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Enough is Enough: Rebound Headaches
By Kerrie Smyres | June 20, 2005
News anchors, journalists and medical websites have warned that “painkillers might be causing your pain!” too many times to count. OK, OK, rebound headaches are nasty; so are chronic daily headaches and migraines. I want to know how much is too much. Not vague amounts, but clear, precise doses.
In comes the conflicting advice. One doctor said to rotate Imitrex, Migranal and Advil every three days to avoid rebounds. Another said that it’s perfectly fine to take a triptan a couple days a week and an OTC painkiller another few days. Of course, no doctor knew just how much Advil I took because I was afraid to admit the amount to myself, much less say it out loud.
When dignity took a backseat to pain relief, I stopped the painkillers. Four years later, I can barely remember how much better I felt when I took occasional painkillers. I often forget that it’s even an option. But I do remember my headache specialist telling me that the goal of my treatment is to make me feel like I do when I take Advil*. Lately, the forbidden drug has started calling my name.
Because my headache specialist, who I think is terrific, relies on the International Headache Association’s standards, I’ll do the same. IHS’s bottom line is that rebounds are likely if you take painkillers or migraine abortants more than once or twice a week or more than 10 times a month. As you well know, nothing is one size fits all, but these are good guidelines.
Think you might be in rebound? Here are some frequently prescribed meds that can cause rebound headaches. You’ll be miserable if you stop them cold turkey, so get your doc’s advice first.
Triptans: Amerge, Axert, Frova, Imitrex, Maxalt, Relpax, Zomig
Ergots: Cafergot, D.H.E. 45, Migranal, Sansert
OTC Painkillers: Acetaminophen (Tylenol, Excedrin, Vanquish), Asprin (Bayer, Bufferin), Ibuprofen (Advil, Motrin), Naproxen Sodium (Aleve)
Prescription NSAIDs: Indomethacin (Indocin), Ketorolac Tromethamine (Toradol), Naproxen Sodium (Anaprox, Naprelan, Naprosyn), Piroxicam (Feldene)
Opioids: Fentanyl (Duragesic, Actiq), Hydrocodone (Vicodin, Lortab, Lorcet, Norco), Morphine (MSIR, MS Contin, Oramorph), Oxycodone (Roxicodone, OxyContin, OxyFast, OxyIR)
The scariest part about stopping the meds is that your headaches might not change or may even worsen.The underlying condition that prompted you to take them in the first place is probably still there. Even if you don’t get immediate relief, your headaches may be easier to treat in the long run with fewer drugs getting in the way. And your kidneys will thank you.
*Advil doesn’t get rid of my headaches, but it sometimes reduces the severity of the pain. For me, feeling “much better” is having pain that’s below threshold that would keep me in bed.
Topics: Treatment | 60 Comments »
June 21st, 2005 at 1:47 pm
Wow. Also scary – I’ve been on a majority of the migraine/headache drugs listed above, not to mention a bunch that aren’t. And I’d bet that anyone who’s struggled with migraines for very long has, too.
July 5th, 2005 at 11:54 am
Wow! I can’t believe Advil works for you. I started out with the OTC pk’s like Advil and Ibuprofen, but they couldn’t touch the pain. Even the pk’s I’m on now, barely touch it. I’m glad those otc’s work for you. What a gift!
November 1st, 2005 at 5:31 am
THANKS TO PEOPLE LIKE YOU. I SEE I AM NOT ALONE. I’M 48,BEEN A MIGRIANER SINCE 1990. IMITREX IS MY WONDER DRUG. CURRENTLY MY LONGEST BATTLE OF 90 DAYS. ALL MY DOCTORS BELIEVE I HAVE REBOUNDS. THEY ARE STOPPING MY PRESCRIPTION. SO I HAVE NO CHOICE BUT TO TAKE A DAY OFF WORK AND BATTLE THIS DEMON. SO HERE I AM ALONE AND WAITING. BATTLED IT FOR 1 HOUR LAST NIGHT AND I JUST WAS NOT GETTING ANY RELIEF. SO I TOOK MY LAST SHOT OF IMITREX. I REALLY DON’T NO WHAT TO DO. THANKS FOR THE HELP.
March 15th, 2006 at 1:48 pm
I need help…. I have been taking Hydrocodone for almost 2 years now (on and off) I recently had back surgery and have been taking the PK’s on an (what seems like) hourly basis… I have recently (3days) been experiencing these horrifying headaches when the PK’s wear off….. I can not keep my eyes open… My head hurts sooooo bad, I feel like I am going to die…. Is this a rebound headache?? What can I do to get rid of it? I have tried excedrin (tension) Mobic, and Cephadyn…. Nothing is working… I have had this headache for 3 days now, and I am a single mother of a 2 year old… Can anyone help???
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It definitely sounds like a rebound headache to me. Taking other painkillers will likely keep the problem going. Some doctors will prescribe something to make the withdrawal easier, but I’m not sure what that is. I think that a lot of people just stop it cold turkey and go through some nasty withdrawal symptoms.
I know that’s not much help. Anyone else have suggestions?
K
April 5th, 2006 at 1:54 pm
I have had migraines since I was a teenager, but in the last year (I turned 40 in August) they have been increasing in frequency, pain, and duration. I was on imitrex, but it stopped working for me. Over the years I have been on:
Caffergot
Darvocet
Imitrex
Zomig
Maxalt
Emerge
Topomax
Flova
Relpax (current one)
Vicodin
Zoloft
Percocet
Inderall
Depakote(current one)
Naproxin (allergic)
Fioricet (allergic)
The Relpax isn’t working and he has me taking 2 pills together with Reglan for my stomach which also doesn’t work. The headache comes back after about an hour and my stomach feels like crap for the whole 12 hour dose. These meds are just the ones I can remember.
Now on top of this problem, I have sinus issues and am due to have surgery on April 26th.
The only thing that worked for me in the last 4 months or so is Percocet, but the Dr. doesnt like to prescribe them very often. Honestly, I don’t like taking them either, but I don’t like not being able to function 15+ days a month either.
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I’m sorry you suffer with this too. Good luck with your surgery. I hope it helps you tremendously. Let me know how it goes.
K
June 30th, 2006 at 9:30 pm
It would be nice if doctors could agree on which meds cause rebound. Last week after a migraine that dragged on for 5 days I contacted my doctor to get her perspective on which NSAIDS cause rebound. She said that NSAIDS don’t cause rebound very often, and in her opinion the biggest problems are caffeine and opiates.
