Medication Overuse Headache

This is commonly confused with a Tension Headache.ย  A person complains of a headache, gets a prescription, and keeps on using it, frequently.ย  When they stop (or run out), a rebound headache occurs.ย  So they get more medication.ย  Vicious cycle.ย  Medication Overuse Headache is a major cause of disability throughout the world.

The main medications responsible seem to be:

  • Narcotics (opioids) like codeine, hydrocodone (Norcoยฎ) oxycodone (Percocetยฎ, Oxycontinยฎ), and others;
  • Combination products with the barbiturate butalbital (e.g. Fiorinalยฎ);
  • Acetaminophen (Tylenolยฎ)
  • Combinations with aspirin + acetaminophen + caffeine have also been implicated, triptans used for migraine too, and even NSAIDs (ibuprofen, naproxen, etc.).

We consider this diagnosis if a single headache medication is taken over 10 days per month, or if various meds are mixed for over 15 days.ย  The headache usually begins in the morning, upon awakening.ย  To diagnose it, we discontinue all possible offending medications, and begin a migraine-prevention medicine (see Migraines).

It’s hard to convince people that their beloved pain medicine is working against them.

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