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Rebound headaches, also known as medication overuse headaches, occur when pain medications (analgesics) are taken too frequently to relieve headache. Any painkiller can cause rebound headache. Over-the-counter agents such as Excedrin, Tylenol and Advil can cause rebound headache. Prescription medications such as Fioricet, Fiorinal, Imitrex and Vicodin can cause rebound headache. The medications most likely to cause rebound appear to be the combination analgesics such as Fioricet, Fiorinal, and Excedrin, as well as narcotic medications. Rebound headaches frequently occur daily and can be very painful. They are a common cause of chronic daily headache. They typically occur in patients with an underlying headache disorder such as migraine, that "transforms" over time from an episodic condition to chronic daily headache due to more and more frequent analgesic use.


Rebound headache is common and can be treated. The pain medications must be stopped in order for the patient's headaches to resolve. This is usually done under the care of a neurologist. Often patients are started on preventive medications to ease their transition off their painkillers.


In general, any patient who has frequent headaches should be considered as a potential candidate for headache preventive medications instead of being encouraged to take more and more painkillers. Preventive medications are taken on a daily basis. Some patients may require preventive medications for many years; others may require them for only a relatively short period of time such as six months. Effective preventive medications have been found to come from many classes of medications including neuronal stabilizing agents (aka anticonvulsants), antidepressants, antihypertensives, and antihistamines. Some effective preventive medications include Elavil (amitriptyline), Depakote (valproate), Topamax (topiramate), and Inderal (propranolol).


The phenomenon of rebound headache was first described by the actress Lisa Kudrow's father, Dr. Lee Kudrow. PMID: 7055014 (Adv Neurol. 1982;33:335-41)

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