Rebound headaches?

What are some drugs that can cause rebound headaches?

How are rebound headaches usually described? Is it more of a typical headache--throbbing, pulsing, and/or painful--or more of a pressing/tightening sensation?

Just curious. Has anyone here had them, and what was your cause?

So far, the only med that has put me in rebound was Ibuprofen. I was taking it on prescription for pains other than headache. It did nothing to relieve those pains.

Anyone else?

Does anyone get rebound headaches from 1-2 cups of coffee per day, etc?

Oh yeah - I get headaches if I don't have my coffee. That's more of a withdrawal from caffeine I think...?

I have steered away from OTC drugs for ages now, pretty sure I got some yucky side effects from nurofen plus when I was taking it daily - like an afternoon headache. This was back before my migraines really kicked in tho.

Not sure if it's rebound or not cos I'm not sure what that's all about.

I've had some folks tell me on other boards that my 3 cups of coffee per day habit could be a BIG factor in my 7 year 24/7 head pressure, and that the mechanism through which it does so is "rebound headache." Just like you, living, I don't quite understand the logic of it--when I actually do stop caffeine for 3, 4, 5 days straight, THEN I get that "caffeine headache" and it is unpleasant (of the pulsating painful type), but the head pressure is not worse, nor better.

1) I don't understand how you can have a rebound headache from caffeine when you're not in withdrawal from it, 2) caffeine does not relieve head pressure temporarily when I ingest it, nor when I stop using it for a few days. As I have read elsewhere, if you have longterm rebound headache, the aggravating substance will cause temporary relief, in my case this does not happen. I will admit, though, I probably don't know enough about this subject, so for anyone who does, please don't be offended by my ignorance...

The nuero had me stop taking pain relievers for my headaches. No more than 3x week he said (I had headaches pretty much every day). All that did for me was make me more miserable. It did not lower the incidence of headaches. Stopping caffeine (I drink tea but not coffee) made no difference either. So I'm not a big believer in the rebound headache idea.

Some people here have done better by cutting out pain meds, so maybe they had a rebound problem. I can't say. But I don't believe that it is the same for everyone.

Hi Batman,

I'm afraid I have no clue apart from that I make sure I don't miss my coffee. If I miss it, the withdrawal can kick off a migraine - and I'm aware that it's not the lack of coffee causing a migraine, it's just the 'change' that my stupid body can't cope with so I get a migraine. That's not a rebound. That's just a withdrawal from a drug (caffeine) that my body has become dependent on through having it every day- I only have one or two max! If I miss it, I'llh ave the headache by 3pm. Migraine by 7pm. Having coffee by that point won't stop the migraine at all for me. Don't know it if would stop the headache because the migraine would be masking it!

It's not surprising it's hard to figure out what the hell is going on in our heads with 'pressure', 'headache', and 'migraine' to sort through. Rebound, withdrawal, Medication overuse headache - which is, I think, another term for the rebound headache term are just more to add into the confusing mix.

I admit there have been times when I have taken lots of Imitrex in a day, every day, for a week or more that I start to wonder if the next day's head is because of the imitrex - but part of that is conditioning I think. Humans are pretty well set up to believe that whatever we do before 'something' happens is what caused that 'something' to happen. If I take lots of imitrex, and get lots of migraine, I soon forget I was getting lots of migraine anyway, and start blaming imitrex. That's my theory anyway!

I really hope you figure out some triggers so that you can get relief. And I really hope that topamax kicks in and does something for you!

All the best!
Living

I have been getting migraine symptoms every day since November, mostly neurological symptoms (numbness, tingling, phantom odor, tinnitus), but sometimes mild to medium headache as well. I was taking Advil Migraine almost daily since November - sometimes one, sometimes 3 a day. When these symptoms didnt stop I suggested to my doctor that perhaps I was getting rebound headache. She didnt think so.

I did my own experiment a few weeks ago and went off any type of pain med for 2 weeks. Within one week I noticed a significant decrease in my symptoms. They were still there mind you but not as severe.

These past 2 weeks have been extremely stressful for me and noticed my symptoms return with a vengence and with headache so back to the pain meds I went. Hopefully things calm down soon and I'll be able to try going without them again.

