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To the Editor:
I commend Katsarava et al.1 for undertaking the difficult task of a prospective study that involved hospitalizing a large number of patients, and for producing an incredible long-term success rate of 97%. However, I wish the authors had taken the extra step of double-blinding the trial. My concern is that their report describes clinical features of a condition that may not exist. Although withdrawal from caffeine has been shown to cause headaches in a double-blind experiment,2 the existence of withdrawal or rebound headaches due to daily use of a simple analgesic, ergotamine, or a triptan has never been demonstrated scientifically. It may be that a number of anecdotal reports have created a myth of headache from medication overuse that is not supported by …
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