More than 20% of headache disorders could be avoided or eliminated by curtailing the overuse of medication, according to the Global Burden of Disease (GBD) Study 2023.

The analysis found that medication-overuse headache accounted for 58.9% of the years lived with disability (YLD) estimate for tension-type headache in men and 56.1% in women.

For migraines, medication overuse headache made up 22.6% and 14.1% of the YLD estimate for men and women, respectively. 

The very substantial burden attributed to medication-overuse headache was “of profound clinical relevance and implication for public health,” the authors said in The Lancet Neurology [link here].

“Our findings indicated that more than 20% of headache-attributed burden would be mitigated or completely averted if an important minority of people with headache did not overuse medication.

“This underpins the need to raise awareness among both people with headache and health care providers about the risks associated with the overuse of acute medication,” they added.

The study tracked headache burden from 1990 to 2023 and encompassed data from 41,653 individuals across 18 countries.

The results also show that, in 2023, headache disorders affected 2.9 billion people and had a global prevalence of 34.6%.

The age-standardised rate of 541.9 years lived with disability per 100,000 population made it the sixth most disabling group of conditions worldwide, the authors said, with 487.5 per 100,000 population attributed to migraine.

While tension-type headache was almost twice as prevalent as migraine (24·9% vs 14·1%), migraine accounted for 90% of YLDs attributed to headache disorders in 2023, due to its substantially higher disability weighting, the authors noted.

Women were disproportionately affected, with YLD rates due to headache disorders more than twice as high than in men (739.9 per 100,000 versus 346.1 per 100,000, respectively), the study found.

Additionally, the duration of headache symptoms tended to increase with age, peaking in people over the age of 50, especially in the case of those with definite migraine.

“Headache disorders continue to be among the most prevalent and burdensome conditions worldwide,” the authors wrote.

“Our findings highlight the pressing need for effective management and prevention strategies for headache disorders.”