Ergotamine medications include DHE-45 and Migranal Nasal Spray.
The triptans include Imitrex, Maxalt, Zomig, Amerge, Relpax, Axert, and Frova -- as well as Treximet, which is a combination of Imitrex and Naproxen Sodium.
Analgesics are medications for the relief of pain, medications such as acetaminophen.
There is a bit of confusion about nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs were protective against transition to TM at low to moderate monthly headache days (10 - 14 days a month), but were associated with increased risk of transition to TM at high levels of monthly headache days (15 or more days a month). This would serve to confirm that NSAID use should be restricted to no more than two or three days per week and should NOT be used for Migraine prevention.
Although caffeine is not specifically listed, it IS a drug, and for some people, it can indeed cause MOH. The caffeine content is one reason that compound medications such as Excedrin and Fioricet can be such horrid MOH culprits. They contain multiple ingredients, including caffeine, that can cause MOH.
How can we avoid MOH?
Medication overuse headache is avoided by not using medications for the relief of headache and/or Migraine too frequently. Although that statement may look simple, for the chronic sufferer, it's anything but a simple solution. As you can see, the ICHD-II defines overuse in terms of days per month, which vary from 10 days to 15 days per month, according to the type of medication. Most doctors will advise staying below those numbers by limiting use to two or three days per week. For those who take triptans, doctors will sometimes recommend taking triptans two days a week and another type of medication another two days a week if absolutely necessary. Beyond that, there is no real answer for pain on additional days that week. The long-term answer is, of course, an effective preventive regimen that reduces the need for MOH-causing medications.
How can we distinguish MOH from other headaches and Migraines?
Differentiating between a tension-type headache, for example, and MOH can be difficult. There are, however, some very discernable differences between MOH and a Migraine attack. Migraine pain is worsened by activity; MOH tends not to be. MOH is also missing other Migraine symptoms such as nausea, vomiting, phonophobia (sensitivity to sound), photophobia (sensitivity to light), hot flashes, chills, dizziness, and so on.
