Chrys asked
I have chronic headaches. Could OTC pain meds cause rebound headaches? Which medication is most effective without rebound?
Answer
Over the counter pain medications, like Tylenol (acetaminophen) and Advil (ibuprofen), can cause rebound headaches, but not as commonly as many prescription drugs (e.g. barbiturates, opioids). Rebound headaches from analgesic use is sometimes referred to as "medication overuse" headaches.
Over The Counter Analgesic Rebound Headache
Who exactly is more susceptible to rebound headaches and how long you need to take a medication for them to occur isn't well known. When it comes to over the counter analgesics (e.g. acetaminophen, ibuprofen), some sources state that you are at risk for rebound headaches if you take them for the acute treatment of headaches for 15 or more days per month, for three months or more.
Acetaminophen and ibuprofen both appear to have a similar risk of causing rebound headaches in individuals. Combination analgesics, such as Excedrin (acetaminophen, aspirin, caffeine), do appear to be a little more risky according to some studies.
The treatment for medication overuse headaches is to stop using the offending medication, however this can certainly cause withdrawal symptoms such as:
- Worsening headaches
- Anxiety
- Nausea and vomiting
- Insomnia
Acetaminophen and ibuprofen typically do not need to be tapered and can be stopped abruptly. If you do get withdrawal effects, they usually last two to ten days. If they are particularly troublesome, your doctor may recommend a short course of steroids, like prednisone or methylprednisolone.
If you have chronic headaches which necessitates consistent use of over the counter analgesics, it is important to speak with your doctor for a proper treatment plan.
Summary
- Over the counter analgesics, such as Tylenol (acetaminophen) and Advil (ibuprofen) can cause rebound, or "medication overuse" headaches with prolonged use, although the risk isn't as high as with many prescriptions
- Combination analgesics, such as Excedrin appear to have a higher risk of rebound headaches that single ingredient acetaminophen/ibuprofen products.
