Objective:

The objective of this study is to investigate the relationship between medication overuse (MO) and the frequency and intensity of headaches in patients diagnosed with Idiopathic Intracranial Hypertension (IIH).

Background:

Headaches are the most prevalent symptom associated with IIH and can
significantly impair quality of life. Various factors contribute to headache presentations, and while there is evidence that treatment for obstructive sleep apnea (OSA) may improve IIH symptoms, research on MO in relation to headache characteristics in patients with both IIH and OSA remains limited. This study emphasizes the necessity of screening for MO in headaches related to IIH as a potentially significant contributing factor.

Design/Methods:

We conducted a retrospective analysis involving 25 IIH patients from the University of Puerto Rico Medical Sciences Campus Ophthalmology and Headache Specialty Clinics. Participants completed a questionnaire assessing headache frequency and intensity, the number of prophylactic and abortive medications used, and any previous diagnoses of sleep apnea. MO was defined as having an average ≥10 days of abortive therapy use per month.

Results:

Data analysis employed chi-squared and t- test statistical methods. Among the participants, 12 were identified as high risk for MO. Those at higher risk of MO reported increased headache frequency (p < 0.05) and intensity (p = 0.18).
Additionally, patients with a higher risk of OSA had fewer prophylactic medications and a higher headache frequency (p < 0.05).

Conclusions:

These findings suggest that medication overuse may negatively
impact headache frequency and intensity in patients with IIH. Moreover, the results highlight the issue of under-treatment with prophylactic medications, reinforcing the need for recognition and screening of MO in the assessment and management of IIH. MOH, a fairly common and treatable secondary headache disorder attributed to the overuse of acute headache medications, is under recognized and produces significant disability and substantial reduction in quality of life.