I gave up triptans because I’d read they were a significant source of rebound, and this was consistent with my experience. The only drug I’m taking right now as a preventative is a low dose of Amitriptyline, which I know isn’t sufficient because I still need to use Relafen (an NSAID) and/or Valium about 2-5 days a week to stop a headache from escalating into a migraine.
I had the least amount of migraines several years ago when I took 20 mg of Feldene once a day for a little over a year. I didn’t know it was Feldene that was keeping the migraines at bay. I’d started taking the drug to help with another chronic pain condition. I thought something had finally shifted and I’d outgrown my migraines.
And then one day I started getting horrific upper abdominal pain. My doctor was convinced the Feldene had given me an ulcer, but the test results came back negative. I’d been taking the Feldene with Cytotec to protect my stomach so it didn’t surprise me that I didn’t have an ulcer. However, it did become clear to me that immediately after I’d take the drug that gawd awful abdominal pain would start up. So I stopped the Feldene–and within a few weeks the migraines returned. So much for my delusion that I’d outgrown them.
Even though I stopped the Feldene the pain didn’t stop, it was just further aggravated by the drug. It took 3 months of testing to finally be diagnosed with non-erosive GERD, and now I need to take Prilosec twice a day to keep that condition under control.
This was a disappointing experience. Feldene was such a wonder drug for me for a year, and I suffered no rebound while taking it.
July 12th, 2006 at 9:25 am
I started taking oxycontin for a bladder disease that was very painful. The pain mgmt Dr. kept me on the drug for over 4 years. Now I have constant headaches and am afraid to take more nsaids because of the rebound. I have an imitrex and am going to try it. Let’s see if it works. I am told these oxycontin headaches can last up to a year. I have been off the drug for not quite 2 months.
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I’m sorry you’re still suffering. A year seems like a long time to have rebound headaches. I hope you find something that helps.
Take care of yourself.
K
July 27th, 2006 at 1:57 pm
I have since been put onto Midrin which seems to work about 75% of the time. From what I understand it is an older drug, but so far it is more successful than anything I have taken in the past 2 years.
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That’s terrific! My husband has tried all the new drugs, but Midrin is the best for him too.
K
September 24th, 2006 at 12:31 pm
Ice packs on my eyes and neck; scrubbing my scalp; massage…in concert with drug therapy…has helped.
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I’m so glad you’ve found something that helps. Take care of yourself.
K
October 30th, 2006 at 4:47 am
HI, I WAS PUT ON PAIN KILLERS FOR OTHER REASONS AS WELL. PERCOCET, TYLOX, VICODIN, NORCO, LORTAB AND ALL THAT STUFF . BUT EVERYTIME I TAKE ONE, AFTER THEY START TO WEAR OFF, NOT ONLY DO THEY MAKE ME FEEL AWEFUL, I ALSO GET A VERY BAD HEADACHE. I HAVE BEEN TAKING THESE PAIN KILLERS FOR OVER A YEAR NOW. AND I THINK I AM GOING TO COME OFF OF THEM. THEY DO CAUSE REBOUND HEADACHES. I TALKED WITH A DOCTOR AT THE E.R. ONE DAY AND HE SAID THAT THEY DO CAUSE REBOUND HEADACHES. MY MOM IS A NURSE AND ALSO HAS MIGRAINES. SHE SAID THEY CAUSE HER TO HAVE REBOUND HEADACHES. I THINK THE REBOUNDS ARE THE WORST. WHEN I GET THEM, I ALSO FEEL LIKE I’M DYING. IT DOESN’T JUST EFFECT MY HEADACHE, BUT MAKES ME FEEL BAD ALL OVER. DON’T THINK THE PAIN MEDS ARE WORTH IT. I HOPE EVERYONE FEELS BETTER SOON :O) LR
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Best of luck breaking your rebound headache cycle.
K
November 27th, 2006 at 6:36 am
How long do nsaids stay in your system? I have had bad headaches for the past 2 or 3 years that I’ve treated with ibuprofen. If I take it, I avoid the headaches. The best description of my headaches are the cluster type: pain always on the left side, centered around my sinuses, often making my nose on that side clog up. They last 30-45 minutes & recur about every 8-10 hours, but not if I take nsaids–ibuprofen works best. I’ve tried cutting out AM coffee and the PM glass of red wine with no change. I saw a chiropractor and tried acupuncture.No help. I bought a capsacin (pepper) based nasal spray and am trying that.
My neck and shoulders always carry tension. Can that cause a pinched nerve or something else that could trigger the headaches? I’m so tired of taking the pills so I quit them yesterday and am suffering. I don’t know what else to do. Any suggestions?
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I don’t know how long it takes for meds to get out of your system. I think the rule of thumb is three to four weeks, but it could be less and it could be more.
Have you considered seeing an MD? Knowing what type of headaches you’re having could help you, even if you don’t want to take any meds for them.
Sorry I couldn’t be more helpful. Let me know if there’s anything else I can do.
Take care,
K
December 29th, 2006 at 10:07 am
I read a book on Migraines written by a neurologist who said NSAIDS DON’t cause rebounds! I am so confused. I’ve had migraines for years, am 47 and getting more chronic. Here I am taking Advil daily thinking it is safe! Great. Guess I need to withdraw and go through pain like I did giving up caffeine. The book is Heal Your Headache, the 1.2.3 program by David Buchholz, M.D. Any chance I’ll be free after menopause? What choices do I have if I am only allowed Advil a couple of times a week? Isn’t it better to abort than keep the brain in an over-excited state? Won’t it do damage?
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I saw that in Heal Your Headache too, but everything else I’ve ever read and been told by doctors is that they NSAIDs do cause rebound headaches.
There are a lot of other treatments for migraine, both abortive and preventive, so you still have many options without taking NSAIDs very often. It’s definitely something to talk to your doctor about. Also, you may be in a rebound cycle right now so that not taking NSAIDs may make your headaches better.
Some women do stop having migraines after menopause, but not all do. The Women’s Migraine Survival Guide by Dr. Christina Peterson is full of great information about headaches, hormones and menopause. It may help answer some of your questions.
