Medication Overuse Headache:
Information for adults

Medication overuse headache is a chronic headache syndrome with 3 core criteria:     

• The use of a medication meant to stop headaches is being taking in too high a dose and too often.
• The majority of days are notable for persistent headache (often, headaches occur daily).
• There is no other medical explanation for the headaches.

The duration of medication overuse required to precipitate headache, length of withdrawal necessary to achieve relief, and relapse rate appear to depend on the specific medication that is being overused. In general, it takes 1–2 years of excessive triptan use (those drugs used in the treatment of migraine and cluster headaches, both discussed separately), 3 years for ergot derivatives (drugs also given for headaches, for those that do not first respond to other drugs), and 5 years for simple analgesics (over-the-counter "anti-inflammatory painkillers" such as aspirin, ibuprofen, acetaminophen, etc) to bring on medication overuse headaches. It also takes longer periods off simple analgesics to achieve relief in comparison to triptan medications. Relapses are more common for analgesic-induced chronic headaches than those facilitated by triptans.

Unfortunately, abruptly stopping the offending medication often elicits severe "rebound headaches," perpetuating the cycle of medication overuse. Whether or not medication overuse is a cause or result of an otherwise difficult headache disorder in some people is still somewhat controversial.

Immediately seek medical attention if you or someone you are caring for experiences any of the following:

• Stiff neck and a high fever associated with headache
• Sudden onset of a severe headache
• Loss of motor function, the ability to think clearly, or convulsions associated with headache
• Head injury
• Increased intensity and/or frequency of headaches