Approximately 7 million Americans have chronic migraine, meaning they experience ≥15 headache days per month, including ≥8 days per month that meet the diagnostic criteria for migraine with or without aura. More than half of people with chronic migraine use medications intended to relieve the symptoms of a migraine headache too frequently, a condition known as medication overuse. Chronic migraine with medication overuse is associated with a high frequency of headaches, substantial functional impairment, high rates of comorbid medical disorders, and the potential for medication-related toxicity and side effects. There has been clinical equipoise regarding the optimal treatment strategy for patients who have chronic migraine with medication overuse.