I’m not sure about the brain being in an over-excited state or if it can cause damage — a neurologist is probably the only one who can answer that question. I know that headaches are harder to treat the longer a patient has had them. It’s like the brain learns to be in pain and has trouble un-learning it.
I hope this helps. Let me know if I can help with anything else.
K
January 11th, 2007 at 7:52 pm
I have had cluster headaches for 30 years. They have become increasing worse. I have tried every drug made. Most recently, Lyrica, and Cymbalta, neither worked for me. I take a combination of Zomig and Exceedrin and get the most relief from them. However, my doctor believes I have rebound headaches from the exceedrin I take daily. I have tried to get off it, but my headaches become out of control. Is there any way of successfully weaning ones self from the Exceedrin?
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It’s much easier to slowly wean yourself off medications than it is to stop them cold turkey. Your doctor should be able to give you a schedule to follow for decreasing the medication slowly — it depends on how much you’re taking and what your dose is.
Best of luck.
Kerrie
February 19th, 2007 at 6:59 am
I am doing so much better since my last post. I was unable to take Topamax even at 50 mg because my loss of appetite was severe, and friends and my brother, were getting kidney stones. (am told that is the worst pain EVER, more than childbirth!)Plus, the other side effects were bad. I have weaned myself, slowly, off of daily advil, been diligent to the point of madness with the migraine diet (it’s not so bad after the initial “woe is me” phase, esp at the Superbowl party!), and am on a low dose of Pamelor (nortriptyline). ( tried Amyltriptiline, Elavil, but heart racing was a prob and Pamelor has worked better on my headaches)I still have vague pain around menstruation, and ovulation, but my need for abortives has become less, (2x mo) and I haven’t had an aura now since Jan 1st. I was getting those on a regular basis. I also have prescription Phenergan suppositories that help with the nausea, and I use even w/out a major migraine, because you can still get migraine symptoms without the major headache) I am cautiously optimistic, but very encouraged. Even though Dr. Buchholz’ book didn’t indicate advil as a potential rebound causative, the rest of the book helped me a hundrefold. So has your blog. Thank you so much and blessings and Godspeed to fellow sufferers. Thanks again!
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What great news! I hope you continue to feel better.
Kerrie
February 20th, 2007 at 11:39 pm
I’ve been taking hydrocodone/apap for herniated disk for the last 3 or 4 months, and all of a sudden I’m realizing that the migraines that I thought were a thing of the past are with me 4 or 5 days of the week. It’s the painkillers isn’t it? I never even heard of rebound headaches from this medication. Imitrex helps but I take it way too much. Guess I need to stop the meds….thanks for the helpful comments
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The painkillers could definitely be the culprit. Don’t get discouraged if you don’t notice a change for a while — it can take two months to get the rebound-causing drugs out of your system.
Take care of yourself.
Kerrie
July 8th, 2007 at 11:56 pm
Meds Taken I’m 22 years old
Adderall for 9 years works well still no problem except need a benzo to call my CNS
Ritalin for 2 years
Lamictal I hate you
Risperdal sleep but not my preference
Straterra sucks for ADHD
Abilify I’m awake, then tired no good
Trazadone insomia and headaches
Amitriptyline insomnia and neuropathy , no good
seroquel insomnia and horrible nightmares
Ropinorole I don’t have RLS, symtoms are similar
Klonopin great for headaches
Soma short term pain help headaches
Vicodin short term pain, give headaches if I don’t have anticonvulsant to take bfore hand
Lexapro depresion baby stuff
Zyprexa insomia
Symbyax insomnia
Trileptal moderate success for headaches
Xanax (iiegally bought, but at a dose just enough to get rid of headaches )
Gabapentin no real relief
With the exception of Klonpin and Adderall and never had dehabilitating headaches till after taking Lamictal for 2yrs. With no meds that the appropriate certain pharmacokentics take away the chronic headaches , Im uaable to workout, concetrate , ( one alcoholic beverage in the leave hunch over the next morning with the shakes for example ) I quit taking Adderall my 1st semester college to see how would and I did well, but began havin mood swings…this led to various meds I was prescibed for Bpolar 2.. I now believe i was withdrawals after Adderall for long. thats my story
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Thanks for sharing your story, Shawn. I’m sorry that you’re suffering so much. Hang in there!
Kerrie
August 11th, 2007 at 10:13 pm
My daughter age 10 has had only a couple migraines, (these we’ve just figured out were incorrectly diagnosed as sinus infections_. A month ago one started and we ended up giving her ibuprofen (2 – 6 a day) for 3 weeks straight. As we tried to figure out what was going on with her (trips to the ER, spinal tap, CT scan, homeopath, allergist, accupuncturist, etc.) we finally ended up at the neurologist who diagnosed rebound headache. She is now still suffering tremendously from am – pm. Got her Xanax today which relaxed her a bit, but she’s crying now. Does anyone have experience with HOW LONG THIS WILL GO ON?? We stopped ibuprofen 4 days ago. The neurologist told us 4 – 8 weeks. This is insane to me. Any thoughts. Thanks.
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I’m so sorry to hear your daughter is suffering so much. I’m sure it is really stressful for you too.
Unfortunately, rebound headaches can last eight weeks. Usually it happens more quickly than that, but there’s no way to predict how long it will be.
Kerrie
October 10th, 2007 at 6:21 am
I’ve always had tension headaches growing up. But they stopped for a number of years and would come and go..they were never drastic. ABout 3 months ago i had some major dental work with my wisdom teeth & a root canal..I also suffer from TMJ which i wear a mouth guard for. The dentist put me on Motrin for 3 weeks, taking up to 1600 mgs a day. I went on several rounds of antibiotics as well. The nausea began after the antibiotics and never subsided since. I still suffer from major headaches now that im not even taking any motrin. I have major eye pain and the pain is all over my head including my neck and shoulders. I went to a neurologist, she prescribed me prednisone, fioricet, relpax..NONE of which worked. I even went to the opthomologist who also said she saw nothing wrong with me. I went for an MRI ysterday and i am awaiting the results.
Is there any way this could just all be rebound headaches?
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There’s definitely a chance of it. Did you talk to your doctor about the possibility?
