8.2.3 Non-opioid analgesic-overuse headache

Description:

Headache occurring on 15 or more days/month in a patient with a pre-existing primary headache and developing as a consequence of regular use of one or more non-opioid analgesics on 15 or more days/month for more than 3 months. It usually, but not invariably, resolves after the overuse is stopped.

Comments:

A patient who fulfils criteria for more than one of the subforms of 8.2.3 Non-opioid analgesic-overuse headache should be given all applicable codes.

Many patients use more than one non-opioid analgesic: a common example is paracetamol (acetaminophen) and a non-steroidal anti-inflammatory drug (NSAID). For the purposes of ICHD-3, all non-opioid analgesics are regarded as a single class; therefore, a patient who uses more than one non-opioid analgesic cumulatively, but not any single drug, on 15 or more days/month is coded 8.2.3 Non-opioid analgesic-overuse headache (with the individual drugs specified in parenthesis) and not 8.2.6 Medication-overuse headache attributed to multiple drug classes not individually overused.