Preface to the First Revision of the Second Edition
The need for revision of the criteria for 8.2 Medication-overuse headache and its subforms became apparent soon after publication of The International Classification of Headache Disorders, 2nd edition. Fred Sheftell first drew attention to potential problems with these criteria, and constructive criticism at the International Headache Research Seminar in Copenhagen in March, 2004, which discussed the classification in considerable detail, confirmed that some re-writing was necessary. This task was undertaken by Stephen Silberstein, chairman of the Working group on Headache Attributed to a Substance or its Withdrawal, together with the other members of the IHS Classification Subcommittee.
There are two major resultant changes. The first is the elimination of headache characteristics for the subforms of medication-overuse headache since it was agreed that none could be regarded as typical. The second is the introduction of a new subform, 8.2.6 Medication-overuse headache attributed to combination of acute medications, that recognises patients overusing medications of different classes whilst not meeting the criteria for overuse of any single class. This change required the re-numbering of subforms 8.2.7 (previously 8.2.6) Headache attributed to other medication overuse and 8.2.8 (previously 8.2.7) Probable medication-overuse headache.

