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When Medicine Makes Headaches Worse

Curing Rebound Headaches

The only way to stop rebound headaches is simple, at least in theory: Stop taking the medication that's causing them. However, it isn't easy in practice.

"During withdrawal, you can get nausea and extreme fatigue," says Diamond, "as well as severe headaches."

These symptoms usually abate within days or weeks, but full recovery is a gradual process and can take months, Gallagher says.

Gallagher also observes that the effects of the overused drug are not only physiological. "There's a psychological dependence that can develop as well," he says. "A person gets used to taking the medication in response to any headache pain or even a sensation that they think might develop into headache pain. That makes going off the drug harder."

To help ease both the physical and psychological symptoms of withdrawal, other medications might be necessary.

"Most patients need a bridge, a regimen of transitional medications to help them through," says Smith. Depending on the type of medication a person was abusing, a doctor may prescribe an anti-inflammatory drug and a muscle relaxant to help with sleep. Sometimes an injection of steroids might be useful, Smith says, as well as beta-blockers and antidepressants.

"Instead of going cold turkey, some doctors prefer to taper off the abused medication gradually," says Smith. "That's often a reasonable idea, especially if patients are taking barbiturates, since they may have seizures during withdrawal."

While Smith says that most of the people he sees are able to kick the drug without being hospitalized, Diamond says that many of his patients need the extra help. Hospitals allow for transitional medications to be administered intravenously around the clock, and in some cases, it may be important for a person to be under observation for the first few days of withdrawal.

In addition to medications, behavioral techniques offer relief as well. "We use biofeedback to help people learn how to relax their body and muscles and control their blood vessels," says Diamond. "And we also use other relaxation techniques."

Kicking your reliance on a painkiller is not easy, and it may require work and cause significant discomfort. "It may take three months or more for a person to get completely free of the cycle," says Smith. But given the risks of chronically overusing painkillers, he considers those few months "time well spent."

Getting the Right Help

The price of headaches, both to the individual and society, are enormous. "The economic estimates for the cost of headaches range from 5 to 13 billion per year," says Gallagher. "That's in time off from work, the inability to work at full capacity, and the costs of medical care."

Rebound headaches only account for a portion of that total, but they carry the special risks that come with overusing medication in addition to the chronic pain. Even so, many people, including doctors, don't really understand how serious a condition rebound headaches can be, Smith says.

"We see patients at our clinic every day," Smith tells WebMD, "and I can tell you that there are still a lot of doctors out there who are not giving the right advice to their patients about how to use painkillers. We've got to prevent people from developing this problem in the first place."

Diamond gives a straightforward suggestion. "If you're taking any kind of painkiller on a near-daily basis," he says, "whether it's over-the-counter or prescription, get help now."


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