Types Of Headaches Rebound

A rebound headache is a cruel twist of fate for many headache sufferers. The very headache treatment they look to for relief can actually cause headaches if taken for too long. Rebound headache treatment often forces people to give up tried-and-true headache medication.

What’s a Rebound Headache?

A rebound headache, put very simply, is a withdrawal response to medication your body has grown accustomed to, often headache treatment medication. People using painkillers as a preventive, taking headache medication regularly or in large doses have a high risk of developing rebound headaches.

Rebound headaches can create a vicious cycle. Overuse of medication causes the body to become resistant to the medication’s effects. When painkillers no longer work as well, people often believe their headaches require stronger treatment, so take larger doses of that headache medication. This continues to desensitize the body to the medication.

When the overused medication wears off, a rebound headache develops because the body goes into drug withdrawal. Believing they are dealing with their “normal” headache, people take more medication, which only works until the medication wears off again, triggering yet another rebound headache.

Persistent rebound headaches caused by overuse of headache treatments are very common. According to one study, 73 percent of headache clinic patients complaining of chronic headaches are eventually diagnosed with rebound headaches.

Rebound Headache Symptoms Rebound headache pain may resemble either tension or migraine headaches, making it difficult to differentiate between the original headaches that required treatment or the rebound headache caused by the treatment. Symptoms that suggest a rebound headache include:

  • a progressive increase in headache frequency
  • frequent or daily use of headache medication
  • headaches occur at predictable times, often within hours of headache treatment
  • preventive treatment no longer stops headache onset.

If a person experiences headaches fifteen or more days of the month, despite headache treatment, he or she may be experiencing rebound headaches. The chance of rebound headaches is higher if painkillers are used, and if they are used more than twice a week.

Treatment That May Cause Rebound Headaches

Unfortunately, many medications used for headache treatment have the potential to cause rebound headaches. Some medications can result in rebound headache after only two or three days of use.

Treatments that may cause rebound headaches include:

  • acetaminophen
  • aspirin
  • caffeine (both in medication and caffeinated drinks)
  • ergotamines
  • ibuprofen
  • mixed analgesics (combinations of aspirin, acetaminophen and caffeine are especially likely to cause rebound headaches)
  • opiates (codeine-based medication causes rapid dependency and rebound headaches)
  • triptans.

Rebound Headache Treatment

The only effective rebound headache treatment is to stop taking the medication causing the headaches. A number of considerations complicate rebound headache treatment. Stopping medication initially results in more frequent and more severe rebound headaches. Patients who have developed a dependency on the medication while using it for headache treatment may be unwilling to accept that they are “addicted.”

Rebound headache treatment attempts to “wean” the patient off the headache-causing medications. Low doses of the analgesic naproxen are sometimes administered to ease the pain of rebound headaches during the initial withdrawal period.

Successful rebound headache treatment may take up to two months. While it is possible for some rebound headache treatment to succeed with outpatient care, periods of hospitalization are often required for successful treatment. Intravenous medication may be required for pain and nausea in cases of severe medication withdrawal.

Preventing Rebound Headaches

The best rebound headache treatment is prevention. Painkillers should only be used for headaches when necessary and in the smallest effective dose.

If preventive headache treatment is required, antidepressants and anticonvulsants provide headache relief without the risk of rebound headaches, so should be tried before preventive painkillers. Neither antidepressants nor anticonvulsants are effective as rebound headache treatment.

Resources

Lichten, E. (2000). Analgesic rebound headache: Out patient management.

Mayo Foundation for Medical Education and Research. (2003). Rebound headache: The cost of overmedication.

National Headache Foundation. (nd). Other types: Rebound headache. The Complete Guide to Headaches.

National Pain Foundation. (updated 2004). My treatment: Headache types.

Robert, T. (2003). Arghhhhh! Rebound headaches!