BACKGROUND Common practice in patients overusing medication is to place major emphasis on detoxification. OVERVIEW This is based on decades of disappointing experience trying to treat patients with prophylactics despite medication overuse. Several trials have shown that, when patients are taken off medication overuse, approximately 50% of them get so much better that prophylactic drug treatme...

Endogenous catecholamines in excess are known to cause dilated cardiomyopathy. A patient presented with dilated cardiomyopathy after many years of overusing an adrenaline inhaler. Pathological features and a considerable improvement in myocardial function after withdrawal implicated the exogenous catecholamine excess in the pathogenesis of the cardiomyopathy.