Greater Occipital Nerve Block for Migraine with Medication Overuse Headache

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This interventional study evaluates the efficacy of a greater occipital nerve block (GONB) as a bridging therapy for detoxification in patients with migraine and medication overuse headache (MOH). Participants will receive either lidocaine with methylprednisolone or placebo, as part of a detoxification plan across three Thai headache centers from February 2026 to January 2028. The trial targets adults diagnosed with MOH per ICHD-3 criteria, excluding those with other headache types, certain medical histories, or current CGRP/botulinum toxin therapies. Outcomes will inform whether GONB can reduce withdrawal-related headache and support MOH treatment strategies. The research is sponsored by Mahidol University with collaborators from three universities.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Patients who have a diagnosis of migraine with medication overuse headache according to ICHD-3 criteria confirmed by a neurologist
* Female patients will be screened for pregnancy planning and married female patients must undergo a urine pregnancy test

Exclusion Criteria:

* Patients who have other types of headache disorders other than migraine
* Patients who have a previous history of allergy to corticosteroid or lidocaine
* Patients who had previous skull surgery
* Pregnant women
* Patients with a history of uncontrolled depression, or psychosis
* Patients who get or plan to get CGRP-targeted therapies or botulinum toxin injection
* Patients with an increased risk of bleeding or underlying bleeding disorders

Where it's running

• Faculty of Medicine Siriraj Hospital, Mahidol University
  Bangkok, Bangkok, Thailand Recruiting
• Faculty of Medicine, Prince of Songkla University
  Hat Yai, Changwat Songkhla, Thailand Recruiting
• Faculty of Medicine, Chiang Mai University
  Chiang Mai, Chiang Mai, Thailand Not yet recruiting

Study contacts

• Study coordinator: Pannathat Soontrapa, M.D.
• Email: pannathat.soo@mahidol.ac.th
• Phone: +6690-568-6388

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.