How to Treat and Prevent Rebound (Medication Overuse) Headaches

Rebound headaches, also called medication overuse headaches, are caused by repeated frequent use of over-the-counter and prescription headache remedies, and can be difficult to treat. With this type of headache, the medication goes from relieving the headache to actually causing the headache. Follow these steps to begin treating and preventing this vicious cycle of head pain.

Instructions

Difficulty: Moderately Challenging

Things You’ll Need:

• A health care provider who specializes in headache/migraine
• Strategies for coping with head pain
• Your support system
• Patience and courage

1. Eliminate all headache rememdies from your life. The first step in stopping the cycle of rebound headaches is to quit using all headache medication. This includes abortive and long-term medications, and over-the-counter as well as prescription drugs. You and your health care provider (who needs to be a headache/migraine specialist), may decide that you quit cold-turkey or that you taper off the medication(s).
   
   Although this is a very difficult thing to do, and you will likely experience withdrawal symptoms, it is imperative that you do so in order to get to the underlying cause of your headaches/migraines.
2. Expect withdrawal symptoms, and work with your health care provider to manage them. These symptoms may include headaches that are as bad as or worse than what you are already experiencing (though they will improve within a few days to a few weeks, depending on the individual), insomnia, anxiety, constipation or diarrhea, nausea, and vomiting. You and your health care provider may implement such coping strategies as stress management, lifestyle changes, and/or a long-lasting pain management medication that is different from the medication(s) you've been overusing to help you better tolerate the pain during the withdrawal/tapering phase.
3. Consider hospitalization or other monitored care if you find that you can't stop using pain medication for your headaches. If you can't or think you won't be able to stop on your own, find help so you can take control of managing your pain.
4. Topical products help relieve head pain. Use topical treatments such as HeadOn, MygraStick, peppermint oil, and lavender oil, rather than ingested medications, to ease the pain.
5. Once the rebound headache cycle is broken, you and your health care will decide whether to use a daily headache prevention medication. These medications are thought to treat chronic headaches/migraines while avoiding rebound headaches since the drug is consistently in your system, leaving no opportunity for withdrawal. Drugs from a variety of classes are used to treat and prevent daily headache/migraine, including anti-depressants, anti-convulsants, anti-histamines, and anti-hypertension drugs.
6. When you are finally free of rebound headaches, you may find that you don't wish to use medication, even a daily preventive medication, to cope with your headaches/migraines. If this is the case, implement natural treatments such as a regular schedule of sleep, meals, exercise, and stress management techniques.
7. Exercise caution when using abortive medications. If you decide to use prescription abortive medications after you rid yourself of rebound headaches, use them very carefully so as to avoid getting into the rebound cycle again. Be sure to discuss in detail with your health care provider how to use this type of treatment without risking rebound headaches.
8. Exercise caution when using over-the-counter remedies. Be very careful if you decide to use over-the-counter headache remedies after going through this process. Limit your usage to just a few doses per month, and discuss future use of over-the-counter headache remedies with your health care provider.
9. Use your support system to help you through the process. Gather your strength and courage! This is NOT an easy process, and you will probably be frustrated at times. Work with a good health care provider who has experience with headache/migraine, and call on your family, friends, and pets to soothe and distract you when you are in pain. You're taking an important step to ease your chronic pain, and you deserve help and praise for your actions.

Tips & Warnings

• If you are pregnant or nursing discuss all medication use with your health care provider. Some medications will harm the fetus and some are excreted in breast milk. Work together to devise coping strategies and treatments for headaches/migraines, and for the discontinuation or introduction of any headache treatments.