| Q: |
Can my medication give me a headache?
| | A: |
Yes, there are medications that, taken on a routine basis, can
cause a headache known as medication overuse headache (previously called
rebound headache). Some medications are known to induce headaches,
while the effects of others remain controversial. It is important that
you do not use any migraine-relief medication for more than 2 days a
week. Therefore, an aggressive preventive treatment program is
essential.
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| Q: |
Why do I need to be concerned about medication overuse headache?
| | A: |
In headache clinics in the US, nearly 80 percent of patients with
chronic daily headache (more than 15 headache days per month) have
medication overuse headache. If you are among the millions whose
headaches have become chronic, you probably have medication overuse
headache in addition to your main headache disorder.
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| Q: |
What are the symptoms of medication overuse headache?
| | A: |
The daily headaches may vary depending upon the type of
medication that is being overused. Those caused by the excessive use of
analgesics resemble tension headaches, whereas triptan
overuse headaches are more like migraine headaches. The headaches
caused by medication become more frequent over time, causing the user to
become dependent upon the medication. This is not an addiction, but it
is a dependency because if you do not take the pill, you get a severe
headache. The more you take the pills, the more headaches you have, and
the more pills you need to take.
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| Q: |
How do I avoid medication overuse headache?
| | A: |
Taking a medication for a headache for more than 3 days a week
can cause medication overuse headache. A treatment program that includes
effective therapy to stop migraine attacks without the overuse of
medications is essential for the control of migraine. If migraine
attacks are occurring more than 3–4 times a month, then preventive
medication may be needed. Daily medications do not have to be taken
forever. Once you reduce the frequency of migraine to less than 2
attacks a month, you can slowly reduce the preventive medication.
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| Q: |
Could a certain medication that I am taking for another problem cause medication overuse headache?
| | A: |
Yes, frequent use of analgesics for any type of pain can cause
medication overuse headaches in individuals with migraine. Many people
with medication overuse headache think their headaches have a different
cause. For example, they may believe that their headache is due to a
sinus problem or an allergy because many of the medications used to
treat sinus congestion and allergic symptoms can cause medication
overuse headache. In fact, sinus or allergy problems do not cause a
chronic daily headache; it is the medication used for the sinus symptoms
or allergy. Stopping the overused medications brings a significant
reduction in the frequency of headaches.
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| Q: |
Apart from chronic daily headache, are there other problems associated with medication overuse?
| | A: |
Yes. You may develop a dependence on symptomatic medication, and
medications for preventing migraine may become less effective. If you
are overusing a medication and consequently the associated migraine
symptoms of nausea and sensitivity to light or sound are less severe and
less frequent than during typical migraine, you may not be diagnosed
with migraine and may therefore not receive appropriate treatment.
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| Q: |
Why do some drugs cause medication overuse headache?
| | A: |
Experts do not know why medication overuse headache develops in
those who have migraine. Theories vary from a change in neurotransmitter
function to a “rewiring” of the pain control system in the brain. What
we do know is that by stopping the offending medication, daily headaches
stop and migraine preventive medication is more effective.
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| Q: |
What should I do if I think my headache is due to medication overuse?
| | A: |
The first step to treating any headache problem is getting the
right diagnosis so, if you have headaches that trouble you, you should
see a doctor. Once you have been diagnosed with migraine, it is
important that you avoid the overuse of any medication that could
complicate your treatment. For those who are experiencing medication
overuse headache, it is imperative to treat the underlying migraine, as
well as the overuse headache. Suddenly stopping medications can cause
withdrawal headaches unless you and your doctor plan ahead. Failure to
maintain control of the headaches can convince you that the only way out
is to return to using the pills that have complicated your problem. For
the best results, see a doctor who is familiar with the treatment of
medication overuse headache. Some individuals may require the expertise
of a headache specialist. However, do not give up—migraine and headache
disorders are treatable. No one should be told to just go home and live
with the pain.
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| Q: |
Can a medication cause a headache that is not a rebound headache?
| | A: |
Yes, there are medications used for other health problems that
may have headache as a side effect. and may trigger migraine attacks.
The medications that are most likely to trigger migraine are those that
widen blood vessels, such as those used for angina, high blood pressure,
and sexual dysfunction. Some medications used for ulcer disease and
certain antibiotics may aggravate migraine as well. Hormonal therapy
with cyclical progestogen can trigger migraines too. If your migraine
attacks increase in frequency after you start a new medication, or if
you have difficulty controlling your migraine, you may need to
investigate the possibility that another medication you are taking is
interfering with your migraine control.
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Medications that can cause medication overuse headache
Many different
medications can be associated with medication overuse headache. Some of
these are prescription, some over-the-counter (nonprescription), and
some are considered natural herbal medications. Medications containing
analgesics are the most common cause of medication overuse headache.
These painkillers range from acetaminophen, found in nearly every
over-the-counter medication, to very addictive opioids (narcotics).
Acetaminophen Combinations of acetaminophen, aspirin, and caffeine Combinations of acetaminophen or aspirin and butalbital plus caffeine, with or without codeine All sinus/cold pills, nasal sprays, eye drops (unless pure steroid or pure antihistamine) All opioid (narcotic) painkillers (codeine) All sedatives (sleeping pills) All antianxiety medications All hypnotics (sleeping pills) All muscle relaxants (except baclofen) Herbal energy or diet pills
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