What Are Medication Overuse Headaches?

Medication overuse headaches are caused by frequent or excessive use of medication to treat migraines or other headaches. They are also known as rebound headaches or analgesic withdrawal headaches and are one of the most common chronic headache disorders.

Symptoms

Medication overuse headaches often occur every day or nearly every day and often wake an individual in the early morning. The pain tends to improve when taking pain-relieving medication but returns as the effect of the medication wears off. Medication overuse headaches are diagnosed when headaches occur more than 15 days per month for at least three months while taking pain relieving medications.

In addition to head pain, symptoms of medication overuse headaches include the following:

• Nausea or vomiting
• Sensitivity to light or sound
• Difficulty concentrating
• Memory problems
• Irritability
• Insomnia
• Restlessness
• Constipation

Causes

Treating chronic migraines, chronic tension headaches, or other types of chronic headaches, often requires taking pain-relieving medications most days of the week. Medication overuse headaches occur when medication used to treat the initial headache wears off. This can occur with almost any type of headache medication, including the following:

• Over-the-counter pain relievers, such as aspirin and acetaminophen
• Combination pain relievers that combine caffeine, aspirin, and acetaminophen, or pain relievers that include the sedative butalbital
• Migraine medications, such as triptans and ergots
• Opioid-based pain medications

Doctors are not sure why overuse of these medications leads to headaches. When pain-relieving medications are taken for other health conditions, such as back or neck pain or arthritis, rebound headaches are not an issue. Rebound headaches only occur in combination with a pre-existing chronic headache condition.

Risk factors

Medication overuse headaches can occur at any age. The primary risk factors include the following:

• A history of chronic headaches
• Regular use of combination analgesics, triptans or ergots for 10 or more days per month (for 3 months or more) or use of simple analgesics for more than 15 days per month (for 3 months or more)