Medication-overuse headache

Medication-overuse headache can happen when many acute headache medicines are used too often. It is sometimes called rebound headache, but the practical issue is the same: more medication days can sometimes lead to more headache days. Newer medicine classes may have different risk profiles, so medication-day limits should come from a clinician who knows the exact medicine.

Why it matters in migraine

People with frequent migraine may treat attack after attack, then discover that headache days are becoming more common and medicines work less reliably. Medication overuse can coexist with chronic migraine.

Common warning thresholds

Risk thresholds vary by medicine. Many resources warn about triptans, ergotamines, opioids, or combination pain relievers at around 10 or more days per month, and simple pain relievers such as acetaminophen or NSAIDs at around 15 or more days per month. Mayo Clinic notes that gepants do not seem to cause medication-overuse headache. Some public guidance uses a simpler rule of trying not to use painkillers more than two days per week.

What to do

Do not stop prescribed medicine abruptly without medical advice, especially if opioids, barbiturate-containing medicines, or other complex regimens are involved. Track medication days and ask about preventive treatment, safer rescue options, and a withdrawal plan if your clinician thinks medication overuse is present.

Sources

• American Migraine Foundation: Medication overuse headache
• Mayo Clinic: Medication overuse headache
• NHS: Migraine