RESUMEN
The management of medication overuse headache (MOH) is sometimes challenging, particularly for patients with a long disease duration. We observed that patients who used goshuyuto, a traditional Japanese medicine, exhibited a favorable clinical course. Two women who had a history of MOH for over 20 years were treated using 5.0-7.5 g/day goshuyuto in an outpatient setting. The treatment reduced their use of habitual drugs, including triptan (33-55%) and non-steroidal anti-inflammatory drugs (75-82%), as well as the headache impact test score-6 (16-23%) over 24 weeks. As goshuyuto has a protective effect on chronic headache and is reported not to lead to MOH, it is a good candidate for the treatment of patients with MOH in an outpatient setting, even for those with an over 20-year history of MOH.