Traditional Japanese Kampo medicines contribute to successful withdrawal from the causative drug in medication-overuse headache

Abstract

　In the treatment of medication-overuse headache （MOH）, discontinuation of the causative drug often results in rebound headache and subsequent difficulty in withdrawing from the causative drug. Prophylactic drugs are not fast-acting and do not counteract rebound headache. We investigated the efficacy of traditional Japanese Kampo medicines, which can be taken in combination with regular medication and at the time of headache, in 298 first-time headache outpatients from 2017 to 2020; 54 patients were diagnosed with MOH, and 47 of these patients with concomitant symptoms were treated with Kampo medicines. Primary endpoints included the success rate of withdrawal from the causative medication and course of treatment, and secondary endpoints were the Kampo medicine prescription, age, sex, underlying headache disorder, and use of prophylactic medication. The male to female ratio was 7：40, and the median age was 43 years. Successful withdrawal was the complete resolution of chronic headache and analgesic use<10 days/month within 2 months after discontinuation of overuse medication. The successful withdrawal rate was 89%. Migraine was the most common underlying cause of headache. The prescriptions were “goreisan”, “keishibukuryogan”, and “tokishakuyakusan”. Concomitant use of Kampo medicines contributes to successful withdrawal from the causative drug in MOH.