Kerrie
October 26th, 2007 at 11:27 am
Help me? I woke up with a severe headache all over my head into my ears. All the through my neck & shoulders??? Took advil cold & Sinus, then a Fiorcet, then a aleve w/800 motrin w/aleve. I really don’t like takin Imitrez 100mg to much. They kinda give me mild pains in my chest. Any Solutions please help me…
March 29th, 2008 at 6:21 am
I stopped taking daily OTC meds for headaches on January 1. I’ve had headaches related to food allergies every day for 15 years, as well as fibromyalgia. Allergy elimination treatment by my chiropractor helped get FM under control, but not the headaches. I finally realized they were rebound headaches, thus stopping meds. The frustrating part is that about 3 days out of the week, I finally feel great. No headache. Then comes 4 days of ongoing pain. This after 3 months of no pain meds.
What I find is that my head is very sensitive to triggers – mostly food related, and things that I cannot identify. I’ve already eliminated most of the common triggers. I was advised to shop the “outside walls” of the grocery store – where the foods have no additives. I think there is validity to this. I’m about to give up spices and seasonings as well.
I don’t know how long the sensitivity and rebound will last – hopefully it is not tied to the length of time I took daily excedrin (15 years). However, there are those 3 or more days a week without pain – and I see a light at the end of this very long tunnel.
Thank you for your blog. It helps to see what others are experiencing as well. God bless you
May 18th, 2008 at 10:25 pm
I can’t believe how many others are like me! My migraines have become so frequent within the last few years that I don’t tell anyone for fear of sounding like a Hypochondric. The only complete and lasting relief I ever had was during the last 5 months of my pregnancy. (I’m not pregnant now.)
I’m taking Relpax 40 mg. and it works 90% of the time. My problem is, the migraines have been coming back daily at almost the same time every night. Maybe due to allergies? (It’s Spring and EVERYTHING is in bloom right now.) I’m considering going to an allergy doctor to find out what I’m allergic to, and see if I can get some type of shot to avoid the allergic reactions (that may cause my sinus problems), then trigger migrains. Have you ever heard of that working for anyone? After reading your blog, however, I now wonder if rebound is my main problem.
July 22nd, 2008 at 5:43 am
I’ve just read a wonderful book called “Heal Your Headache: The 1,2,3 Program” by Dr.David Buchholz, MD. You can read the reviews on Amazon.com. People rave about it. Dr. Buchholz is a neurologist at Johns Hopkins and has been dealing with people with headaches for years. He seems to see amazing results with his plan. It’s based on three things: 1) getting off all medication, 2) diet (a major trigger) and 3)safe pain meds (only if necessary and he states most people don’t need this step). I’ve been following the book for almost three weeks now and I have great hope. It can take a couple of months to begin to see the results but people say it truly works. Dr. Buchholz also states that he believes almost all head and neck pain is actually a form of migraine (including so-called tension and sinus headaches). I recommend this book.
September 1st, 2008 at 7:50 am
I was lucky to have very few headaches until about 4 years ago, when I was 38. I started having migraines once every other month until I contracted meningitis. Unfortunately, that triggered daily migraines. I had no idea there were so many other people that have daily migraines, as well. This site has helped me find some hope that maybe something will help. It’s so depressing to wake up every day and go to bed every night with something that hurts so much. As scary as it is I am going to try to cut my meds (hydrocodone & advil) to see if maybe I’m suffering a rebound which is making my underlying problem worse. Best of luck to all of us getting some relief.
November 9th, 2008 at 3:22 am
I have suffered from cluster headaches for 35 years. It wasn’t until 2001 that I started taking Imitrex. My cycles would usually be every other year and last about 4 weeks. I was taking Imitrex (50mg) at least 4 times per day. Imitrex really worked for me but I started to notice that my headaches would come back right after the pill wore off. When I wasn’t on Imitrex, the headache would come at night, last 45′, then go away for about 4-5 hours.
I went into remission in 2004 until now. Started taking Imitrex again but noticed that after about two weeks (at least 40 pills) they were not working as well.
My cycle ended and now I was getting these dull headaches that would last all day, EVERY DAY. I would take an Imitrex which would work, but 6 hours later, the pain returned.
I now believe these to be rebound headaches. I tried Advil believing that these were on the “safe” list, but have now discovered they are not. So……….I will try to go Cold Turkey and hopefully these will go away.
November 11th, 2008 at 2:19 pm
Linda – it sounds like yours are rebound headaches caused by the Relpax. Try taking Claritin D daily to see if that broke the cycle. It broke mine but after three months my migraines came back and I made the mistake of taking Relpax again (40mg)and I got the rebound headaches back. They are more like transformed headaches and they end up becoming migraines. They start in the back of my head and go to my forehead/temples/cheeks/neck/sholders and end up making me nauseated. Nothing kicks them other than what they are asking for (Relpax)…
December 3rd, 2008 at 7:54 pm
I have been suffering from daily headaches for 10 years. I used to take excedrin which was successful,but Recently my headaches are worsening that even triptans recommended to me by my Dr. doesnt work. I have read about dehydroergotamine as the good headache reliever helping withdrawal to daily medications for rebound headaches. Please advise me.
February 24th, 2009 at 3:37 pm
I have done accupunture for my migraines with varying degrees of success, but they definely reduce the severity of the pain. They are at least tolerable after the treatments. But it is expensive and I need to do it every 2-3 weeks to keep it successful.
March 29th, 2009 at 3:43 pm
Has anyone tried Tramadol for rebound headaches caused by opiates (eg, Hydrocodone)?
April 13th, 2009 at 10:01 am
I have had back pain followed by back surgery for the last 3 to 4 years. I routinely take Lorcet. I have developed SEVERE headaches, with a sensitivity to light when I have them. Nothing seems to do more than dull the headaches. Could they be caused by my Lorcet usage and how do i stop them (or at least reduce them to bearable level)?
June 30th, 2009 at 3:52 pm
I can’t believe this. I have been taking Hydrocodone for about a month now and I have been having the most painful headaches! I was getting to a point where I was so scared that I went to the hospital thinking that I may have had increased intracranial pressure but my ct scan was perfectly normal. I think it’s pretty ironic that this medication is supposed to be helping with pain but in fact, is causing it. Not to mention that even went to a Neurologist and got my eyes checked out and everything was still normal. I’m glad I stumbled upon this website because it does make me feel somewhat better.