Not sure if this was just a coincidence or not but I believe there is some truth to it.

Batman-Its my opinion that for a daily 24/7 headache, not migraine, that coffee at the same amount and same time of day would not cause rebound, only meds. For migraine, it could be a trigger though. For my NDPH, I have tried cutting out the stuff like coffee, aspartame, cheese, dairy, gluten, etc (all at different times)...no help. Thats great Imitrex helps, but yes, that can cause rebound if taken more than 2-3 days a week, assuming you are prone to rebound. Some people think that with NDPH instead of migraine, you aren't prone to rebound. I don't believe I've ever had rebound, but the only meds I've ever taken often enough are Tramadol (years ago), and lately, Methadone. For the Percocet, Excedrin, etc, of the past (combo meds which are more dangerous), I alwasy stuck to the 2-3 days a week rule. I think you are safe with the coffee, but I would spend 2-3 weeks without Imitrex to see if you get a decrease in pain (if at one time you took it daily for a week or whatever, and now you take only 2-3 days a week, you could still potentially be in a rebound cycle and you'd have to stop it to know). Best wishes.

i got rebound headaches from taking to much Amerge. My understanding you get caught up in rebounds when you take too much medicine and it stops working but you still continune to take it. It can happen with pain medication also. I had to stop taking it and go through a horrible withdrawl period.

Dear tortoisegirl,

I think you probably saw someone else mention Imitrex--I personally have never used it. But really now, the whole rebound/migraine/CDH/NDPH thing is getting a bit overwhelming for me now... is there ever such a thing as a "clear" diagnosis when someone has a daily headache?

I have 24/7 head pressure, everywhere around my head, including my neck... I don't have typical migraine pain.. I don't have aura (except for about 4 times a month when waking up in the morning--only in the morning--my vision is a little "odd" for a few minutes, and I feel a bit tingly/numb)... I rarely have nausea, but I *do* sometimes get car sickness, although I was much worse with car/motion sickness as a child (the neuro thought this motion sickness thing was important)...

Does it always have to be NDPH when it's 24/7, and you can only check the boxes for 1-2 classic migraine symptoms?

If other conditions have been ruled out (blood work, ct scan, spinal tap, etc), as far as I know, NDPH is the most likely possibility (assuming criteria such as sudden onset and more than 6 months are met). No, there is not a clear diagnosis. It took me years and dozens of doctors to even here of NDPH. So, I try to mention it online. I was even on this forum and similar in those years. You can also have more than one headache condition (like NDPH + migraine), or NDPH with a migrainous tendancies. A lot of times you and your doctor may think your diagnosis is clear, yet its not. THe good news is that the treatments of different headache conditions aren't that different. Some may be more likely to help certain conditions though. The big difference is that NDPH can be very unresponsive to treatment. I think they've shown relation between car sickness and and headache conditions? I too got car sickness as a child which actually got worse with the beginning of my headache. Yet when I got my stomach problems under control (which began after the headache), the nausea and car sicknesses mostly subsided. Hope my ramblings haven't confused you...hope you find some relief soon and can get some answers too. Best wishes.

tortoisegirl wrote:If other conditions have been ruled out (blood work, ct scan, spinal tap, etc), as far as I know, NDPH is the most likely possibility (assuming criteria such as sudden onset and more than 6 months are met). No, there is not a clear diagnosis. It took me years and dozens of doctors to even here of NDPH. So, I try to mention it online. I was even on this forum and similar in those years. You can also have more than one headache condition (like NDPH + migraine), or NDPH with a migrainous tendancies. A lot of times you and your doctor may think your diagnosis is clear, yet its not. THe good news is that the treatments of different headache conditions aren't that different. Some may be more likely to help certain conditions though. The big difference is that NDPH can be very unresponsive to treatment. I think they've shown relation between car sickness and and headache conditions? I too got car sickness as a child which actually got worse with the beginning of my headache. Yet when I got my stomach problems under control (which began after the headache), the nausea and car sicknesses mostly subsided. Hope my ramblings haven't confused you...hope you find some relief soon and can get some answers too. Best wishes.

