Rebound headache

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Rebound headaches (medication-overuse headaches) are a type of headaches caused by long term use of analgesic agents. These analgesics may decrease the intensity of pain for a few hours, however used on a daily basis, can perpetuate in such a way that chronic headache results.

Pain relievers have been shown to cause chronic headaches only in people who have already a headache disorder such as migraine, but have not been shown in patients who take them for another condition such as arthritis.


The rebound headache may feel like a dull, tension-type headache or a more severe migraine like headache. Unless the analgesic is completely discontinued,the chronic headache is likely to continue.

When analgesics are discontinued, usually the patient may experience severe headache, nausea and vomiting for several days. After this period, the symptoms begin to improve.

Rebound headaches tend to occur every day or nearly every day.

Other symptoms may include:

  • Nausea
  • Vomiting
  • Irritability
  • Difficulty in concentration
  • Memory problems

What causes rebound headaches?

The medications that have the potential to cause rebound headaches include simple pain relievers such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin, or others) as well as migraine medications such as ergotamine and triptane.

  • Combination of pain killers are also a common cause of contributing to rebound headaches.
    Painkillers derived from opium compounds have also a high risk of causing rebound headaches.

How can we prevent rebound headaches?

Medications such as ergotamins, opioides and barbiturates should not be used more than 10 days per month.

Simple analgesics should not be used more than 15 days per month.

Doctor's Advice

The first step in management of overuse of analgesic medication headache, it is essential that analgesic use be reduced and eliminated.

Once the patient has substantially reduced analgesic use a preventive medication should be indicated.

Clonidine is used for opiate withdrawal symptoms.
For acute intolerable pain during the waking hours aspirin 1g IV is useful.
Some patients will require hospitalization for detoxification.

Medically Reviewed by a doctor on 9 Jan 2018
Medical Author: Dr. med. Diana Hysi