What is a rebound headache? What causes it, and how can I treat it?

A pattern of taking acute headache medications too often (more than two days per week)
or in excessive amounts (more than the label or a doctor advises) can lead to a condition
known as "rebound headache." With rebound headache, your medications not only stop
relieving pain, they actually begin to cause headaches. Doctors treat rebound headache
by tapering the medication that is being overused, sometimes by gradually substituting
a different type of treatment or medication. Stopping may be a challenge, but regularly
overusing a medication increases the potential for serious side effects. Consult
a physician if you regularly use headache medications more than two days per week or
more than the label advises.

Analgesic agents are prescription or over-the-counter medications used to control
pain including migraine and other types of headaches. When used on a daily or near
daily basis, these analgesics can perpetuate the headache process. They may decrease
the intensity of the pain for a few hours; however, they appear to feed into the pain
system in such a way that chronic headaches may result.

The rebound headache may feel like a dull, tension-type headache or may be a
more severe migraine-like headache. Other medication taken to prevent or treat
the headaches may not be effective while analgesics are being overused. Rebound
headaches can occur with most analgesics but are more likely with products containing
caffeine or butalbital.

Unless the overused analgesics are completely discontinued, the chronic headache
is likely to continue unabated. Usually when analgesics are discontinued the headache
may get worse for several days and the sufferer may experience nausea or vomiting.
However, after a period of three to five days, sometimes longer, these symptoms
begin to improve. Preventive medication will be needed to reduce the need for
analgesics. For those patients willing to persevere, the headaches will gradually
improve as response to more appropriate medication occurs. Most patients are
able to stop the use of analgesics at home under physician supervision, but some
find it difficult and may require hospitalization.

If you have overused analgesics, you are at high risk of relapsing and using too
many analgesics again in the future. Therefore, all analgesics should be limited
to no more than an average of 10 days use per month to reduce the risk of
rebound headache.