Headache meds worsening your headache?

Ugh. Just when you think your headache is under better control. But you’re taking ibuprofen every 6 hours, every day, every week, for months. Not only is this horrible for your stomach, but it can also result in significant kidney damage and other adverse bodily effects. Like WORSENING YOUR HEADACHES. As it turns out, taking an over-the-counter pain reliever more than twice per week may be enough to tip your headache from “kind of under control” to absolute misery. Check out the latest from our BrainWaves archives as we discuss the risk factors and management of medication overuse headache:

I know what you’re thinking. No way, right? Or if you know someone who has frequent headaches, I am sure they can attest to it. It’s an easy trap to fall into, too easy perhaps. 1 in 100 people fall into it actually. You, your friend, or your patient pick up some over-the-counter Tylenol at the local CVS and instead of getting pain relief, you fall into a cycle of unremitting and disabling head pain.

But there’s a cure! In fact, probably several effective ways. Every patient is different, and an open discussion between the patient and the provider about the risks of relapse and compliance with therapies is critical to prevent further decline. In general, physicians recommend a short course of steroids to break the chronic daily headache cycle, medication like valproic acid, or even an over-the counter NSAID–I realize this sounds pretty counter-intuitive given all the blackbox warnings I’m giving you about these pills. But it’s true: if someone has been religiously taking acetaminophen for several weeks without benefit, a short burst of ibuprofen may push that headache back into normalcy while the acetaminophen washes out of the body.

Think about it, and take a listen. It’s some straightforward neurology that anyone can learn from. Just try not to get a headache over it.


[Jim Siegler]

The content in this episode was vetted and approved by Roderick Spears.


Dodick DW. Clinical practice. Chronic daily headache. The New England journal of medicine. 2006;354:158-165

Diener HC, Limmroth V. Medication-overuse headache: A worldwide problem. The Lancet. Neurology. 2004;3:475-483

Tomkins GE, Jackson JL, O’Malley PG, Balden E, Santoro JE. Treatment of chronic headache with antidepressants: A meta-analysis. The American journal of medicine. 2001;111:54-63

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