The 10-20 rule in headache therapy

The 10-20 rule in headache therapy

The increase and worsening of headaches due to overuse of painkillers or triptans should be suspected whenever acute medication is required for more than ten days per month, regardless of the dose used.

The “10-20 rule” for avoiding and recognizing medication overuse headaches (MOH) is: Painkillers and specific migraine medications (the so-called triptans) should be used a maximum of 10 days per month.

So 20 out of 30 days should be free from taking them. This rule does not count the tablets used over the 10 days, but only the day in question, regardless of the amount taken.

This also means: It's better to treat properly once than just a little often. For these reasons, recording headaches over the course of the month using a pain calendar is essential for contemporary headache therapy.