of headache. The mean values for severity of headache were 8.2 ±0.71 ,  2.33 ± 0.84 and 2.3 ±0.95 at the first, second and third visits respectively. The mean values for severity of headache at first visit was higher in the patients receiving celecoxib compared to those in the other two treatment groups. At the second and third visits, the mean values for severity of headache were lower in the patients receiving combination therapy. Difference between the scores of severity of headache at the first visit was higher than those at the second and third visits in the combination group which indicated greater effect of this treatment regimen on reducing the severity of the headache compared to the other treatment groups. Conclusion: All three-treatment regimens were effective in reducing headaches, but the combination regimen was more effective. Both celecoxib and prednisolone  had beneficial effects on reducing the severity of headache, but celecoxib was more effective.