Headache medicine can cause headaches

By Veronica Pike Kennedy
The Oregonian, Monday, November 22, 1993

You know the feeling. It starts with a subtle pulse of pain that blossoms - within minutes - to a full-blown throbbing, throbbing, throbbing.

You've got a headache and you do what most people do: You reach for your favorite brand of over-the-counter painkiller. You open the bottle, swallow two (maybe even three or four), and wait for the throbbing to subside.

That method usually works for most people, but if you reach for that painkiller bottle two, three or more times a week, you may be giving yourself headaches.

When taken in excess, analgesics such as aspirin, acetaminophen and ibuprofen create what is called analgesic rebound effect.

It's a type of chemical dependency. Your body gets used to taking an analgesic to relieve the pain of headaches, so it begins to actually produce a headache so it can get an even larger dosage of the painkiller.

"It's like a dog chasing its tail," said Seymour Diamond, a neurologist and headache specialist who is executive director of the National Headache Foundation and practices at the Diamond Headache Clinic in Chicago.

The headaches usually get stronger and more frequent - and the standard way to end the headache-analgesic-headache cycle is through detoxification in a general hospital.

People who prefer over-the-counter painkillers such as Vanquish or Anacin also are in danger of building up a caffeine dependence as well as an analgesic dependence.

"If you take an aspirin or Tylenol or Nuprin and get temporary relief but the headache recurs, you should see someone who can help you with your headaches," Diamond said.

The best choice of a medical practitioner is a headache specialist who has more insight into headache causes than a general practitioner, he said.

"A headache history takes two or three hours to do," he said.

Your headaches may be analgesic rebound-related if:
· They occur almost every day.
· They are present upon awakening and last almost all day, fluctuating in intensity.
· The pain is mild to moderate.
· You take over-the-counter painkillers at least every other day and have been for at least one month.

"Sixty percent of 70 percent of headache patients are victims of analgesic rebound," said Birmingham, Ala., neurologist and headache specialist Robert Ford of Ford Headache Clinic.

He said that kind of headache tends to be concentrated in the 25- to 35-year-old age group. Other statistics indicate it is between five and 12 times more common in women than men, probably because more women suffer from chronic headaches.

The headache apparently is the result of an altered serotonin level in the brain that is caused by taking too many painkillers, he said. Serotonin is a powerful agent in narrowing blood vessels and is through to be involved in the body's sleep and sensory activities.

Ford said people who are headache-prone can have analgesic rebounds by taking Tylenol as little as two times a week. For more information on headaches, or for a listing of headache specialists in your area, call the National Headache Foundation at (800) 843-2256

Return to health articles listing