What are Rebound Headaches?

Rebound headaches, also called medication overuse headaches, can occur if you take certain pain relievers above their recommended dosages. Learn about what causes rebound headaches and how to prevent and treat them.

Share This Post

For the past few years, I have experienced an occasional migraine. Lately, I have been experiencing more frequent migraine with symptoms of extreme pain on one side of the head and sensitivity to light and noise (iPads off, kids!). 

Usually, I’d reach for a bottle of Excedrin Migraine and lay down to rest. In an hour, I would be good as new. That was when I had two or three migraine days a month. Now, I’m experiencing up to ten migraine days per month. Because of the risk of rebound headache, I’m not so quick to reach for the Excedrin Migraine.

What are Rebound Headaches?

When you get a headache or migraine, you might take an over-the-counter (OTC) or prescription medication to try to stop the pain. This may be an effective strategy to combat the pain and other associated migraine symptoms. 

However, if you take more medication (we’ll get into amounts shortly) than the label (or your healthcare provider) recommends, you may rebound into another headache. Rebound headaches are also called medication overuse headaches.

Unfortunately, a cycle can develop. You have a migraine, take a pain reliever, get a rebound headache, and take more medication. The cycle can continue until you suffer from more and more headaches.   

What Medications Cause Rebound Headaches?

According to the American Migraine Foundation, medication overuse is defined by how much acute medication (medication used to stop a migraine, as opposed to preventing one) you take per month. 

  • Simple analgesics (single-ingredient products such as aspirin, acetaminophen, ibuprofen, or naproxen) can contribute to rebound headaches if you exceed the recommended daily dosage or use them for 15 or more days per month.
  • Combination pain medications (such as OTC Excedrin Migraine or prescription Fioricet) containing several ingredients including caffeine, aspirin, acetaminophen, or butalbital may cause rebound headaches if taken for ten or more days per month.
  • Triptans/ergotamines may lead to rebound headaches if used for ten or more days per month.
  • Opioids such as oxycodone, tramadol, morphine, codeine, or hydrocodone can cause rebound headaches when used for ten or more days per month.
  • Caffeine intake over 200 mg daily can increase the risk of rebound headaches. 

*Note: butalbital (found in Fioricet, Fiorinal) or opioids should only be used as a last resort in treating migraines. 

What are the Symptoms of Rebound Headaches?

Although symptoms and severity vary, rebound headaches may occur daily (or almost every day). These headaches frequently occur first thing in the morning, often waking you up. With the cycle described above, you may reach for a pain reliever and feel better, but the pain soon returns. 

Besides pain, other symptoms of rebound headache include nausea, anxiety, irritability, lack of energy, restlessness, difficulty concentrating, memory problems, and depression. 

How are Rebound Headaches Diagnosed?

Your healthcare provider can usually diagnose rebound headaches clinically by looking at medication use and headache frequency. He or she may also order imaging studies or lab work if necessary. 

How Common are Rebound Headaches?

Rebound headaches occur in one or two out of every 100 people. These headaches are more common in women than in men. Patients with chronic pain, depression, or anxiety are more likely to experience medication overuse headaches. 

What is the Treatment for Rebound Headaches?

Rebound headaches will worsen until you are adequately treated, so it’s essential to see a headache specialist. 

Your specialist will likely prescribe preventive medications. He or she may also prescribe prescription drugs to treat a migraine when it occurs. At the same time, your doctor will instruct you on how to stop or taper off the medication(s) that were causing rebound headaches. 

Patients on larger doses of sedative medications or narcotics may need to be detoxified in the hospital. 

The first few weeks of your new regimen may lead to increasing headaches, so it is important to be closely supervised by your specialist. Keeping a record of your symptoms, frequency, and duration will help your specialist as well. 

Eventually, with proper treatment, the rebound headaches will stop, and you will just have your “normal” headaches. But, hopefully, the preventative medications will decrease the frequency and severity of your migraine. 

Migraines finally meet their match with treatment from our Partner, Cove 😊

Introducing Cove, a new way to diagnose and treat migraines.

The following services are available with Cove: Acute Medications, Preventative Medications, Anti-Nausea Medications, and Dietary Supplements. WORKS WITH YOUR INSURANCE.

>>> Start your Cove Journey HERE.

How can I Prevent Rebound Headaches?

Here are some tips to prevent rebound headaches:

  • Limit the use of pain relievers (see above for doses that cause rebound headaches).
  • If you need to take headache medications more than two days per week, see a headache specialist. You may need preventive medicine and a treatment plan, depending on frequency and severity. 
  • Avoid butalbital (Fioricet, Fiorinal) or opioid pain relievers (such as oxycodone or hydrocodone) except when prescribed as a last resort by your healthcare provider.
    • Note: DO NOT stop taking any medications prescribed to you by your provider without consulting them first* 
      • Identify and control triggers (see below for more about triggers).

What are Some Other Tips to Prevent Migraine?

In addition to following the treatment regimen prescribed by your headache specialist, you can try these tips to avoid migraine:

  • Sleep: Keep a regular sleep schedule, even on the weekends. Go to sleep and wake up around the same time each day. Avoid naps (they can interfere with nighttime sleep) or keep them short. 
  • Eat: Eat regular meals (don’t skip!) and drink plenty of water. Keep a food diary to help identify trigger foods. Avoid common trigger foods such as chocolate, aged cheese, alcohol, and caffeine (your trigger foods may vary; if it is not a trigger, you don’t have to avoid it).
  • Exercise: Regular exercise helps pain and can also help symptoms of depression and anxiety. Exercise can help you maintain a healthy weight.
  • Manage stress: Try relaxation or yoga. Take time to do things you enjoy. 
  • Keep track: A migraine journal can help you identify patterns or triggers. There are many apps you can find if you prefer to track electronically. 
  • Seek support: Find help through counseling, a support group, or even a social media support group (Only take medical advice from your healthcare professional).

