3/27/07 Podcast: Rebound - When Our Medications Cause Headaches

  • The transcript of this podcast is below. Ifyou prefer to listen to it, you can do so easily from the MigraineCast Web site.

    Welcome to MigraineCast, the weekly podcast brought to you by MyMigraineConnection.com and the HealthCentral Network. They're a conundrum, a vicious cycle, a Catch-22. I'm talking about medication overuse headaches, also known as rebound.

    In a recent poll on MyMigraineConnection.com, only 3% of respondents said that they're doctors told them about rebound before they experienced it. 26% said their doctors explained it after they experienced it. The remainder? Their doctors never explained it at all. Sad statistics.
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    So, what is medication overuse headache or rebound? Notice that I said overuse, not misuse or abuse. In a nutshell, medication overuse headaches are headaches caused by taking pain medications or Migraine abortive medications too often, which is more than two or three days a week. Medication overuse headaches make things even more complicated for chronic headache and Migraine sufferers. It's like the old phrase, "adding insult to injury." The very medications we take for relief come back and bite us in the behind. A simple way to describe it is that it's as if, after a few days of taking a medication, our bodies begin to like it. Then, when we don't take the medication, the body asks itself what it did to get the medication before. It had a headache? OK, it will just produce another headache to get us to give it the medication again.

    Unfortunately, most of the medications we take to relieve a Migraine attack or headache, both over-the-counter and prescription medications, have been found to cause medication overuse headache. Acetaminophen, ibuprofen, aspirin, combination products such as Excedrin. We tend to think anything over-the-counter is safe, but when you're prone to headaches and Migraines, these products can be major culprits in actually making things worse if taken too frequently. Vicodin, Percocet, Fioricet. These compound prescription analgesics contain multiple ingredients that can cause rebound. The triptan medications such as Imitrex have also been know to cause medication overuse headache. The exception may be the longer half-life triptans, Amerge and Frova, which have been studied, taken daily for a week around the menstrual cycle, to prevent menstrually associated Migraines.

    The logical question is, "What do we do when we have headaches or Migraines more than two or three days a week?" This is when we must work with our doctors to find an effective preventive regimen. Finding that effective regimen, however, isn't always a quick process. It can involve trial and error, leaving us with frequent headaches and Migraine attacks during the process. A method many Migraine and headache specialists employ for Migraineurs is to prescribe a triptan that can be taken two or three days a week and a pain medication that can be taken two or three other days a week. That give us four to six days a week that we can treat Migraines. It's more difficult with chronic headache for which triptans don't work because that reduces treatable days to just two or three a week.

  • Some people debate just continuing to take the medication that has caused their rebound every day. After all, once they take it, the headache stops. There are problems with this theory. Many preventive medications don't stand a chance of helping if we're in rebound. Our bodies build tolerances to the medications, and it eventually takes more of them to get the same results. Additionally, if we have surgery or another issue requiring pain medications, it's more difficult to find one to address the additional pain. We also have to consider the long-term effects the medications have on our bodies. For example, recent studies have been questioning the safety of long-term use of acetaminophen because of liver damage. The bottom line though is that if we decide to just keep taking the problem medication every day, we ourselves are sentencing ourselves to a headache every day of our lives.
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    The only way out of a medication overuse cycle is to stop taking the medications causing the problem. It's not easy. It can take 10 days or even longer of taking none of the medications to break the cycle. Sometimes, doctors will prescribe anti-anxiety or anti-nausea medications to help us get through it. Sometimes, we have to fall back on cold packs, meditation, and sheer will power.

    If you think you're experiencing medication overuse headaches, talk to your doctor. If you've never experienced medication overuse headaches, beware of your medications so you continue to avoid the experience.

    After living with Migraine disease for over 40 years, I've come to realize that learning about Migraine disease can allow us to work with our doctors as treatment partners to gain control over this disease rather than the disease controlling us. Please join us at MyMigraineConnection for information and support or for a transcript of this podcast. From MyMigraineConnection.com and the HealthCentral Network, this is Teri Robert reminding you that you can live well with Migraine disease and headaches.
Published On: March 27, 2007