Medicines for Medication-overuse headache

What it is

Medication-overuse headache (also called rebound headache) is a common but often unrecognised cause of frequent headaches. It develops in people who already have a headache condition (such as migraine or tension-type headache) and who take painkillers or migraine medicines too frequently to treat them. Over time, the regular use of these medicines can paradoxically cause the headaches to become more frequent — often a daily or near-daily headache — creating a cycle in which more painkillers are taken, which perpetuates the problem. It can happen with ordinary painkillers, and particularly with those containing certain ingredients, as well as with specific migraine treatments, when used on more than a certain number of days per month over time. The key clue is frequent headaches in someone regularly taking headache medicines. Recognising it matters, because it is reversible.

How it is treated

The main treatment is to reduce and stop the overused medicines, which breaks the cycle and usually leads to the headaches improving over a period of weeks — though headaches often get temporarily worse before they get better as the medicines are withdrawn, which is expected and worth knowing about. This is done with support and a clear plan, sometimes stopping the medicine abruptly and sometimes reducing it, depending on the medicine and the person. Preventing the underlying headache condition (for example with a migraine-prevention approach) is often part of the plan, so the person has better long-term control without relying on frequent painkillers. Education is central — understanding the cause and having realistic expectations of the temporary worsening. Care is guided by a GP or headache specialist. The encouraging message is that, once the cycle is broken, the frequent headaches usually settle substantially.