From what I've read car/motion sickness is strongly associated with migraine conditions--that was something my neurologist reinforced on me at least. Whether or not it's clearly associated with NDPH also, is not something I've specifically looked at. That's the hope for me, that this condition is "more migrainous" than "NDPH-like", then the preventatives have a better chance of working. But of course I'm sure you've already seen the literature to prove that motion sickness is strongly associated with all chronic headache conditions, just shooting down more of my hopes, as you've done already. It's one thing to state facts, another to show someone there's no room for optimism if they have a daily headache beyond one year. I understand well and good no miracle cure exists for such things, nothing will improve overnight, but remember I've barely even tried ONE treatment, and can use all the hope I can get.

I have suffered (right choice of word) daily pressure type headaches 24/7 for 12 years.
My neurologist said I have transformed migraines and although migraines have become less
frequent the daily headache persists. I do not use triptans anymore (they don't help) and OTC pills .
Amitryptiline 20mg to help me manage the discomfort.

Tried Topamax, too many side effects. Botox no effect.
My blood pressure/puls is normal. ( I am 65 yrs)
I am trying to live with it....no other choice.

Angela

Call me unrealistic if you want... but my ultimate goal is to reverse the 24 hour head pressure from 30 days per month down to 7-10 or something of that nature. I'm aware just how far-fetched it is, but I'm not giving up on that, just yet. Not until I've tried 10+ treatments and exercised some discipline for once, in terms of trying alternative therapies and possibly an improved diet.

At 75mg of Topamax I'm beginning to realize it sucks and I don't want to be on it, and so far it has not helped. However, if it does eventually help, apparently it is one of just a scant few drugs that can reverse a chronic headache.

Batman55 wrote:Call me unrealistic if you want... but my ultimate goal is to reverse the 24 hour head pressure from 30 days per month down to 7-10 or something of that nature. I'm aware just how far-fetched it is, but I'm not giving up on that, just yet. Not until I've tried 10+ treatments and exercised some discipline for once, in terms of trying alternative therapies and possibly an improved diet.

At 75mg of Topamax I'm beginning to realize it sucks and I don't want to be on it, and so far it has not helped. However, if it does eventually help, apparently it is one of just a scant few drugs that can reverse a chronic headache.

Keep trying ....we are all different. I wish you well !

Well, personally I don't think caffeine has much to do with migraines. Maybe typical headaches, but let me re-phrase, I don't think caffeine is the cause of any sort of migraine or migraine condition. I have cut caffeine out completely in the past, to just see if it had any bearing on my pain, and it did not. I started drinking Pop (I don't drink coffee, maybe a cappuccino a couple of times a year) again, and noticed no changes in migraines, severity or duration.

Several Migraine medications, and I am not just talking about the OTC meds actually contain caffeine. (I beilive migranal is one, and I think Fioricet, might want to dbl check though). when I have a migraine starting the first thing I do I go for a soda. It doesn't curb it that often, BUT I think it works if I am just having a run of the mill headache.

Rebound headaches, ahhh, I think this is something that is little understood. I have had rebounds, or what i believe to be rebounds. To me it didn't feel like a normal headache. More like a mid-grade hangover headache. Annoying, constant and throbbing. I could totally differentiate between my migraines and the rebound.

(sorry that my fingers are not working properly, my typing sucks today! )

I sometime swonder if a rebound is more just a withdrawl. I never seemed to get that when I was taking any medication,but more when I hadn't for a while. Years ago, my first response was to reach for the whatever to make it go away, but then it seemed to get a lot worse before I felt better. I think you can have a sort of withdrawl from ANY medication you are taking on a regular basis. This is the dependency factor (not ADDICTION, these are separate things).

For myself, I don't take the combo drugs. I take Oxycodone, not percocet. Another thing people don't realize is when they take other medications together. If you take a medication with acetmenophen already in it, and then take cough syrup, or even a few tylenol in addition to it, you are getting waayy more acetmenophen than you need, or intended to take. I suppose I am rambling now. I hope something in here pertains to what you want to know.

Batman55 wrote:Call me unrealistic if you want... but my ultimate goal is to reverse the 24 hour head pressure from 30 days per month down to 7-10 or something of that nature.

