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Aug. 30, 2024—When you have a headache, you want relief quickly. That often comes in the form of prescription or over-the-counter (OTC) headache medication. But taking those medicines too often can backfire—and trigger more headaches.

This pattern of rebound headaches is known as medication overuse headache (MOH). The term is used to describe headaches that occur 15 or more days per month due to regular overuse of pain medication for more than three months.

A cycle of headache pain

With MOH, a pattern develops. You take medication for your chronic headache. When the medicine wears off, the pain returns, and you take more medicine. Eventually, your body becomes dependent on the pain relievers, and more headaches occur.

MOH can also occur if you frequently take medication to relieve pain in another part of your body.

Both prescription and OTC pain medications can trigger MOH:

• Opioids, a type of powerful prescription pain reliever, are more likely to cause MOH than any other kind of medication.
• OTC medications, such as acetaminophen (Tylenol), can trigger MOH if taken more than 10 times per month.

MOH is most likely to develop in people who already have chronic migraine headaches. People with tension headaches may also develop MOH, but this is less likely. According to the American Headache Society, other factors may also increase your risk:

• Women may be at a higher risk than men.
• People under age 50 may be more likely to experience MOH.
• Smoking, a sedentary lifestyle, substance use disorder, and depression and anxiety may also contribute to risk.

Avoiding rebound headaches

To better manage your migraines and protect yourself from MOH, it's helpful to track your symptoms and medications. Start tracking when you get headaches. You can also track how severe they are and any medications—including OTC medicines—you use to treat them. Also note if you can tell when your medication wears off.

Share this info with your doctor. They can help spot patterns that could lead to MOH and suggest alternative ways to treat or prevent headaches. And if you start needing to take your pain medication more than two or three days a week, contact your doctor right away.

If you do get rebound headaches, your doctor may need to create a new treatment plan for you. Breaking the cycle often involves stopping or reducing your headache medication. Your doctor may recommend a temporary medication to treat your pain after discontinuing the overused medication. This is called bridge therapy.

Get help for headaches

If you have frequent headaches, talk to your doctor. Treatment can help you manage your chronic headaches safely and effectively. Our assessment can help you decide if it's time to see a doctor about your headaches.

Sources

• American Headache Society. "What Is Medication Overuse Headache?" https://americanheadachesociety.org/wp-content/uploads/2021/02/AHS-First-Contact-Medication-Overuse-Headache.pdf.
• American Migraine Foundation. "Headache Journals: Tracking Your Migraine." https://americanmigrainefoundation.org/resource-library/headache-journals/.
• American Migraine Foundation. "Medication Overuse Headache." https://americanmigrainefoundation.org/resource-library/medication-overuse-headache-3/.
• UpToDate. "Medication Overuse Headache: Etiology, Clinical Features, and Diagnosis." https://www.uptodate.com/contents/medication-overuse-headache-etiology-clinical-features-and-diagnosis.
• UpToDate. "Medication Overuse Headache: Treatment and Prognosis." https://www.uptodate.com/contents/medication-overuse-headache-treatment-and-prognosis.
• UpToDate. "Patient Education: Headache Treatment in Adults (Beyond the Basics)." https://www.uptodate.com/contents/headache-treatment-in-adults-beyond-the-basics.