IV Aspirin for Medication Overuse Headache

by Teri Robert, Lead Expert

One of the most frequent topics of discussion among people with chronic Migraines or headaches is how to break a "rebound cycle." How do they get out of a medication overuse headache (MOH) situation without being incapacitated by the horrible headaches?

A new study has revealed one potential answer to this question. The researchers for this study wrote,

"Most patients with headache are well managed as outpatients; however, a small proportion are probably better managed by a short hospital admission. For some patients, typically those with medication overuse, hospital admission with medication withdrawal can be a helpful part of their overall management. One crucial issue for inpatients is, what is to be done when the medicine they are overusing is withdrawn?"1

The study

Study methods:

  • Researchers reviewed the medical records of 168 people between the ages of 18 and 75, hospitalized for Migraine or headache and given aspirin through an IV.
  • Of those 168 people, 117 were women.
  • All but three of the 168 had chronic daily headache.
  • Most had a diagnosis of Migraine.
  • Of these 168 patients, 159 were overusing medication at the time of admission
  • Participants received doses of one gram of aspirin in the form of lysine acetylsalicylic acid, from one to 50 doses, with an average of five doses.
  • Before, during and after treatment, 86 participants completed hourly diary entries regarding their pain.
  • Pain was rated on a 10-point scale
    • scores of 1-3 for mild headache,
    • scores of 4-7 for moderate headache, and
    • scores of 8-10 for severe headache.
  • Participants’ comments, along with nurses’ notes, were also used to rate the effectiveness of IV aspirin.

Study results:

  • People experienced a three-point or greater reduction in pain scores on more than 25% of occasions, downgrading the headache from severe to moderate, moderate to mild or from mild to no headache.
  • 5.9% of the patients experienced side effects, none of which were considered severe.
  • Side effects included nausea, pain from IV insertion and vomiting.
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