Rebound Headaches As A Result Of Over Useage of Common Over-The-Counter Medications
Toxic headaches, other wise known as rebound headaches, are well known amongst headache sufferers. Excess use of pain medications to treat chronic headaches can result in rebound headaches. They are relatively common, as many as 70% of patients treated in headache clinics suffer from daily headaches resulting from overuse of medications. Medications to prevent headaches will normally not work until the pain medication that caused the rebound headache is stopped and the patient has been through complete withdrawal. It is often necessary to hospitalized the patient for this withdrawal process.
You may have rebound headaches if you have some of the following symptoms: the patient has a gradual increase in the frequency of their headaches, they have frequent daily use of rebound inducing medication: gradual increases in headache frequency, alternate or preventive medications fail to control the headache attacks, psychological or physical dependency on rebound headache-inducing medications, the headache predictably begins within hours to days of the last dose of the medication.
Occasional headaches can be treated quickly with pain relievers. But there’s a limit. If you find yourself taking pain medication more than two or three days a week, you may actually be contributing to your headaches rather than easing them. It’s a cycle known as rebound headaches.Taking to much headache medication is the start of the rebound cycle. Your body quickly adapts to the medication. You may not even realize that you’ve been dosing yourself too often until you miss a day and your head starts to hurt again — sometimes more intensely than before.The only way to stop rebound headaches is to reduce or stop taking the pain medication that’s causing them. It’s tough, but your doctor can help.Rebound headaches — also called medication overuse headaches — tend to occur every day, sometimes waking you in the early morning and continuing throughout the day. The pain may be most severe at first, when the medication begins to wear off.
Nearly any pain reliever can contribute to rebound headaches. Certain medications tend to cause rebound headaches more than others. Common medications such as aspirin, acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin, others) may contribute to rebound headaches — especially if you exceed the recommended daily dosages.Over-the-counter pain relievers that contain a combination of caffeine, aspirin and acetaminophen (Excedrin, others) are common culprits. This group also includes prescription medications such as Fioricet, Fiorinal and Esgic, which also contain the sedative butalbital. Painkillers derived from opium or from synthetic opium compounds include combinations of codeine and acetaminophen (Tylenol with Codeine No. 3 and No. 4). These can lead to rebound headaches as well. Daily doses of caffeine — from your morning coffee, your afternoon soda, or any pain reliever or other product containing this mild stimulant — may fuel rebound headaches as well. Read product labels to make sure you’re not wiring your system with more caffeine than you realize. Sometimes headache relief is as simple as giving up the coffee.
To break the cycle of rebound headaches, you’ll need to restrict how much pain medication you use. Depending on what drug you’ve been taking, your doctor may recommend stopping the medication right away or gradually reducing the dose until you’re taking the drug no more than twice a week. Stopping pain medication isn’t easy. Expect your headaches to get worse before they get better. You also may experience withdrawal symptoms such as nervousness, restlessness, nausea, vomiting, insomnia, abdominal pain, and diarrhea or constipation.The symptoms will eventualy stop. Within a week to 10 days, your headaches may become less intense and happen less often. With perseverance, most people break the rebound headache cycle within two months.
Your doctor can prescribe various treatments to help alleviate headache pain and the side effects associated with drug withdrawal. Sometimes it’s best to be in a controlled environment when you stop taking pain medication. A short hospital stay may be recommended if you: haven’t been able to stop using pain medication on your own.
After you’ve broken the rebound headache cycle, your doctor can find a safer way to manage your headaches. Before, during or after withdrawal, your doctor may prescribe a daily preventive medication, such as: A tricyclic antidepressant such as amitriptyline or nortriptyline (Aventyl, Pamelor, others). An anticonvulsant such as valproic acid (Depakene, others), topiramate (Topamax) or gabapentin (Neurontin), or a beta blocker such as propranolol (Inderal, InnoPran, others) These medications can help control your pain without risking another cycle of rebound headaches. If you’re careful, you may be able to take a medication specifically meant for pain during future headache attacks. Be sure to take any medication exactly as prescribed. Headache treatment for rebound headaches is usually very successful, if done properly.
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