Celecoxib or Prednisolone for Treatment of Medication Overuse Headache: A Randomized, Double- Blind Clinical Trial in Migrainous Patients

Background:Treatment of Medication Overuse Headache (MOH) is yet under debate and Celecoxib as a Cyclooxygenase 2 (COX2) -inhibitor has not been tried widely as a pain relief drug for this type of headaches in migrainous patients. Objectives: comparing the efficacy of celecoxib versus prednisolone for withdrawal period of MOH. Materials & Methods: A double-blind, randomized clinical trial was carried out, on 75 patients with MOH who visited the Isfahan Neurology Clinic in 2016. They were assigned into two groups of oral prednisolone and celecoxib prescribed for 15 days. Any changes in the duration (average hours of daily headache), frequency, and severity of headaches, and intake of rescue medication and their side effects were recorded after the 15-day intervention period. Data were analyzed by independent t, paired t, Mann-Whitney, Wilcoxon test, and chi-square tests in SPSS software version 20. Results: Average duration of headache in both groups significantly decreased after treatment (P<0.001). It decreased significantly in celecoxib group (P=0.04). Headache frequency decreased more but not significantly in the celecoxib group (P=0.08). Considering MIGSEV (Migraine Severity) and VAS (Visual Analogue Scale) scales, headache severity alleviated significantly after treatment in both groups (P<0.001). The decrease was more noticeable in the celecoxib group. Need for rescue medications (P=0.048), and side effect appearance (P=0.001) was also lower in patients who took celecoxib, compared to the other group. Conclusion: Celecoxib showed higher efficacy and fewer side effects, compared to prednisolone in treatment of medication overuse headache in migrainous patients.