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Table 1 International Classification of Headache Disorders Third Edition (ICHD-3) Criteria for Medication-Overuse Headache (MOH) [22]

From: Medication-overuse headache: a widely recognized entity amidst ongoing debate

8.2 Medication-overuse headache (MOH)

 A. Headache occurring on ≥15 days/month in a patient with a pre-existing headache disorder

 B. Regular overuse for > 3 months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache

 C. Not better accounted for by another ICHD-3 diagnosis.

  8.2.1 Ergotamine-overuse headache

   A. Headache fulfilling criteria for 8.2 Medication- overuse headache

   B. Regular intake of ergotamine on ≥10 days/month for > 3 months.

  8.2.2 Triptan-overuse headache

   A. Headache fulfilling criteria for 8.2 Medication- overuse headache

   B. Regular intake of one or more triptans,1 in any formulation, on ≥10 days/month for > 3 months.

  8.2.3 Non-opioid analgesic-overuse headache

   8.2.3.1 Paracetamol (acetaminophen)-overuse headache

    A. Headache fulfilling criteria for 8.2 Medication- overuse headache

    B. Regular intake of paracetamol on ≥15 days/ month for > 3 months.

   8.2.3.2 Non-steroidal anti-inflammatory drug (NSAID)- overuse headache

    A. Headache fulfilling criteria for 8.2 Medication- overuse headache

    B. Regular intake of one or more non-steroidal anti-inflammatory drugs (NSAIDs) (other than acetylsalicylic acid) on ≥15 days/month for > 3 months.

    8.2.3.2.1 Acetylsalicylic acid-overuse headache

     A. Headache fulfilling criteria for 8.2 Medication- overuse headache

     B. Regular intake of acetylsalicylic acid on ≥15 days/ month for > 3 months.

   8.2.3.3 Other non-opioid analgesic-overuse headache

    A. Headache fulfilling criteria for 8.2 Medication- overuse headache

    B. Regular intake of a non-opioid analgesic other than paracetamol or non-steroidal anti-inflammatory drugs (including acetylsalicylic acid) on ≥15 days/month for > 3 months.

  8.2.4 Opioid-overuse headache

   A. Headache fulfilling criteria for 8.2 Medication- overuse headache

   B. Regular intake of one or more opioids on ≥10 days/month for > 3 months.

  8.2.5 Combination-analgesic-overuse headache

   A. Headache fulfilling criteria for 8.2 Medication- overuse headache

   B. Regular intake of one or more combination-analgesic medications on ≥10 days/month for > 3 months.

  8.2.6 Medication-overuse headache attributed to multiple drug classes not individually overused

   A. Headache fulfilling criteria for 8.2 Medication- overuse headache

   B. Regular intake of any combination of ergotamine, triptans, non-opioid analgesics and/or opioids on a total of ≥10 days/month for > 3 months without overuse of any single drug or drug class alone.

  8.2.7 Medication-overuse headache attributed to unspecified or unverified overuse of multiple drug classes

   A. Headache fulfilling criteria for 8.2 Medication- overuse headache

   B. Both of the following: 1. regular intake of any combination of ergotamine, triptans, non-opioid analgesics and/or opioids on ≥10 days/month for > 3 months

  8.2.8 Medication-overuse headache attributed to other medication

   A. Headache fulfilling criteria for 8.2 Medication- overuse headache

   B. Regular overuse, on ≥10 days/month for > 3 months, of one or more medications other than those described above, 1 taken for acute or symptomatic treatment of headache.