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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(09): s00451809333
DOI: 10.1055/s-0045-1809333
Point of View

In the era of monoclonal antibodies targeting the calcitonin gene-related peptide pathway, is it still necessary to stop taking excessive pain medication?

Renata Gomes Londero 
1   Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Clínica de Cefaleia, Porto Alegre RS, Brazil.
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Abstract

Medication-overuse headache (MOH) was first described in 1951 with ergotamine overuse. Since then, much has been studied about its risk factors, pathophysiology, prevention, and treatment. Despite this, many people still suffer from this condition. Even for those who reach medical care, the path to maintaining significant improvement is neither short nor easy. Here, we propose the ubiquitous individualization of headache treatment. The more we study the condition, the more it becomes evident that different groups of patients benefit from different approaches: starting prophylactic medication immediately or postponing it, providing a bridge treatment or not, and advising patients to either stop medication overuse immediately or reduce it gradually.

Keywords

Headache Disorders, Secondary - Antibodies, Monoclonal - Eptinezumab - Galcanezumab - Fremanezumab

Data Availability Statement

The contents are already available.


Editor-in-Chief: Hélio A. G. Teive 0000-0003-2305-1073.


Associate Editor: Carlos Henrique Ferreira Carmago 0000-0002-3533-0347.


Guest Editor: Pedro Augusto Sampaio Rocha Filho 0000-0001-5725-2637.


This article is part of a debate series on Headache and Pain (CGRP Monoclonal Antibodies for Migraine), featuring different perspectives. Check out the other points of view: https://doi.org/10.1055/s-0045-1809332 and https://doi.org/10.1055/s-0045-1809658.




Publikationsverlauf

Eingereicht: 11. Februar 2025

Angenommen: 07. März 2025

Artikel online veröffentlicht:
28. Juli 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Renata Gomes Londero. In the era of monoclonal antibodies targeting the calcitonin gene-related peptide pathway, is it still necessary to stop taking excessive pain medication?. Arq Neuropsiquiatr 2025; 83: s00451809333.
DOI: 10.1055/s-0045-1809333
 

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