Dawn Buse, PhD: Inappropriate Prescriptions in Acute, Preventive Migraine Treatment


The clinical professor of neurology at Albert Einstein College of Medicine spoke to the findings of the OVERCOME study, and how recent literature has suggested that improper prescriptions and medication use in migraine have been ongoing in spite of the current recommendations.

“In the acute space, we’re seeing a troubling rate of opioid prescription use for people with migraine, despite the fact that, for the last decade, the American Headache Society and other organizations have specifically advised against its use. And we see this across all specialties of care.”

Data from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study survey, were presented at the 2019 American Headache Society (AHS) Annual Meeting, July 11-14, 2019, in Philadelphia, Pennsylvania, and revealed some troubling trends in the prescription rates of opioids for acute therapy patients with migraine. This, in turn, became a hot topic of discussion among the headache and migraine specialists and pain clinicians in attendance.1

These results are troubling, as opioids are generally not recommended for the treatment of migraine as there is little evidence of their efficacy in its treatment, there is a risk of dependence, and literature suggests that it is a risk factor for headache exacerbation. As Richard Lipton, MD, one of the study authors, noted, “the very medication that relieves pain short term may lead to the onset of chronic migraine.”

Additionally, data from the OVERCOME study showed a similar trend, with a wide number of patients either not using or not being prescribed the proper acute medications, and that this trend was extending out to include improper preventive migraine prescriptions. To discuss this further, NeurologyLive® spoke with one of the authors of the OVERCOME study, Dawn Buse, PhD, clinical professor of neurology, Albert Einstein College of Medicine, and assistant professor, Ferkauf Graduate School of Psychology, Yeshiva University.

For more coverage of AHS 2019, click here.


1. Schewdt TJ, Lipton RB, Friedman BW, et al. Demographics, headache characteristics, and other factors associated with opioid use in people with migraine: results from the chronic migraine epidemiology and outcomes study. Headache. 2019;59(S1):1-208. Presented at: 2019 American Headache Society Annual Meeting; July 11-14, 2019; Philadelphia, PA. Poster OR05.

2. Buse D. Migraine Care Across the Healthcare Landscape in the United States Among Those with ≥4 Migraine Headache Days Per Month: Results of the OVERCOME Study. Presented at: 2019 American Headache Society Annual Meeting; July 11-14, 2019; Philadelphia, PA. Poster P60.

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