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    When Medicine Makes Headaches Worse

    Difficult Diagnosis continued...

    However, the symptoms can be somewhat different. The nausea and sensitivity to light that are typical with migraine headaches are usually absent in rebound headaches, and the pain can be anywhere on the head.

    "The typical patient with rebound headaches will come in and complain that he has headaches every day," says R. Michael Gallagher, DO, founding director of the University Headache Center in Moorestown, N.J. "The pain will escalate to a point where it's interfering with his life and he's suffering from depression and anxiety, and simply not feeling like himself anymore."

    The Culprits

    Experts say any painkiller in your medicine cabinet is capable of causing rebound headaches if you take it often enough and in a large enough quantity. Over-the-counter medications that contain aspirin, acetaminophen (such as Tylenol), and ibuprofen (such as Advil) can all cause rebound headaches. However, overuse of medications that combine these painkillers with caffeine, such as Excedrin or Anacin, are even more likely to cause a problem.

    "Over-the-counter medications with caffeine are among the biggest culprits," Gallagher tells WebMD.

    The overuse of prescription drugs can also cause rebound headaches, especially drugs such as Fioricet and Fiorinal -- barbiturate sedatives mixed with caffeine. Smith says that the overuse of a number of narcotic painkillers, such as Darvocet, Tylenol with codeine, Vicodin, and Lortab is also likely to result in rebound headaches.

    For many sufferers, it's a combination of prescription and over-the-counter medications that leads to the problem.

    "A lot of people are taking both kinds," says Gallagher. "They do it because they're desperate. They're in pain and even if they're already on a prescription, they're easily influenced by commercials on television for medications designed to treat headaches."

    Deceptive Warnings

    Smith says people often believe that if they can buy something without a prescription, it can't really be that dangerous.

    "I think that patients sometimes look at the disclaimers on painkiller bottles and assume that the warnings are just perfunctory things stuck in there by lawyers," says Smith. "However, if people followed those warnings, they would be at a lower risk of developing medicine overuse headaches."

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