Rebound headaches are caused by the very things that relieve
headaches -- pain medication. So basically it becomes a choice
of suffer now, or suffer later.
Rebound headaches are usually daily occurrences, beginning early
in the morning. Rebound headaches can lead to other problems
including anxiety, depression, irritability and sleeplessness.
Medications
Migraine medications work to raise serotonin levels to ease
pain. However, when too much medication is ingested something
happens to the serotonin levels, which causes the chemical to
lose its effectiveness. Research has shown that serotonin levels
are lower when you take too much pain medication and then they
rise slightly after the headaches gets better and you stop
taking the medication.
If prescription or over-the-counter drugs are taken too often or
in greater amounts than recommended, this can lead to rebound
headaches. In addition to sedatives and tranquilizers, other
rebound-causing medications include:
1. Caffeine-containing analgesics (Anacin, Excedrin, etc.).
Caffeine, a primary ingredient in many headache medicines, can
relieve migraine pain temporarily. However, taking medicine
containing caffeine every day -- as well as drinking
caffeine-loaded beverages such as coffee or soft drinks -- can
lead to more frequent and severe headaches. If the headache gets
worse when you stop using caffeine, the caffeine may be the
cause of some of your headaches.
2. Butalbital compounds (Fioricet, Fiorinal, Phrenilin, etc.);
Isometheptene compounds (Duradrin, Midrin, etc.); Decongestants
(Afrin, Dristan, Sudafed, Tylenol Sinus, etc.); Ergotamines
(D.II.E. 45, Ergomar, Migranal, Wigraine); Triptans (Amerge,
Axert, Imitrex, Maxalt, Zomig); Opioids and related drugs
(Darvocet, OxyContin, Percocet, Tylenol with codeine, etc.).
Medications that include any form of codeine, such as Percocet,
Tylenol 3, or Vicodin, must be used with care because they can
cause dependency quickly.
Symptoms
* Your headache occurs daily or almost daily (3 or 4 times a
week). * Your headache deviates in form, location on the head,
severity and strength. * You have a lower than normal threshold
for pain. * You begin to notice evidence of an increasing
tolerance to the effectiveness of analgesics over a period of
time. * You notice a spontaneous improvement of headache pain
when you discontinue the medications. * You are considered a
sufferer of a primary headache disorder and you use prevention
medication frequently and in large quantities. * Even the
slightest physical movement or bare minimum of intellectual
expenditure causes the onset of the headache. * Your headache is
accompanied by any of these symptoms: anxiety, depression,
difficulty in concentration, irritability, memory problems,
nausea, and restlessness. * You suffer withdrawal symptoms when
you abruptly are taken off the medication.
Recovery
If you have rebound headaches due to the overuse of medications,
the only way to recover is to cease taking the drugs. If it is
caffeine that is causing your rebound headaches, reducing your
intake may be of help. Before deciding on whether you want to
stop abruptly or gradually, the following need to be considered:
1. Make sure you consult with a physician before withdrawing
from headache drugs. Certain non-headache medications, such as
anti-anxiety drugs or beta-blockers, require gradual withdrawal.
2. The patient (you) may need to be hospitalized if the symptoms
do not respond to treatment, or if they cause severe nausea and
vomiting.
3. During the first few days, alternative medications may be
administered. Examples of drugs that may be used include
corticosteroids, dihydroergotamine (with or without
metoclopramide), NSAIDs (in mild cases) or valproate.
4. Whatever method you choose when stopping your medication, you
will go through a period of worsening headache afterward. Most
people will feel better within 2 weeks, however, headache
symptoms can persist for as long as 4 months and in some rare
cases even longer. Good News
Many patients experience long-term relief from all headaches
afterward. The conclusion of one study showed that over 80% of
patients significantly improved 4 months after withdrawal.
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