Rebound Headaches – The Merry-Go-Round of Medication Overuse Headaches & Recurring Migraines

October 20th, 2019

When a headache strikes, our first instinct is to reach for the medication cabinet. Over-the-counter (OTC) painkillers like ibuprofen and acetaminophen may be effective at treating headaches and generally cause fewer side effects than their prescription counterparts.

But OTC pain relievers and headache medications are not without side effects. Rebound headaches are one of the biggest concerns for regular headache sufferers. A rebound headache, also called medication overuse headache, occurs as a result of misusing or taking painkillers (or migraine medications) too frequently.

Experts are not sure why rebound headaches happen. However, the general consensus is that as medications wear off, the body goes through a withdrawal reaction – typically another headache – that causes the person to reach for another painkiller. Eventually, this cycle may shift receptors or pathways on the brain and alter how pain is perceived by the body.

Scientists have determined that rebound headaches tend to occur as a result of medication misuse or overuse. That means that those who use medicines for longer than advised by their doctor or pharmacist or take too many pills at once are at greater risk for developing these headaches.

Most of the time, those who get rebound headaches do so after they’ve used medications for 15 days of the month or more. Though no two medications are the same, most OTC painkillers should not be taken for more than two days per week unless instructed by a doctor.

Which Medications Cause Rebound Headaches

Both OTC and prescription medications can cause rebound headaches. The most common OTC medications that cause these headaches are NSAIDs (naproxen, ibuprofen, etc.) as well as acetaminophen. Prescription painkillers like Vicodin, Percocet, and sedatives for sleep have also been shown to trigger rebound headaches.

How Are Rebound Headaches Treated

Because these unpleasant headaches are caused by medications, discontinuing their use may seem like the obvious choice. However, that’s not always safe. If a doctor has prescribed you narcotics, painkillers or migraine medications, ending the treatment abruptly can worsen headaches. That’s why it is important to talk to your physician and come up with an action plan to adjust your treatment safely.

On the other hand, if OTC pain relievers are causing your rebound headaches, it may be safe to try and eliminate them on your own. To break the medication-headache cycle, you can try to discontinue them altogether or to cut back gradually. Some people notice that rebound headaches may persist or worsen for a few days or even weeks after they’ve stopped taking medications. That happens because the body may need longer to metabolize and eliminate the medicine from the bloodstream.

Depending on the type of medication and the severity of the rebound headaches, doctors may choose to prescribe other drugs to help ease withdrawal symptoms. In some cases, the person may be asked to stay in the hospital for a few days to monitor their symptoms and make sure they are responding well to the new treatment.

 

Signs of Rebound Headaches (Medication Overuse Headaches/Recurring Migraines)

If any of the following signs apply to you, you are probably experiencing Rebound/Medication Overuse Headaches and have probably realized by now, that spending the rest of  your life taking pain medications is NOT the answer.

•You suffer from headaches daily or every other day.

•Your pain intensifies about three hours after your last dose of medication.

•Your pain medications don’t work as well as they used to.

•You take more medication, but your headaches are worse.

•You rely on more pills, and you take them more often.

•You take medication even for mild headaches, and you often try to ward off a headache by using a medication.

•You take pain relievers three to four days a week, and you average more than three tablets per day. (This depends on the kind of medication you’re taking, so you’ll need your doctor’s advice.)

•Your pain runs the gamut from mild to moderate to horrible. Usually, the pain is a dull ache that you feel on both sides of your forehead and, sometimes, on the top or back of your head.

•Your headaches occur much more frequently.

How To Prevent Rebound Headaches

Because treating rebound headaches is not always easy, prevention is always the safest approach. These are the three golden rules to prevent medication overuse headaches:

Follow your doctor or pharmacist’s advice: just because OTC pain relievers don’t require a prescription, doesn’t mean they should be taken lightly. In addition to rebound headaches, long term NSAID use can cause stomach problems like gastritis. To avoid rebound headaches, don’t take medications for longer than advised by your physician, pharmacist or by the manufacturer.

Only use pain relievers when you need them: pain relievers are not meant to ‘prevent’ headaches or pain. Avoid rebound headaches and other related issues like drug dependency and withdrawal by only taking medications when you need them.

Avoid caffeine when taking painkillers: rebound headaches are more likely to stem from medications that have caffeine – which many headache and migraine relievers do because caffeine has a tendency to cause dehydration. Taking additional caffeine (like coffee) can further increase the likelihood of getting a rebound headache or a migraine.

Nutritional Options for Migraine & Headache Sufferers

If you suffer from daily headaches or chronic migraines, talk to your general practitioner or neurologist to get a proper diagnosis. Also, consider nutritional supplements and natural alternative therapies.  Nutritional support, lifestyle changes, tracking your migraine triggers,  may be helpful to people who find themselves on the merry-go-round of recurring migraines.

Nutritional supplements that contain magnesium, vitamin B (riboflavin) and feverfew can help you maintain healthy cerebrovascular tone and function as well as maintain healthy mitochondrial reserves in your brain cells. Research has also shown that some migraine sufferers have low levels of melatonin.  Melatonin is a hormone that’s secreted by the pineal gland in your brain.  Supplementing with melatonin has also been shown to be beneficial to migraine sufferers.  It also helps with sleep when taken in the evening.  It is important to note that there is also a sleep/migraine connection.  It is crucial for migraine sufferers to get proper sleep.  Consider healthy sleep habits to keep migraines at bay.  Avoiding foods that trigger migraines, practicing yoga and meditation, and alternative therapies like chiropractic or acupuncture treatments may also help with daily headaches.