Signs and symptoms of rebound headaches may differ according to the type of original headache being treated and the medication used. Rebound headaches tend to:
- Occur every day or nearly every day, often waking you in the early morning.
- Improve with pain relief medication but then return as your medication wears off.
Other signs and symptoms may include:
Nausea, Listlessness, Restlessness, difficulty concentrating, memory problems, Irritability etc.
Seek immediate medical care if your headache:
- Is sudden and severe.
- Accompanies a fever, stiff neck, rash, confusion, seizure, double vision, weakness, numbness or difficulty speaking.
- Follows a head injury.
- Gets worse despite rest and pain medication.
- Is a new type for someone older than 50.
- Wakes you from sleep.
Rebound headaches can develop if you frequently use headache medication. Although the risk of developing medication-overuse headache varies depending on the medication, any acute headache medication has the potential to lead to rebound headaches, including:
- Simple pain relievers. Common pain relievers such as aspirin and acetaminophen (Tylenol, others) may contribute to rebound headaches — especially if you exceed the recommended daily dosages. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) have a low risk of contributing to medication-overuse headaches.
- Combination pain relievers. Over-the-counter (OTC) pain relievers that combine caffeine, aspirin and acetaminophen (Excedrin, others) are common culprits. This group also includes prescription medications such as Fiorinal, which contains the sedative butalbital. Butalbital-containing compounds have an especially high risk of causing rebound headaches, so it`s best not to take them to treat headaches. If you do take this type of drug, limit its use to no more than four days a month.
- Migraine medications. Various migraine medications have been linked with rebound headaches, including triptans (Imitrex, Zomig, others) and certain ergots — such as ergotamine (Ergomar, others). These medications have a moderate risk of causing medication-overuse headaches. The ergot dihydroergotamine (D.H.E. 45) appears to have a lower potential for leading to this problem.
- Opiates. Painkillers derived from opium or from synthetic opium compounds include combinations of codeine and acetaminophen (Tylenol with Codeine No. 3 and No. 4, others). These medications have a high risk of causing rebound headaches.
- Daily doses of caffeine— from your morning coffee, your afternoon soda, and pain relievers and other products containing this mild stimulant — may fuel rebound headaches, as well. Read product labels to make sure you`re not wiring your system with more caffeine than you realize.
Risk factors for developing rebound headaches include:
- History of chronic headaches. A history of migraines, tension-type headaches or other chronic headaches puts you at risk.
- Frequent use of headache medications. Your risk increases if you use combination analgesics, ergotamine or triptans 10 or more days a month or simple analgesics more than 15 days a month — especially if this regular use continues for three or more months.
