You have pain. Your headache specialist prescribes medication. You take it. It doesn’t help. So you take it again later that day. And then again the next day. And soon you’ve developed a new headache that’s worse than the one you were trying to treat.
It might be tempting to take more medication than you’ve been prescribed. But it’s important to be aware that taking medication too often can actually cause new headaches. This is called “rebound headache” or “medication overuse headache.” The new pain pops up as a dull, tension-type headache or a more severe migraine-like headache. It’s a common problem that affects some 80 percent of patients in headache clinics.
The rule of thumb is moderation and adherence to the doctor’s prescription. Taking acute medications more than your physician advises could lead to new headaches.
Analgesics
Analgesics are used to treat migraine and headache once they’ve already begun. But the National Headache Foundation (NHF) warns that using analgesics daily or on a near-daily basis can lead to rebound headache.
Triptans (e.g., Imitrex), opioids (e.g., Tylenol with codeine), and barbiturates (e.g., Fiorinal) are common analgesics. The NHF warns that these should not be used more than 10 days per month. Simple analgesics (e.g., ibuprophen) should not be used for more than 15 days per month. Evidence has shown that over-the-counter meds containing caffeine could be particularly problematic. Regarding nasal sprays, it’s generally best to avoid taking these more than two days per week, according to the journal Neurology.1
Preventive Medications
To reduce the likelihood of experiencing rebound headaches, consider switching to preventive medications to prevent headache from ever setting in. Marcelo E. Bigal, MD, PhD, who shared his research with the NHF, says: “Preventive medications do not cause progression…When we talk about medication overuse we are talking about acute medications that are taken to reduce symptoms.” If analgesics lead to rebound headache and are not then discontinued, use of those analgesics could lead to chronic headache or migraine.
References:
1. Neurology.
