Understanding Rebound Headaches And Their Causes

Headaches are a common ailment that many people try to alleviate with over-the-counter medications like Tylenol, Advil and Excedrin. However, as Dr. Stacy Chronister, an internal medicine specialist with OSU Medicine, explains, this can lead to a dangerous cycle of “medication overuse headaches” or “rebound headaches.”

The Vicious Cycle of Rebound Headaches

“What happens is people have headaches for all kinds of reasons, and that's one of the big reasons they come to see the doctor,” says Dr. Chronister. “They start taking a medication to get rid of it, and then what do you know? We have a whole different type of headache on our hands.”

Dr. Chronister compares this process to a caffeine headache, where missing a daily dose can trigger unpleasant symptoms. “This is that same type of process, but it's actually with medications,” she explains.

Identifying the Warning Signs

According to Dr. Chronister, a key sign of a rebound headache is when the medication “helps” the headache go away, only for it to return shortly after.

“That person who says, 'Yes, I then take Tylenol, and it makes my headache go away until the next time I need it,' I go, 'Oh, we might actually have a dependency on that medication,'” she says.

Dr. Chronister also notes that those at the highest risk are people who already struggle with frequent headaches, such as 15 or more per month.

Breaking the Cycle

Overcoming medication overuse headaches can be challenging, but Dr. Chronister outlines a few strategies:

“One is to just stop the offending agent, and that can look pretty, pretty uncomfortable,” she says, acknowledging that the withdrawal process can be difficult.

Alternatively, she suggests “decreasing the frequency” by waiting an hour before taking the next dose to see if the headache subsides on its own.

If those methods prove too difficult, Dr. Chronister advises consulting a physician, as “you might have something else going on” or may need preventive medication to help manage the headaches.

The Risks of Over-the-Counter Medications

In addition to the rebound headache issue, Dr. Chronister cautions that overusing over-the-counter medications can also lead to other health problems.

“When we're talking about acetaminophen or Tylenol, we have to worry about liver damage. When we're talking about ibuprofen, the heart, our blood vessels, and our kidneys, but especially our stomach. A lot of people get ulcers from taking the medication too often,” she explains.

Dr. Chronister emphasizes that even taking slightly more than the recommended daily dose can be dangerous, especially if it is done frequently. She advises speaking with a healthcare provider if you're struggling with persistent headaches and medication dependency.