Medication Overuse Headaches

MEDICATION OVERUSE HEADACHES

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Overview

This headache can happen when you frequently take pain relievers for your headaches. With regular use of painkillers, you can increase the number of headaches days and also reduce the efficacy of treatment prescribed. It is believed that regular overuse of painkillers results in an increase in the brain’s sensitivity to pain and tendency to develop headaches. Therefore when trying to relieve pain, patients actually end up making them worse. We consider ‘overuse’ as regularly taking painkillers on more than 10 days. A month. These include, triptans, and other over the counter painkillers.

Symptoms & Diagnosis

There is normally a pattern of increasing frequency of headaches with increased use of painkillers. It seems the frequency of use rather than total dosage of acute-relief medication is most strongly associated with the development of daily headache. A clear headache diary in particular noting the average headache score as well as when painkillers are used can be beneficial in the diagnosis and management.

Treatments & Key Areas We Specialise In

  • Treatment

    Studies have shown that in the majority of individuals taking frequent acute-relief medication stopping the medication results in significant improvement of the headaches. In some people the headaches resolve altogether. However stopping the medication completely can cause a severe withdrawal headache for around 2-10 days. Once the painkillers have been stopped it can be easier to assess the original underlying headache characteristics and frequency. This will allow us to suggest more effective treatment options. Other ways to helping people to stop regular painkillers is by starting a preventive alongside weaning off the painkillers for example Topiramate; greater occipital nerve blocks can also be used.  Another option is adding in Naproxen for 1-2 weeks whilst weaning off the other painkillers. A short course of oral steroids could also be tried under supervision.  Once medication overuse has been addressed, painkiller should be limited to 10 days a month. If headache are frequent then preventatives should be considered. 

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