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Stopping Rebound Headaches with Fewer Withdrawal Headaches

© Barbara J. Mitchell

In previous articles I've discussed rebound headaches. Rebounds are chronic daily headaches caused by taking too much pain relief medicine for too long. It isn't a rare phenomenon, nor is the amount of medication required to cause it unusually large. In fact, an article published by the American Headache Society claims as few as 15 acetaminophen a week can cause rebound headaches. I doubt if very many of us can say we haven't taken at least 15 of some sort of pain reliever in a week's time.

Once people realize their chronic daily headaches are rebound headaches, fear of withdrawal symptoms can prevent them from solving the problem. But, as bad as migraines are, who wouldn't trade daily migraines for the old familiar episodic kind? Too, once the rebound headaches are gone, preventive migraine drugs have a better chance of working for you.

There have been two standard solutions. Either you could just stop all pain relievers and tough it out, or the doctor could hospitalize you for intravenous dihydroergotamine (DHE) and initiation of migraine preventive drugs. There is, however, a better option.

Dr. Stewart Tepper of the University of Washington School of Medicine conducted a study of 26 migraineurs with long-standing chronic daily headaches. The participants stopped all pain relievers and then were given oral sumatriptan three times a day until they had been free of headaches for 24 hours.

When they reached that point, the oral sumatriptan was given only as needed to abort headaches.

This wasn't a double blind study; all participants were given sumatriptan. However, 24 of them felt that sumatriptan definitely helped relieve withdrawal headaches. They were also started on migraine preventive medications during this time.

Withdrawal using oral sumatriptan took longer than hospitalization for IV DHE, and some did have to have DHE injections during withdrawal, but the major benefit was that none of them had to be hospitalized for this treatment.

By the end of six months 69% of these study participants had reverted to an episodic pattern of migraines and were well established on migraine preventive medication. Actually, 58% of them had achieved this at the end of one month.

There is one possible drawback to this method in that sumatriptan itself may cause rebound headaches after a while. I should also point out that what you have might just be recurrence of the same headache. Let's say you take something for a headache and it helps. Then a few hours later or the next day the headache is back. That may be simply because the medication you took has worn off and you need to repeat the dose. Headaches, as you well know, can last two or three days.