Medication Overuse Headaches HF#5896

What is a medication overuse headache?

 

There are many types of headache, such as tension headaches and migraines.  One cause of headaches is too much headache medicine.  This is called a medication overuse headache, also know as an analgesic rebound headache.

 

Some kinds of headache medicine can cause headache if you take them too often.  If you use these medicines for headache relief more than two times a week, your headaches may start to occur more often, last longer, and become more painful.  Your usual headache medicines may no longer work as well.  The headache may now be a medication overuse headache – the result of too much headache medicine. 

 

How do you know if you have medication overuse headaches?

 

Your health care provider will help you to answer this question.  Clues that you might have medication overuse headaches include 

• You have a history of migraine or tension-type headaches.
• You have a headache more than 15 days per month. 
• You are using more and more medicine to fight the headaches, but it doesn’t last as long or doesn’t work at all. 
• The headaches seem to be getting worse, especially if you don’t take the medicine.
• You often wake up with a headache.
• The headache may be on both sides of your head, even if it often was one-sided before.

What medicines can cause medication overuse headaches? 

• Acetaminophen (Tylenol®); aspirin; ibuprofen (Advil®, Motrin®)
• Pain medicine/caffeine combinations (Anacin®, Excedrin®)
• Combinations with butalbital, caffeine, or others (Fiorinal®, Fioricet®, Esgic®, Midrin®, others)
• Caffeine (coffee, tea, sodas, “energy drinks,” caffeine tablets, chocolate)
• Opioid pain medicines (morphine, oxycodone, hydrocodone, propoxyphene, butorphanol, others)
• Tramadol (Ultram®)
• Migraine medicines, if overused (Imitrex®, Maxalt®, Relpax®, Amerge®, Migranal®, others)
• Decongestants (pseudoephedrine, phenylpropanolamine, oxymetazoline)

How do I treat my medication overuse headaches?

 

As with all headaches, the goals of treatment are to have fewer and milder headaches and also to become more active and functional.  With medication overuse headache, your doctor will often follow the steps listed below.  It will probably take a few weeks before you begin to see an improvement. You need to go through all of these steps in order to succeed.  

1. Stop the problem medicine.  You must completely stop the medicine(s) causing the medication overuse headache.  Your doctor will teach you the proper way to do this.  This is called “analgesic washout.”  If you do not do this, the treatment will not work. 
2. Be prepared and be patient.  As you stop the medicine, your headaches may not stop, or may even get worse for a few weeks.  Your doctor will prescribe other medicines and other techniques to help you through this time.  Be patient and stick with the plan.  All of the problem medicine must be out of your body before the new treatments will work well.  It might be tempting, but you must not use problem medicines during the washout period.
3. Change your lifestyle.  Medicines are only part of a good headache control plan.  Learn to avoid the things that trigger your headaches.  Regular mealtimes, proper nutrition, better sleep habits, stress management, and regular exercise can all help you to have fewer and milder headaches.  Learning to manage pain, learning to relax, biofeedback, and meditation may also be helpful.  Your doctor can help you to set up many of these lifestyle changes. 

Once the medication overuse headaches are gone, don’t go right back to your old habits.  Your doctor will help you to begin a healthier headache care plan that will work better for you. 

 

Other headache resources

 

American Council for Headache Education
(609) 845-0322 or 1-800-255-2243
http://www.achenet.org/

 

National Headache Foundation
(312) 388-6399 or 1-800-843-2256
FAX (312) 525-7357
http://www.headache.org/

The Spanish version of this Health Facts for You is #6765.

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 12/06/2012

Copyright © 12/06/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5896

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