July 1st, 2009 at 10:17 am
I was receiving Social Security Disability Benefits because of the severity and frequency of my migraines. My Migraines decreased about 80% with Cryoneuroablation, also known as cryoanalgesia or cryoneurolysis this was performed by a Doctor of Medicine who is an Anesthesiologist and Pain Specialist. First I was placed on a low dose of Methodone daily to lessen the frequency of the migraines and over the course of 4-6 weeks after my doctor carefully studied the nerves in my face and head that were causing my migraines she treated them with this method which was a huge success for me and of course I was weaned off of the Methodone. I have tried everything under the sun and the only thing that worked was this treatment that most Neurologists have no idea what it is about. Find an Anesthesiologist/Pain doctor in your area!!!
and check out: http://www.painphysicianjournal.com/2003/july/2003;6;345-360.pdf?PHPSESSID=b76e322715badee...
July 19th, 2009 at 8:46 am
I’ve been using Imitrex for the past five years and it’s been awesome for me. However, my frequency has also increased so that I’m having migraines/headaches 2-3 times per week and thus using up my prescription of nine per month every month. I was following what I thought was a safe diet (cutting out the standard and other triggers, including legumes, red wine, chocolate, bell peppers, onions) so that I could try to pinpoint what was causing the next migraine (I now keep a headache journal). Though I could find a cause for most of my headaches, I now think that many of them were rebounds. Thinking of how fast Imitrex works, it makes sense that rebound could be an issue.
I read Bucholtz’s book and the bit about threshold levels made sense to me. He also thinks that triptans are a 1-2 times per month medication because of their strong rebound potential. Around the same time, a nutritionist-friend suggested that my diet was too restrictive and that by eating the same foods all the time I wasn’t getting enough diversity and enough nutrients to reduce my threshold level. She examined my diet and made some radical suggestions: eliminate cow’s milk, dairy, corn, pork and gluten (to name a few, which she said
were all high allergens), and increase intake of fruit and vegetables (5-7 servings per day, I think). I was having cow’s milk and gluten on a regular basis (1-3 meals per day), so I decided to eliminate those, and I now have fruits or
vegetables at every meal and in snacks. She also emphasized exercising more.
I’m not actually completely off gluten (I still have crackers, for example), and it’s only been about a month or so, but I’ve already seen a dramatic drop in my frequency. I think it’s early yet, for me, but for the first time I’m quite optimistic that I’m going to permanently decrease my migraine frequency.
(In this time, I also identified a bonafide rebound headache — it just felt different than the others — and I had to resist taking Imitrex to try to break the cycle.)
I want to encourage others out there to see a nutritionist and try something radical in your diet. Maybe together you can identify something you’re eating regularly that’s not on the standard triggers list but ultimately keeps pushing you over your threshold? Maybe it’s a combination of things?
I realize that diet isn’t the trigger for all headaches, and maybe it’s not for yours, but I’ve long had a connection with it, so this is really for those who’ve established a dietary connection.
I wish us all headache-free days.
Daniel
October 20th, 2009 at 9:23 pm
I’m very skeptical bout this rebound thing..my h/a and migraines, neck spasms don’t occur at all when the barometric pressure is low so where is the rebound? Or does it not occur right away? I’m in agreement these drugs aren’t the answer and I’m gonna give it 100% effort to go clean BUT when are we going to be offered a better alternative? Huh? There is a procedure for cutting the nerves that cause migraines but after 6 yrs I still can’t find a doctor who knows about it That’s bcuz I’m in ABQ, a one horse town.
Anyway, most doctors are quick to say get off the drugs but have no appreciation for what it will take to do so and the doctor’s I’ve seen don’t care, either. They’d rather blame me for my pain than try to find the cause. It doesn’t matter that I’ve told them all that I had the head pain before I ever started taking the pain-killers..hello!
They just don’t want to help, period, if it means they have to strain a brain cell to work with me in finding a cause/real remedy or cure. I am very angry and disgusted. And when I told the neuro doc that I had no one at home to help me through the pain when I quit the Oxy, he said that was an excuse! OMG! What an idiot! Aren’t there any human doctors anymore?
November 13th, 2009 at 10:47 am
I’m 25 and have been suffering from so-called migraines since I was 14. I have progressed up the list of meds from OTC painkillers, up to imitrex, and percocet. I know what the cause is, and I honestly believe it is the same cause for 90% of sufferers out there. There is a doctor called Dr. John E. Sarno, who has written many bestseller books on chronic pain, including migraines. He explains how frightening buried emotions, from childhood through adulthood, cause our bodies to defend acknowledgement of these emotions with distractions such as pain. Very interesting,and on the dot. I recommend any pain sufferer, especially us migraine sufferers, to atleast give it an honest chance.
April 1st, 2010 at 2:11 am
I have just completed a three month detox of all pain meds as well as caffeine, decongestants, sleep meds and anxiety meds. My neuro said that they can all cause rebound headaches since your brain reads them the same. I had been on most of the migraine meds listed by others and was avoiding taking the Perkaset or otc meds often so I wouldn’t get rebound, but I didn’t know that I could get it from Imitrex or the sleep and anxiety meds.
After going through some withdrawls my migraines were reduced from every day to about every other day. Then I’d have a good week, then a bad week. Then this woman told me about drinking alkaline ionized water so I tried it. It has been a couple weeks, but every time I start to get an aura or mild headache I down two glasses of the water and I haven’t had a migraine since. It’s worth a shot if you’re dealing with this daily like I had been….and like I pray to be done with!
Thanks for posting this info. I see my neuro tomorrow and just was looking for info to verify what he told me about rebound headaches.
April 1st, 2010 at 4:20 pm
I am going on 9 hours of ice pick migraine pain. My third headache this week. Two different triptans along with tramadol. I just want to give up.I have tried everything. Diet has no effect on me.Weather, allergies and exercising trigger mine with some messed up hormonal imbalance. No Dr. can help me.Over 24 years of suffering.I can tell this one will last for days. Now that I have vented I will wrap my freezing body with a blanket and get back in bed.
April 1st, 2010 at 4:23 pm
Oh, by the way I have also used subliminal miraine tapes and regression therapy cd’s, relaxation,meditation, yoga and believe that they may be effective for some. But so far, nothing has helped me.
