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Rebound Headaches

About the Disease

Rebound headaches (medication- overuse headaches) are caused by regular, long-term use of medication to treat headaches, such as migraine. Pain relievers offer relief for occasional headaches. But if you take them more than a couple of days a week, they may trigger rebound headaches.It appears that any medication taken for pain relief can cause rebound headaches, but only if you already have a headache disorder. Pain relievers taken regularly for another condition, such as arthritis, have not been shown to cause rebound headaches in people who never had a headache disorder.Rebound headaches usually stop when you stop taking the pain medication. It's tough in the short term, but your doctor can help you beat rebound headaches for long-term relief.

Signs and symptoms of rebound headaches may differ according to the type of original headache being treated and the medication used. Rebound headaches tend to:

  • Occur every day or nearly every day, often waking you in the early morning.
  • Improve with pain relief medication but then return as your medication wears off.

Other signs and symptoms may include:

Nausea, Listlessness, Restlessness, difficulty concentrating, memory problems, Irritability etc.

Seek immediate medical care if your headache:

  • Is sudden and severe.
  • Accompanies a fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking.
  • Follows a head injury. 
  • Gets worse despite rest and pain medication.
  • Is a new type for someone older than 50.
  • Wakes you from sleep.

Rebound headaches can develop if you frequently use headache medication. Although the risk of developing medication-overuse headache varies depending on the medication, any acute headache medication has the potential to lead to rebound headaches, including:

  • Simple pain relievers. Common pain relievers such as aspirin and acetaminophen (Tylenol, others) may contribute to rebound headaches — especially if you exceed the recommended daily dosages. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) have a low risk of contributing to medication-overuse headaches.
  • Combination pain relievers. Over-the-counter (OTC) pain relievers that combine caffeine, aspirin and acetaminophen (Excedrin, others) are common culprits. This group also includes prescription medications such as Fiorinal, which contains the sedative butalbital. Butalbital-containing compounds have an especially high risk of causing rebound headaches, so it's best not to take them to treat headaches. If you do take this type of drug, limit its use to no more than four days a month.
  • Migraine medications. Various migraine medications have been linked with rebound headaches, including triptans (Imitrex, Zomig, others) and certain ergots — such as ergotamine (Ergomar, others). These medications have a moderate risk of causing medication-overuse headaches. The ergot dihydroergotamine (D.H.E. 45) appears to have a lower potential for leading to this problem.
  • Opiates. Painkillers derived from opium or from synthetic opium compounds include combinations of codeine and acetaminophen (Tylenol with Codeine No. 3 and No. 4, others). These medications have a high risk of causing rebound headaches.
  • Daily doses of caffeine— from your morning coffee, your afternoon soda, and pain relievers and other products containing this mild stimulant — may fuel rebound headaches, as well. Read product labels to make sure you're not wiring your system with more caffeine than you realize.

Risk factors for developing rebound headaches include:

  • History of chronic headaches. A history of migraines, tension-type headaches or other chronic headaches puts you at risk.
  • Frequent use of headache medications. Your risk increases if you use combination analgesics, ergotamine or triptans 10 or more days a month or simple analgesics more than 15 days a month — especially if this regular use continues for three or more months.

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    Dr. Sitesh Dasgupta

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    Dr. Pawan Kumar

    Dr. Pawan Kumar

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    Dr. Amitabh Varma

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    Dr. S Venkatraman

    Dr. S Venkatraman

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    Dr. Manvir Bhatia

    Dr. Manvir Bhatia

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    Saket City Hospital, New Delhi

    Dr. Amit Aslam Khan

    Dr. Amit Aslam Khan

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    Batra Hospital & Medical Research Centre, Tughlakabad Institutional Area

    Dr. Anand Kumar Saxena

    Dr. Anand Kumar Saxena

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    Saket City Hospital, New Delhi

    Dr. Chandran Gnanamuthu

    Dr. Chandran Gnanamuthu

    Senior Consultant - Neurology

    Sakra World Hospital, Varthur Hobli, Bangalore

    Dr. Shiva Kumar R

    Dr. Shiva Kumar R

    Consultant - Neurology & Epileptology

    Sakra World Hospital, Varthur Hobli, Bangalore

    Dr. Tarun Mathur

    Dr. Tarun Mathur

    Consultant - Neurology

    Seven Hills Hospital, Andheri East, Mumbai

    Dr. Tushar Raut

    Dr. Tushar Raut

    Consultant - Neurology

    Seven Hills Hospital, Andheri East, Mumbai

    Dr. Shirish Hastak

    Dr. Shirish Hastak

    Group Director - Neurology & Stroke

    Wockhardt Hospital, South Mumbai

    Dr. Jay Dip Ray Chaudhuri

    Dr. Jay Dip Ray Chaudhuri

    Consultant - Neurology

    Yashoda Hospitals, Somajiguda, Hyderabad

    Dr. Raja Sekhar Reddy G

    Dr. Raja Sekhar Reddy G

    Consultant - Neurology

    Yashoda Hospitals, Somajiguda, Hyderabad

    Dr. Rakesh Jadav

    Dr. Rakesh Jadav

    Consultant, Neurology

    Apollo Hospitals, Bannerghatta Road

    Dr. Sreekanta Swamy

    Dr. Sreekanta Swamy

    Senior Consultant , Neurology

    Apollo Hospitals, Bannerghatta Road

    Dr. Prashanth L K

    Dr. Prashanth L K

    Consultant, Neurology

    Apollo Hospitals, Bannerghatta Road

    Dr. Rakesh Jadav

    Dr. Rakesh Jadav

    Consultant, Neurology

    Apollo Hospitals, Bannerghatta Road

    Dr. Vikram Kamath

    Dr. Vikram Kamath

    Senior Consultant, Neurology

    Apollo Hospitals, Bannerghatta Road

    Dr. Dhanaraj M

    Dr. Dhanaraj M

    Consultant, Neurology

    Apollo Hospitals, Greams Lane, Chennai

    Dr. Yogaraj S

    Dr. Yogaraj S

    Consultant, Neurology

    Apollo Hospitals, Greams Lane, Chennai

    Dr. Rajendran S

    Dr. Rajendran S

    Consultant, Neurology

    Apollo Hospitals, Greams Lane, Chennai

    Dr. Panneer A

    Dr. Panneer A

    Consultant, Neurology

    Apollo Hospitals, Greams Lane, Chennai

    Dr. Sivarajan Thandeswaran

    Dr. Sivarajan Thandeswaran

    Consultant, Neurology

    Apollo Hospitals, Greams Lane, Chennai

    Dr. Manmohan Gavvala

    Dr. Manmohan Gavvala

    Consultant, Neurology

    Apollo Emergency Centre, Hyderguda

    Dr. P N Shobhvathy

    Dr. P N Shobhvathy

    Consultant, Neurology

    Apollo Emergency Centre, Hyderguda

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