migraine headache medication
Migraine Headache Medication
The Sure Path to Becoming a “Failed” Headache Patient
Many headache and migraine sufferers go from medication to medication and doctor to doctor without relief. These patients are known within the medical community as “failed” patients. What many doctors may not realize is that many of these “failed” patients are actually suffering from rebound headaches. Many doctors do not know that any preventative program will fail as long as a patient is experiencing rebound effect. Any person taking the following medications more than two days per month is likely to be experiencing rebound headaches:
- Pain Medications Containing Caffeine: Excedrin, Anacin, Vanquish, B.C. Headache Powder, Fiorinal, Fioricet, Esgic Plus, etc.
- Decongestants: ALL – over the counter and prescription.
- Opioids and related drugs: Ty6lenol plus codeine, Percocet, Darvocet, Stadol NS, OxyContin, Ultram, etc.
- Triptans: Imitrex, Amerge, Zomig, Maxalt, Axert, etc.
- Ergotamines: Ergomar, Wigraine, Migranal, and D.H.E. 45.
- Butalbital Compounds: Fiorinal, Fioricet, Esgic Plus, Phrenilin, etc.
- Isometheptene Compounds: Midrin, Duradrin, etc.
If the above sounds like you, rebound is a strong possibility. Remember-always discuss discontinuing medications with your doctor as many of the medication above can have severe withdrawal conditions that may require medical supervision. However, the only known way to eliminate rebound headaches is to discontinue the drugs that cause them.
How does rebound occur? It depends on the medicine. In the case of medicine which force inflamed swollen blood vessels to constrict – when the medication wears off the vessels swell up again. The technical term for this condition is rebound vasodilation. Rebound vasodilation can occur with any drug that constricts blood vessels including decongestants and triptans. Pain killing drugs like opiates create rebound through a different mechanism. These types of drugs work by binding to specific receptors – this causes your perception of pain to fade and when the drug wears off, the pain returns. If this type of drug is used too frequently, one’s receptors become used to being bound. Once this happens, one will experience pain – which is really your receptors craving the drug.
For the reasons above, it is recommended to only use rebound causing drugs two days per month at most. For obvious reasons, this advice applies primarily to people who experience infrequent headaches or those who have pain levels that can be adequately managed through other means. What happens if you have frequent severe headaches? This situation is more difficult. If you are able, consider using medications less likely to cause rebound and also pursue methods of migraine and headache prevention by avoiding triggers. Other headache and migraine sufferers also work to rotate medications to decrease how many days certain medications are taken in succession. As always, these are options to discuss fully with your doctor.
Withdrawal from rebound causing medications can be very unpleasant. Many people experience an increase in headaches over a few days to a few weeks, depending on the person, what medication was taken, and for how long. While working with your doctor to reduce your dependency on medication, you should know there are two options – stopping all at once (not safe without speaking to your doctor first as certain drugs like butalbitals can have serious withdrawal effects like seizures that will require medical supervision) or tapering off. Tapering off should work for anyone who is sure that they will work to continually minimize intake. Some of you reading this know that you may be so dependent on the pain killing fix that you may not be able to “taper off” in actuality. Talk with your doctor to devise a plan and see if stopping all at once is feasible. Remember, once you end your dependency on rebound causing medications you should not take them in excess of two days per month (no excuses) ever again or you will end up in exactly the same position as you are now.
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