May 6th, 2010 at 5:28 pm
After a messed up surgery with continued problems that left me in under continued doctors care, PT and more surgery and pain meds I had two years straight of migraines before I was diagnosed with rebounds. My doctor and Neuro put me on Topamax, Nortrypline and Butterbur, while removing me from all pain meds for six weeks. It was an unpleasant six weeks and there were times that I felt that they were crazy but the end result was being almost free from headaches. I had another round of surgeries recently with another round of pain medication and am just now again facing rebounds. It is not a welcoming experience to look forward to; not being able to take pain medication when you need it, but neither is swapping one pain for another one justified. Sometimes life is not fair but at least with sites like this we are not alone and we have answers.
Thanks for all of the great comments and for all of you that all having so much trouble-hang in there.
June 1st, 2010 at 3:41 am
coffe enemas will abate headaches very quickly and the coffe does not enter the bloodstraem and does not cause the rebound effect. I am doing one twice a day to get off advil and excedrin for 4 days now and the headaches are abating. I will see how long it takes.
July 7th, 2010 at 8:40 am
Hi,
I too have been suffering with chronic almost daily severe-migraine headaches…sometimes I throw up. I have gone off all analgesics since May 5, 2010. I didn’t realize though that anti-anxiety meds could cause the rebounds as well, however I am a single mom and have to work so I have been taking 1/2 to 1 clonapen (sp?) everyother night otherwise I’m a zombie the next day. I am getting very depressed and isolated from these migraines as all I can do is go to work and then go home. I have tried many drugs i.e. depakote, lyrica, maxalt, immitrex, ferova…for years and after reading the Mayo Clinics website I am off everything but my headaches still are bad. After two months am I still having rebounds? Sometimes I think that my life isn’t worth living with this constant pain. I went 4 days without a headache and then yesterday after a hayfever attack, I got a bad one…still have it. I am currently in acupuncture and yesterday it made my headache worse. I’m exhausted. These postings help me feel I’m not alone.
Thanks and any ideas/sympathy would be greatly appreciated.
July 22nd, 2010 at 8:55 am
Hi, I’ve had a headache for 2 months now and they think it might be caused by a bad chiropractic adjustment. Had a CT scan that showed nothing and have an MRI (angio?)scheduled for next week.I’ve been prescribed so many meds, including imitrex, flexeril, butalbital, phenergan, toradal, reglan, norco 10-325, and now elavil. the only thing that helped was the norco, which i took for a month. i started with 6 tabs a day (about 5 days)and slowly weened off of it. i haven’t taken it for 2 weeks but am wondering if it could still cause a rebound headache. i’m only taking the elavil now and my headache feels like it’s getting much worse. any ideas?
July 27th, 2010 at 1:24 pm
I feel for all of you. Imitrex and excedrin caused me to have rebound headaches in 2004. Searching the internet led me to that diagnosis. I picked a weekend to stop cold turkey. Suffered the worst headache of my life. Do a search for rebound headaches and you will see it takes 3 – 6 months to finally free yourself completely. What got me through was naproxen (much safer than ibuprofen and acetaminophen) and caffeine. You can buy caffeine pills over the counter at Walmart. Take 1/2 at the first sign of a headache with an alieve. That’s what got me through ( or drink a cup of coffee – but it’s true you have to watch the caffeine intake as well). I don’t recommend cold turkey. Much better go to your doc and let them help you wean off whatever drug you are rebounding on. I think Excedrin and Imitrex are highly dangerous drugs and please don’t take them more than once or twice a week. Hang in there, keep researching – somewhere is a cure that will work for you. Mindful prayer will hopefully lead you to your answer. God Bless.
August 18th, 2010 at 10:23 am
I have been a headache sufferer for a long time. My sister has diagnosed clinical migraines, and my mother suffered from cluster headaches for several years.
Recently, my headaches became worse, more constant, and began affecting my vision to the point where I had tunnel and double vision. CT scan ruled out any tumor, and my PCP recommended that I see my eye doctor. The opthamologist discovered papilledema (swelling of the optic disk/nerve) which after a Lumbar Puncture (Spinal Tap), was diagnosed as Pseudotumor Cerebri. My body is producing too much spinal fluid and it’s pressing on my optic nerves.
I had been taking Tylenol religiously every 4 hours, sometimes up to 12-500mg capsules a day. Eventually I diagnosed myself with rebound headaches and stopped taking Tylenol altogether. Now I no longer have headache spikes when the Tylenol wears off, just a constant ache. I’m afraid to take Advil because I don’t want the rebound cycle to begin again, and cannot take asprin or naproxen as it interacts with other medications I’m taking to reduce spinal fluid production.
So far, my neurologist has offered nothing to me in the way of pain (or stress) management, other than repeated lumbar punctures (every 2-4 weeks) to drain away excess spinal fluid.
August 28th, 2010 at 12:34 am
I am wondering if this is my problem. I get headaches nearly everyday and they always start with my shoulder blades or neck and spread up to the back of my head. Sometimes it gets so bad that I feel like I’m being hit in the back of my head with a bat and it hurts every time I move. My mom also gets headaches and she has started to up her doses on diff meds and I don’t want to end up with liver or kidney failure from taking pain meds everyday. We are both cola drinkers about 2 liters a day but I am attempting to stop to see if maybe they will go away. At first the headaches got worse but now it seems they are getting better I have actually went about 4 days without any pain killers and hopefully I can stop taking them so often. I haven’t went to the doctor because I don’t have insurance but I am glad I found this page and maybe that was my problem… too many sodas and painkillers.
