Yoga for weight loss: Benefits beyond burning calories
Embryo donation: One possible path after IVF
How to stay strong and coordinated as you age
Acupuncture relieves prostatitis symptoms in study
Skin in the game: Two common skin problems and solutions for men
Anti-inflammatory food superstars for every season
Harvard Health Ad Watch: An upbeat ad for a psoriasis treatment
A new targeted treatment for early-stage breast cancer?
What is neurodiversity?
Thinking about holiday gatherings? Harvard Health experts weigh in
Harvard Health Blog
Rebound headaches, also known as medication overuse headaches, are caused by the frequent or excessive use of pain-relieving and/or antimigraine drugs to treat headache attacks that are already in progress. (Note that these are not the same as oral prophylactic or preventive medicines, which should be taken daily.) In other words, the same medications that initially relieve headache pain can themselves trigger subsequent headaches if they are used too often. Medication overuse headaches can be disabling, forcing people with this condition to take sick leave and to be less productive at work and home.
To be diagnosed with medication overuse headaches, a person must experience headaches on more than 15 days per month for at least three months while taking pain relieving and/or antimigraine drugs. In addition to headache, other symptoms can include nausea, vomiting, light sensitivity, sound sensitivity, irritability, difficulty concentrating, insomnia, restlessness, and constipation.
Medication overuse headache is a common headache disorder. Approximately one to two out of every 100 people has experienced medication overuse headache in the past year. This headache is more common in women, and in people with chronic pain conditions and who have depression and anxiety.
Pain relieving or antimigraine medications may stop headache attack when taken as needed to relieve headache. But if a person with a primary headache disorder, such as migraine or tension-type headache, takes these headache-relieving medications more than two to three days a week, they may trigger medication overuse headache.
A variety of medications can lead to rebound headaches. For example, people with migraine who take over-the-counter pain-relieving medications such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve) on more than 15 days per month are at risk for medication overuse headache. So are people who take combination medications such as Excedrin, which contains caffeine, aspirin, and acetaminophen; people who take combination medications that contain the barbiturate butalbital; and those who take triptans, including sumatriptan (Imitrex), ergots, or opioids, if they take these medications on more than 10 days per month. In fact, butalbital-containing medications and opioids have been shown to increase the risk of a person’s migraine progressing from episodic (occurring zero to 14 days per month) to chronic (occurring 15 or more days per month).
Interestingly, the same pain-relieving medications taken for other conditions such as back pain, neck pain, or arthritis usually do not trigger medication overuse headache in people without a pre-existing primary headache disorder.
Medication overuse headaches usually stop when a person stops taking the headache medication. It may be difficult in the beginning, because once you stop your medication, your headache is likely to get worse before it gets better. But medications that prevent headaches, and nonmedical therapies such as biofeedback and avoiding headache triggers, can help get a person through this medication withdrawal period.
Some headache medications can be discontinued abruptly, while others may need to be tapered slowly. For example, following long-term use, opioids and butalbital-containing medications should not be stopped abruptly. Doing so may lead to withdrawal symptoms such as sweating, shaking, nausea, vomiting, diarrhea, body aches, anxiety, irritability, or runny nose. Abrupt discontinuation of butalbital may result in seizures. Some people may benefit from discontinuing these medications in an inpatient setting. If you are taking opioids or butalbital-containing medications, talk to your doctor.
The following steps can help stave off rebound headaches.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
I take sumatriptan for migraine. When I get in a rebound cycle, my neurologist prescribes for me a course of steroids and it does the trick to stop the cycle.
Most of us can’t simply “stop taking the headache medication” that gives us migraine relief. We have to be able to take care of our children, do our jobs, live our lives.
Commenting has been closed for this post.
Diseases & Conditions
Women’s Health
Diseases & Conditions
Get the latest in health news delivered to your inbox!
© 2021 by The President and Fellows of Harvard College
Do not sell my personal information | Privacy Policy
Thanks for visiting. Don’t miss your FREE gift.
The Best Diets for Cognitive Fitness, is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School
Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, and more.
Health Alerts from Harvard Medical School
Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss…from exercises to build a stronger core to advice on treating cataracts. PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts.
BONUS! Sign up now and
get a FREE copy of the
Best Diets for Cognitive Fitness
Stay on top of latest health news from Harvard Medical School.
Plus, get a FREE copy of the Best Diets for Cognitive Fitness.
