Medication overuse headache. When people take too many headache drugs, they have a headache for more than 15 days a month for more than three months, which is known as a medication overuse (rebound) headache. People who suffer from migraines or tension headaches are more likely to develop a medication overuse headache. The type of headache pain that a person experience differs from one person to the next.
The frequency with which people take headache medications and experience headaches are used by doctors to diagnose medication overuse headaches.
Doctors treat these headaches by discontinuing the headache medication, providing a different type of headache medication to manage the withdrawal symptoms, and frequently giving medications to address the initial headache issue.
Medication overuse headache affects about 1% to 2% of the population. It is more prevalent in women than in men.
The majority of patients who suffer from this sort of headache are taking migraine or tension-type headache medications. They are taking too much of the medication or taking it too frequently, usually because the medication isn’t properly reducing their pain.
Causes of Medication Overuse Headache
Overuse of the following medications is the most common cause of medication overuse headache:
- Pain relievers (analgesics) that contain barbiturate
- Aspirin or acetaminophen is taken with caffeine
- Triptans (drugs that prevent and treat migraines)
- This disease can also be caused by excessive use of other nonsteroidal anti-inflammatory medications (NSAIDs) and ergotamine.
Medication overuse headache is thought to be caused by an excessively sensitive neural system. That is, the pain-producing nerve cells in the brain are overly stimulated.
People with medication overuse headaches are more likely to develop substance abuse. They may also be predisposed to drug overuse headaches due to a hereditary tendency.
Symptoms of Medication Overuse Headache
Overuse headaches occur on a regular or near-daily basis and are frequently present when people first get up. The location and nature of pain differ from one person to the next. People may also experience nausea, irritability, and difficulties concentrating.
Diagnosis of Medication Overuse Headache
The frequency with which persons who are frequently using headache meds suffer headaches, as well as how often they use the headache drugs, are used by doctors to diagnose medication overuse headache.
Overuse of medications When all of the following symptoms are present, a headache is diagnosed:
People receiving acetaminophen, aspirin, or another nonsteroidal anti-inflammatory medicine (NSAID) for a headache condition experience headache 15 days or more per month, while those taking ergotamine, triptans, opioids, or combination headache treatments experience headache 10 days or more per month.
People have been taking excessive amounts of one or more medicines to treat headaches for more than three months.
There is no other headache illness that better explains the symptoms.
Prognosis of Medication Overuse Headache
After ten years of treatment, about half of the clients experience pain relief (remission). Migraine sufferers fare better than tension-type headache sufferers.
After a year of treatment, people who have fewer headache days each month are likely to stay in remission for longer.
Medication Overuse Headache Treatment
A different medication to prevent the original headache (usually a migraine).
- Withdrawal of the overused headache drug.
- Use of a different type of headache drug (rescue drug) to manage withdrawal.
- Symptoms that occur after stopping the drug
- Sometimes another drug (transitional or bridging drug)
- Biofeedback and cognitive techniques
Typically, doctors may prescribe a different headache medication to prevent the person from developing the initial headache disease. Later, the overused medicine is discontinued, typically abruptly. When patients take large dosages of opioids, barbiturates, or benzodiazepines, however, the amount of the overused substance is gradually reduced over 2 to 4 weeks. Nausea, restlessness, anxiety, and poor sleep might occur if these medicines are stopped abruptly. When you stop taking pain relievers, your headaches will become more frequent, last longer, and be more painful. Symptoms after discontinuing a medicine might last anywhere from a few days to four weeks.
Headaches that occur after discontinuing an overused medicine are treated with a rescue drug. If feasible, a new type of headache medication is used. If at all feasible, doctors try to keep the usage of rescue medicines to fewer than twice a week.
Other medications (known as transitional or bridging drugs) can be provided if rescue and preventive pharmacological therapies do not appear to be effective in alleviating symptoms.
- A corticosteroid
- Prochlorperazine and diphenhydramine
- Clonidine is a medication that is used to treat (to relieve symptoms due to withdrawal when the overused drug was an opioid)
- Phenobarbital is phenobarbital that is used to (used to prevent withdrawal seizures when the overused drug was a barbiturate)
People are told to minimize their use of all rescue and transitional headache medicines used to stop (abort) headaches once they have been treated for medication overuse disorder:
NSAIDs should be taken no more than 6 times per month.
Limit your use of triptans, ergotamine, or combinations of headache medications to no more than four days per month.
Prescription headache medications should be taken as directed.
Doctors recommend that patients keep a headache journal. People keep track of the number and timing of attacks, as well as suspected cases and treatment responses. Triggers can be identified and, if feasible, eliminated using this knowledge. Then, by avoiding triggers, patients can engage in their treatment, and clinicians can better plan and adjust treatment.
By altering the way people focus their attention, biofeedback and other cognitive treatments (such as relaxation training, hypnosis, and stress management) can help people regulate, decrease, or cope with headaches. People can control their pain through biofeedback.
People are advised to stay away from medications that have been misused in the past. They are also encouraged and trained to embrace good lifestyle choices.