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Rebound Headaches: When Getting Better Makes You Worse
Rebound headaches are caused by the very things that relieve headaches – pain relievers. So basically the choice will be whether you suffer now or suffer later.
Rebound headaches are usually daily, starting early in the morning. Rebound headaches can lead to other problems, including anxiety, depression, irritability, and insomnia.
Medicines
Migraine medications increase serotonin levels to relieve pain. However, if too much of the drug is taken, something happens to serotonin levels that cause the chemical to lose its effectiveness. Research has shown that serotonin levels are lower when you take too many pain relievers, and then rise slightly after the headache subsides and you stop taking the medication.
Taking prescription or over-the-counter medications too often or in larger amounts than recommended can lead to recurring headaches. In addition to sedatives and tranquilizers, other drugs that cause rebound include:
1. Caffeine-containing pain relievers (Anacin, Excedrin, etc.). Caffeine, a primary ingredient in many headache medications, can temporarily relieve migraine pain. However, taking caffeine-containing medications on a daily basis—as well as drinking caffeinated beverages such as coffee or soft drinks—can lead to more frequent and severe headaches. If your headaches get worse when you stop using caffeine, caffeine may be causing some of your headaches.
2. Butalbital compounds (Fioricet, Fiorinal, Phrenilin, etc.); isometheptene compounds (Duradrin, Midrin, etc.); Decongestants (Afrin, Dristan, Sudafed, Tylenol Sinus, etc.); Ergotamines (D.II.E. 45, Ergomar, Migranal, Wigraine); Triptans (Amerge, Axert, Imitrex, Maxalt, Zomig); Opioids and related medications (Darvocet, OxyContin, Percocet, Tylenol with codeine, etc.). Medications that contain any form of codeine, such as Percocet, Tylenol 3, or Vicodin, should be used with caution because they can quickly become addictive.
Symptoms
* Headache occurs daily or almost daily (3-4 times a week).
* The shape, location, severity and strength of the headache are different.
* The pain threshold is lower than normal.
* You begin to notice evidence of increasing tolerance to the effectiveness of pain relievers after a while.
* If you stop taking the drugs, you will notice a spontaneous improvement in the headache.
* You suffer from primary headaches and use preventive medicine frequently and in large quantities.
* Even the slightest physical movement or minimal intellectual effort causes a headache.
* Your headache is accompanied by any of the following symptoms: anxiety, depression, difficulty concentrating, irritability, memory problems, nausea and restlessness.
* Suffers withdrawal symptoms when the drug is stopped suddenly.
Recovery
If you have recurring headaches due to overuse of medication, the only way to get better is to stop taking the medication. If caffeine is causing your recurring headaches, reducing your intake may help. Before you decide whether you want to stop suddenly or gradually, you should consider the following:
1. Be sure to consult your doctor before you stop taking headache medications. Certain non-headache medications, such as anxiolytics or beta-blockers, require gradual withdrawal.
2. The patient (you) may need to be hospitalized if symptoms do not respond to treatment or cause severe nausea and vomiting.
3. In the first few days, alternative medicines can be administered. Medications that may be used include corticosteroids, dihydroergotamine (with or without metoclopramide), NSAIDs (in mild cases), or valproate.
4. Whichever method you choose when stopping medication, you will have a period of worsening headaches afterwards. Most people feel better within 2 weeks, but headache symptoms can last up to 4 months, and in some rare cases, even longer.
Good news
Many patients experience long-term relief after each headache. One study concluded that more than 80% of patients were significantly improved 4 months after withdrawal.
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