Many medications used to treat migraine may lead to daily headaches. In these instances, the person initially gets relief from the medication, but over time finds that more medication is required to keep severe headaches away while suffering a perpetual low grade headache. Without the medication, a severe rebound of the headache results.  Analgesic rebound headache is also known as medication overuse headache.

> Analgesic agents are prescription or over-the-counter medications used to control pain, including migraine and other types of headache 

> When used on a daily or near daily basis, these analgesics can perpetuate the headache process 

> This headache is typically located on both sides of the head and is described as a pressing or tightening type of pain

> The head pain often persists to varying degrees throughout the day, fluctuating in intensity from mild to moderately severe

> Analgesic Rebound/Medication Overuse headache is a result of taking analgesics on 15 or more days/month for more than 3 months; or opioids, triptans, or combination medication 10 or more days per month for more than 3 months

> Initially, the medication may bring relief, but as it wears off the headache returns. As the condition worsens, the medication becomes less effective. Eventually, the medications used to treat headache perpetuate the headache cycle, but going without medication results in a severe “rebound” headache.

> The only effective treatment is to withdraw from the medication responsible for the rebound phenomenon. In some cases, prescription medications need to be tapered; therefore, you should consult your physician before stopping any medication. 

> When analgesics are discontinued, the headache may get worse for several days. It may take up to 30 days to recover from the rebound process. However, once this cycle is broken, headache intensity and frequency usually improve. 

> When the cycle has been broken, other acute medications may become more effective in managing the headache pain, but the use of these medications must be limited to no more than two days in a row or three days a week to avoid returning to the rebound cycle.

Drugs Capable of Producing Analgesic Rebound/Medication Overuse Headache

> Over-the-counter analgesics, such as acetaminophen and acetaminophen-containing drugs

> Over-the-counter anti-inflammatory medications, such as high doses of aspirin, ibuprofen, ketoprofen, and naprosyn

> Combination drugs, such as Excedrine, which contains acetaminophen, caffeine, and aspirin

> Triptans

> Pseudophedrine-containing decongestants

> Prescription pain medication

> Caffeine