September 25th, 2010 at 4:11 pm
I have been experiencing headaches for all my life and in the last year they have suddenly gotten out of control. Does that mean that I suddenly and abruptly have rebound headaches? No, it’s called something has physiologically changed in my body. I have the great news that none of the prophylactics that I have tried thus far have worked except for Lyrica (47 different ones). Lyrica makes me angry and feel like I am no longer on planet earth. Because you took a lot of a medicine and it made you have more headaches does not imply that every person and drug that a headache sufferer takes causes rebound headaches. In fact rebound headache is a physicians assertion that they don’t know what the problem is, but there needs to be a reason, and sometimes people really just have headaches due to psychological reasons as opposed to physiological reasons. Then the studies show that maybe ~50% get better and the rest remain in the same state or are worse off than they were before. Rebound headaches are a way to tell someone that the doctor has no clue. Label it give you a new drug thats really expensive, Next. Then you have the DEA who says that every medicine in the world that might help a person in pain is so bad that if you take them you are an ADDICT. You know what I say. Unschedule drugs and take the power away from the doctors because most of them are like the mechanics that work at a GM Dealership (they don’t know what there doing and they really never fix the problem), Let people make there own decisions and if they die because there to stupid to ask questions or do reserch (which will happen tomorrow, today or some other day!) then let them. But don’t come up with the most unsupported claim in medical history and claim that every medicine that a person can take for a headache can cause rebound headaches. Because then what happens is people like me have to suffer for years and years until some non-idiot Dr. realizes that I just have a physiological deficiency, writes me a script and then suddenly no more ER visits and a week of being pain free which is weird…
February 3rd, 2011 at 7:26 pm
I was told by my headache specialist (very well known doctor in Chicago clinic) that NSAID’s do *not* cause rebound headache… rebound headache is a phenomena associated with opiates and analgesics. So I have been taking a lot of indomethacin (prescribed by my doctor) and they work pretty well for most headaches… but I use them daily, almost as a preventative. Now that I’m out of indomethacin, I’m having headaches again. Not severe, but debilitating enough. I am also on prophylactic therapy of Amiltriptyline, Zanaflex, and Bystolic (evening) and Prozac (morning). With all these doctors with different opinions, I have no clue what is true.
February 13th, 2011 at 4:26 pm
Totally fed up with 3 weeks of headache and visual disturbace of left habnd side. on oxcontin, baclofen,tramadol and fluxetine. Have shoulder problems and fibroymalgia. Drs keep saying rebound, not migraine? Dont give me any advice on what to do? any suggestions?
March 17th, 2011 at 10:46 am
Reading your comments helps me, I have had migraines for over 10 yrs. started at menopause and empty nest, both terrible! So, I have major guilt with headaches, as if I’d wish them for myself! They are from hell! I have begged to die in the midst of them. Since I started Imitrex, 5 or so yrs. ago, they are usually easier, but the “hang over” is miserable. I agree that no one really knows about migraines cause. I have aureas and intense ringing in my ears. I pray and offer my pain up, and I make myself go on thru the day, but it is very hard. So, all of you who suffer are in my prayers.
March 20th, 2011 at 5:35 pm
ahh the rebound. With vicodin,Oxycotin, morphine etc. I find Norco to be the least rebound causing in the group, telling me that the Tylenol in the pills causes it mostly.
A helpful tip to reduce the the chance of a rebound is to take a couple antihistimines before bed. vicodins etc seem to clog the blood flow and sinus.
March 20th, 2011 at 5:37 pm
Oh, my experience is from having headaches every day of my life for over 35 years.
May 12th, 2011 at 11:34 am
I have been having headaches continuously for over a year. i wake up in the morning with a horrible congestion in my upper nose near my eyes. i have been to dentists took a whole tooth thinking it might be the reason, then went to ENT doctors did CT scan and it didn’t show any sinus. the headaches are too strong i feel helpless, they stay for 4-6 hours and no pain killer is working, and no doctor can give me an answer as to what to do. . if it is not sinus, and it is not the teeth, and it is not the eyes and all the test i did show that i am healthy, what is the reason?? and by the way no pain killer is working as well, when the headache starts it will take its time. and it all starts with a very dry nose when i breath i feel like i breath a desert air hot and stuffy then i feel my nose at is congested but i cant sneeze . some headaches have no solution it seems
June 20th, 2011 at 8:55 am
I had a migraine with almost every menstural cycle until I got pregnant, and it stopped. It start back with peri-menopause and now I am post menopause. I have been on Imitrex and Amerge and Zomig for 4 yrs. Ins. will only allow 9 pills a month so I cut them up in quarters to make the pain TOLLERABLE only. A whole one wipes it out but then I run out of pills and want to die. Both my sisters are going thru the same thing. I have been on bio-identical hormone therapy for a year now with no relief. My sisters have tried eating nothing but fresh fruits and veggies for months with no relief.
I am a widow living on disability, no savings AND raising a 11 and 13 yr old still.
Misery is an understatement.
Neuro says it’s rebounds but what was it before the rebounds? My sisters still have them without the meds too.
ReBound, baloney I say……….
I want to die, I am no help to my kids this anyways, so what’s the diff?
Nobody about have said what has truely helped them long term. It is all maybe this maybe that which none work.
I want to die.
June 20th, 2011 at 9:10 am
I had a migraine with almost every menstural cycle until I got pregnant, and it stopped. It start back with peri-menopause and now I am post menopause. I have been on Imitrex and Amerge and Zomig for 4 yrs. Ins. will only allow 9 pills a month so I cut them up in quarters to make the pain TOLLERABLE only. A whole one wipes it out but then I run out of pills, in excruiating pain and want to die. Both my sisters are going thru the same thing. I have been on bio-identical hormone therapy for a year now with no relief. My sisters have tried eating nothing but fresh fruits and veggies for months with no relief.
I am a widow living on disability, no savings AND raising a 11 and 13 yr old still.
Misery is an understatement.
Neuro says it’s rebounds but what was it before the rebounds? My sisters still have them without the meds too.
ReBound, baloney I say……….
I want to die, I am no help to my kids this anyways, so what’s the diff? They won’t have to agonize watching me suffer anymore.
Nobody above have said what has truely helped them long term. It is all maybe this maybe that, which none work. Makes you wonder what people did before pain killers were invented.
I guess they died.
I want to die.
***********
I’m sorry you’re having such a hard time. Please remember that your children love and need you no matter how sick you are. I’ve sometimes thought that dying would be better than living with chronic migraine, but I can’t let an illness defeat me. There’s always hope for improvement.
Talking to other people with migraine is often the most comforting, life-affirming way to cope. I can’t recommend visiting a forum highly enough. Migrainepage – http://migrainepage.forumotion.net/f1-migraines – helped me through my darkest times. HealthCentral is also a popular forum.
Some other thoughts:
The Migraine Brain by Carolyn Bernstein is an excellent resource on the sorts of lifestyle changes that can help migraine — she also explains the pathophysiology of migraine and treatment options. Most libraries seem to have it. I found it tremendously helpful and comforting.
Your comment about your sisters eating only fruit and vegetables caught my eye. Eating enough protein is very important for migraine. Dr. Bernstein was my headache specialist when I lived in Boston and she told me that protein was more important for migraineurs than even vegetables. I have a friend who aborts migraines by eating a roast beef sandwich.