Bottom Line

  • If you are experiencing rebound headaches, seek proper treatment so you can be on your way to feeling better soon!
  • Use a headache diary to keep track of symptoms, triggers, medication use, and headache pain/resolution to help your healthcare provider assist you in management of your migraines 
  • If you notice the frequency of your migraines increasing, make sure to let your healthcare provider know so you can determine a more appropriate treatment plan and avoid rebound headaches before they begin 

References

  1. Headaches: Rebound Headaches. Cleveland Clinic website. https://my.clevelandclinic.org/health/diseases/6170-headaches-rebound-headaches Accessed August 25, 2020.
  2. Medication Overuse Headache. American Migraine Foundation website. https://americanmigrainefoundation.org/resource-library/medication-overuse/ Accessed August 25, 2020.
  3. Five questions for choosing a treatment for severe migraine relief. American Academy of Neurology website. https://www.aan.com/siteassets/home-page/policy-and-guidelines/quality/quality-improvement/patient-handouts/13migrainereliefsdmtool-pg.pdf Accessed August 25, 2020.
  4. Stopping the vicious cycle of rebound headaches. Harvard Health Publishing Harvard Medical School website. https://www.health.harvard.edu/blog/stopping-the-vicious-cycle-of-rebound-headaches-2019110718180#:~:text=Medication%20overuse%20headache%20is%20a,who%20have%20depression%20and%20anxiety. Accessed August 25, 2020. 
  5. Headaches: Rebound Headaches: Management and Treatment. Cleveland Clinic website. https://my.clevelandclinic.org/health/diseases/6170-headaches-rebound-headaches/management-and-treatment Accessed August 25, 2020. 
  6. Migraine: Simple steps to head off the pain. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/migraine-headache/in-depth/migraines/art-20047242 Accessed August 25, 2020.
medically reviewed and fact checked
Sesame Care

Find the best price for great doctors and specialists

  • Thousands of doctors and specialists
  • $13,000,000+ saved by patients
  • 95% patient satisfaction
  • 4.3 on TrustPilot
     

Popular Destinations

Health

Medication

Telehealth Reviews

Shop

Pharmacist Membership

About Us

Pharmacy Near Me

Recent Articles

Share On:

Subscribe To Our Newsletter

Get updates and learn from the best

More To Explore

Inner Knee Pain: Causes, Treatment, and Prevention

The inner knee is a joint where the femur meets the tibia. It's one of many joints in your body, and can sometimes be

Aleve vs Ibuprofen: What’s the difference?

We all have muscle aches and pains every once in a while, and sometimes, the pain gets to be enough that we need to

Questions About Pain on the Left Side of My Body

Do you have pain on the left side of your body? You're not alone. The left side of your body is home to many

Cove Migraine Review: Are These Medications Effective?

Cove is a telemedicine company that provides personalized treatment for migraine sufferers, but are their medications effective? We provide you with an honest review.

Meloxicam Side Effects: What Are They?

People who suffer from rheumatoid arthritis and osteoarthritis deal with daily, chronic pain that can have a serious impact on their quality of life.

Aleve vs Advil: What are the Main Differences?

Although Aleve and Advil are available over the counter, they’re not without risk. Recent studies have concluded that approximately 15 percent of American adults

To Take or Not to Take: Osteoarthritis Supplements

Are you one of the over 30 million Americans suffering from osteoarthritis? Or maybe you know someone who is? Do you or someone you

Meloxicam Side Effects: What Are They?

People who suffer from rheumatoid arthritis and osteoarthritis deal with daily, chronic pain that can have a serious impact on their quality of life.

What Do Muscle Relaxers Do?

If you’ve ever struggled with lower back pain, had certain types of surgery, or are affected by certain chronic muscular conditions like multiple sclerosis,

What’s The Best Over the Counter Migraine Medicine?

We’re revealing the best over the counter migraine medicine to help you in your selection. Read on for more details.

Narcan: The Nasal Spray that Could Save Your Life

Opioids (sometimes called narcotics) are a type of medicine that decreases the feelings of pain. Healthcare providers may prescribe opioids to lessen pain from:

New Treatment Option for Acute Migraine Headaches

Migraine headaches affect 12% of the population in the United States. During an acute migraine headache, symptoms can get severe enough where it becomes

Ocular Migraine Treatment: What You Need to Know

If you’ve experienced the pain of a migraine, you know how strainful it can be. Find out the best ocular migraine treatment and more

To Take or Not to Take: Osteoarthritis and Supplements

Osteoarthritis is a degenerative joint disease, sometimes referred to as “wear and tear” and affects over 30 million Americans. There are a variety of

What Is Plantar Fasciitis? The Symptoms, Causes, Risk Factors, and Treatment Options

Plantar fasciitis is a common foot injury that can cause pain and discomfort. The plantar fascia is a band of connective tissue that runs

Is Hydrocodone an Opiate?

Hydrocodone is an opiate that presents a high risk of abuse and addiction. Commonly prescribed for the short term management of pain, hydrocodone can

Joint Pain Medication: Common Side Effects

Being aware of the potential side effects associated with joint pain medication can help you decide which drug is right for you. Learn more

Hydrocodone vs Oxycodone: The Difference Explained

Hydrocodone and oxycodone are prescription opioid painkillers that are effective medications to treat moderate to severe pain. Oxycodone is more likely to cause side

Gabapentin Side Effects: What Are They?

Gabapentin is in a class all its own when it comes to medications – literally. The medication belongs to a class of drugs named

What’s The Best Over the Counter Migraine Medicine?

We’re revealing the best over the counter migraine medicine to help you in your selection. Read on for more details.