Successful treatment with duloxetine administration for medication overuse headache following chronic cluster headache: a case report

Abstract

Medication overuse headache (MOH) is an aggravation of an underlying headache caused by excessive use of acute medication. The mechanism behind how chronic exposure to abortive medication leads to MOH remains unclear and no consensus for the management of these patients exists. We describe a case with history of MOH, who was able to withdraw from the overused medication after prophylactic administration of duloxetine. The patient was taking naratriptan to go to work on weekdays because he had complained of severe pain attacks in the left orbit accompanied by tearing several times a day, and chronic continuous headache with comorbid depression. Duloxetine and verapamil were administered after a diagnosis of MOH and cluster headache and the patient was able to withdraw from naratriptan without rebound headache. This case suggests that duloxetine may possibly be an option for prophylactic treatment of MOH.