You probably know that Imitrex and Amerge are both available in generic, but I wanted to point it out just in case. They are still expensive as generics, though!
I’ll stop throwing advice at you…. Please take care of yourself the best you can.
Kerrie
July 11th, 2011 at 11:38 pm
Does a rebound headache ever feel like (my version of) a migraine, with pain just on one side of the head and in specific points (above and below the eye, for me)? I’m on day 12 of a bad migraine and I’m wondering if it could be a rebound, but it doesn’t feel like a tension headache…it feels like a migraine. Thanks to all of you for your insight!
August 30th, 2011 at 11:33 pm
I hate pills and hardly take them unless I have too, usually when I have a headache I take a short nap or work through it, but since I’d had Meningitis, my doc told me I would get migranes now and then.. I have had a couple since then.. (that was three years ago) about 2 months ago I had such a bad headache I startd taking excedrin, and when those started hurting my stomach I switched to acetmet.. tylenol.. any ways I went to the hospital because my head felt like it was splitting in two, I have two kids and I can’t even function.. the doc said rebound headaches.. and he told me all of what you all said.. only he said I can’t take nothing for it at all.. he gave my regelin for my stomach he said I would need it for withdrawls from the otc drugs.. thing that get’s me is how could I react to the excedrin like that if I hardly ever took it befor, and does it EVER GO AWAY??? I have been off everything for 2 weeks now, and my head still hurts. Why now? I woke up one day two months ago with a head ache and because I took two excedrin (the first two i have taken in months) I get a rebound headache? Sorry, it fells good to get some of this frstration out.lol any advice?
September 12th, 2011 at 3:37 pm
hi group –
my doc told me to look into rebound headaches as a possible answer for the terrible episodes i’m having. the pain sounds like what a lot of you describe, complete with shortness of breath and nausea.
i take opiates for a chronic nerve pain issue that has nothing to do with the headaches. i take an extended release morphine, 2x/day, and i have another ‘scrip for immediate pain relief – for my arm, not my head. (of course, the pill doesn’t know, but still….)
so, i don’t know that i’m having rebounds since i’m not off the meds. i take 30 mg extended release 2x a day.
any thoughts on this??? thanks!
evi
November 30th, 2011 at 11:01 pm
I think there are a lot of great stories and helpful advice on this blog- I felt compelled to speak to Becky’s question about taking 2 OTC tabs and her know it all er doc telling her she has rebound h/a’s! I say, I know this is late but, get a second opinion! I hope you did not have to pay for that advise- maybe he did not hear what you said maybe he was popping his gum too hard to hear you! Seriously- I’m no Doc but that does not make sense!
Personally, I am planning to stop taking the Vicodin I have been taking since darvocet was pulled from the shelf’s and I told my ARNP to talk with the doc and please figure out a plan! It scares me because I don’t have many vicodin left-2 I think and my
prescription is up. But I told her I’m having rebound headache- this is a pain mmgt doc- they referred me to a neurologist- he does Botox injection- has anyone had any luck with this?
Joan- I know how you feel wanting to die- my headaches get like that too especially when they jeprodise my employment like they are doing now. Consider the possibility that there is another way – we must assume responsibility for our own health- doctors don’t know all they PRACTICE medicine. Think how your headaches were before the meds- are thy worse now? Could be rebound- just exercise your options to heal- we all have the ability and when we have children we have the responsibility to re-spond rather than re-act. You have much to live for even if it is just to show the kids that hope is greater than pain.
Evi- rebounds happen even if ( or especially when) you take mess everyday, I wish you luck with your migraine health.
I wish everyone here pain free days and feel a special bond with everyone of you.
January 30th, 2012 at 10:49 am
I just had my first Botox injection for migraines. It was a miracle! Went from basically headaches daily to four for a three month period. Then I could not get in for my next round at the scheduled three month time and had to wait for almost three weeks– crushing headaches everyday. Had one the day of my injections — that was almost two weeks ago, and the headaches have still not abated. My regular doc told me once pain sets in it takes weeks– sometimes months to abate — and I am hoping this is the reason this second round so far has not been as successful. I fully understand the sensibility of preferring death to life like this– as this is no life— this chronic pain robs you of everything. However– I would strongly urge all of you to try Botox. I am going to continue w/ this treatment. My insurance is covering it– but even if it didn’t– I would pay for it— I do believe so far Botox for migraines has been the best hope I’ve seen. And isn’t it true and just awful that we seem to be blamed for our pain?
*******
I’m so glad your first Botox injections were so successful. I hope that the headaches following the second injections abate soon and that you achieve relief again!
Take care,
Kerrie
January 30th, 2012 at 11:03 pm
I don’t usually get migraines but I do get very painful headaches that last for days. They’re uncomfortable to begin with; as the days wear on and my jaws start to ache from the pain they keep me from sleeping and make me feel exhausted, irritable, and stupid (they’re definitely correlated with a drop in cognitive function).
NSAIDs work well for me if I take them infrequently. When I have an intractable long-running headache and start taking NSAIDs more than 3x a week, I get what I assume to be rebound headaches. Or maybe the headaches are just that intractable.
I’ve found that taking niacin until I flush (250 mg for me) interrupts the headache for several hours, and when it returns I’m in much less pain, have more energy, and the brain fog dissapates. My naturopath said she’s seen this phenomenon in other patients. There are contraindications for niacin, so if you want to try this check it out with someone knowledgeable first.
********
Thanks for the tip. I’ve never heard of using niacin for headaches. I’m glad you’ve found some relief for your headaches — best wishes for further treatment.
Kerrie
January 31st, 2012 at 7:19 pm
I have post herpetic trigeminal neuralgia. I am on high doses of Lyrica & Carbitrol, neurontin. I take prescription painkillers when I have a relapse of the really severe intense pain. Last year I had rebound headaches from Percocet. My neurologist said she drinks caffeine at the 1st sign of a migraine, now I read that is a bad idea. My PCP told me to drink strong coffee. Now I am scared to death of medications making things worse. I just took oxycodone because the pain has returned and is truly unbearable. I wish someone knew of something else that works that will not cause rebound headaches..
********
Caffeine at the first sign of a migraine can be a good abortive; drinking it regularly is the problem. Unfortunately, I don’t know much about your kind of headache and don’t know the medications it responds to. Definitely talk to your neurologist about painkillers. Wish I could be of more help.
Take care,
Kerrie