Medication overuse headaches: How to break the cycle

October 14, 2019

Here’s the scenario: You have a nasty headache, so you pop your over-the-counter (OTC) pain medication of choice. Your headache improves and you’re happy that you don’t feel as bad as you did before you took it. But then, you get a headache the next day, so you take it again. And so on and so forth. No harm, right?! 

Wrong. So begins a dangerous cycle…

Although OTC pain medications can be helpful, if you take them too often, you might find that these common medicines actually start causing your headaches instead of relieving them.

Let me tell you why — and what to do if you’re stuck in this cycle.

The dangers of medication overuse headaches

When used appropriately, OTC medications are quite helpful. The problem becomes knowing what the definition of “appropriate use” really means.

From a headache standpoint, OTC medications such acetaminophen, naproxen, ibuprofen and aspirin should be limited to 10 days per month, which equates to 2-3 days per week of use. However, this does not mean you get 10 days of each medication. Rather, it is 10 days a month combined.

When you take pain relief medications more than 10 days per month, you are setting yourself up for something called a medication overuse headache (MOH), where these OTC medicines end up becoming the cause of your headaches. You get into this ugly cycle of more headaches, so you take more medication, which then causes more headaches, so you take more medication, and… you get the picture. 

It’s important to note that OTC medications are not the only culprits of medication overuse headaches. Caffeine and prescription medications can lead to headaches too, including prescription NSAIDs, triptans and narcotics to name a few.

How to stop medication overuse headaches

So, what do you do if you think you are experiencing medication overuse headaches? Unfortunately, the only way to stop the vicious cycle is to stop use of the offending agent and completely eliminate it from use for about six to eight weeks.

Though some medications can be stopped “cold turkey,” others may need to be weaned slowly. 

However, we usually don’t recommend you attempt this on your own because it can be an uncomfortable process. Though some medications can be stopped “cold turkey,” others may need to be weaned slowly. It is recommended that you schedule an appointment with a healthcare provider to determine the best way to wash-out from medication overuse and manage your pain.

Talk to your doctor about your headaches and whether you may need to see a headache specialist like me.

What can you do while you are waiting for your appointment? Here are a few ways to manage headaches in the meantime.

·         Limit caffeine to no more than 100mg per day only two or three days per week. Zero caffeine is best but reduce your consumption slowly, by about 100mg per week.

·         Maintain a regular sleep schedule — go to bed a and wake up at the same time every day.

·         Do not skip or miss meals. At least grab a small snack.

·         Drink plenty of water.

·         Exercise — After approval from your healthcare provider, start exercising and build up slowly to a goal of 150 minutes per week.

·         Practice stress management techniques, such as meditation.

·         Take steps to maintain or reach a healthy weight.

·         Stop smoking.

·         Avoid your headache triggers and trigger foods.

Ultimately, the best way to avoid the cycle of medication overuse headaches is to prevent it by taking medication thoughtfully and tracking your days of use. If at the time of reading this, you have more than 10 headache days per month, you should schedule an appointment with your doctor.

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