Among patients with chronic migraine (CM) with medication overuse headache (MOH), those treated in an outpatient facility, those with more than 69 headaches during 3 months, and those with relevant symptoms of anxiety and depression who do not improve should be closely monitored to reduce the likelihood of non-improvement after structured withdrawal, according to a study published in Acta Neurologica Scandinavia. With management for CM with MOH including withdrawal therapy, education on medication use, and prophylaxis but little attention given to patients who fail to achieve successful short-term outcomes upon withdrawal, researchers conducted a study to describe predictors of failure among 137 patients. Among the 39 participants for whom withdrawal was unsuccessful, predictors included outpatient facility-based withdrawal therapy (odds ratio [OR], 2.37), emergency department use before withdrawal (OR, 2.81), and baseline headache frequency of more than 69 days per 3 months (OR, 2.97). Patients who failed withdrawal did not improve on medication intake, use of prophylactic and non-pharmacologic treatments, or symptoms of anxiety and depression