I believe in high goals, but also some intermediary more easily reachable ones (more like steps than a high jump). For me, on the short-lived times of relief I've got, it was a decrease in my average daily pain level. I think the symptom vs. symptom free days thing would be more for migraines. 50% reduction in frequency and/or severity is a common figure thrown out by neuros when trying preventatives (if you get that, they call it success). I'd set some goals such as see some sort of measurable relief first. I celebrate every minute I get with reduced pain.

I also definitely think the combo type meds are more likely to cause rebound. Some people are more prone to it, and some headache conditions are more prone to it (ex. pure migraine would be way more prone than pure NDPH). I also avoid the combo pain killers, even though I've never suspected rebound. Caffeine can be shown to both cause and help headaches. Some people have been known to have caffeine as a migraine trigger, but I see no way it could cause a 24/7 or nearly 24/7 headache. Other meds that could cause rebound are Sudafed or even nose sprays...sinus sort of stuff.

Would dropping back in dose help to decrease the side effects (ie. did you only start to get them after a recent dose increase)? Letting your body get used to one dose for weeks or months may be the way to go if you want to give it a true shot...stay at one dose until you can see if the side effects will drop or decease, because for many people, they do. What of the side effects are you getting in particular? Lots and lots of water can help the stuff like the tingling and brain fog. That said, I know its easy to get fed up with something. Your doctor should be willing to switch you, although I wouldn't be surprised if they asked you to try dropping the dose or sticking it out more. One thing to keep in mind is that once you give up on a med, you are emotionally very unlikely to want to pick it up again, so I'd personally do I'll I could to give it a fair shot unless it was some sort of completely unacceptable side effect that didn't allow me to function (for me, its nausea...if a med gives me nausea more than a few days in a row, I won't continue). Good luck!

tortoisegirl wrote:
Would dropping back in dose help to decrease the side effects (ie. did you only start to get them after a recent dose increase)? Letting your body get used to one dose for weeks or months may be the way to go if you want to give it a true shot...stay at one dose until you can see if the side effects will drop or decease, because for many people, they do. What of the side effects are you getting in particular? Lots and lots of water can help the stuff like the tingling and brain fog. That said, I know its easy to get fed up with something. Your doctor should be willing to switch you, although I wouldn't be surprised if they asked you to try dropping the dose or sticking it out more. One thing to keep in mind is that once you give up on a med, you are emotionally very unlikely to want to pick it up again, so I'd personally do I'll I could to give it a fair shot unless it was some sort of completely unacceptable side effect that didn't allow me to function (for me, its nausea...if a med gives me nausea more than a few days in a row, I won't continue). Good luck!

I first noticed Topamax side effects at 50mg. At 75mg they really started to come into focus. Now I'm starting to get a little bit annoyed. That said, certainly they do not impair functioning too badly, no nausea or dizziness, etc. But if you'll allow my bratty-child routine to go on here, I'll tell you what bothers me. It's the tiredness, apathy, the near-total lack of drive, the loss of passion. Lacking excitement is a problem for me--that's my motivator, as I don't have an intellect to rely on. Another nuisance, I have ADD, and rely on coffee for an extra moment of focus. Now it's like caffeine does something "different," like my brain is "fighting" the stimulant effect, resulting in mood swings. But at least the unpleasant effect isn't always there. (Interesting to note: doing a search, other people on Topamax have reported "extra jitters" and "moodiness" when drinking coffee, so I'm not the only one...)

I suppose a grown up would ask for ADD medication but personally my limit is two daily-use medications, thank you, as I have enough trouble dealing with the two drugs I'm currently using every day. I know there are a lot of folks who require three or more psychotropic medications to function properly, hopefully you are not offended by my "wimpiness," all I can say is I prefer to take as few medications as I can get away with. If I can get the headaches under control some day, I'll tackle the other issues. It's just the way I see things right now, and it is subject to change of course, just like everything.

What do you mean you have no intellect to rely on? Do you mean because you get distracted? You're clearly perfectly intelligent. Silly sausage.

Interesting you say you rely on excitement to motivate you. I do too. Frankly I think that's normal. That's why my thesis is dragging out. It's boring as batshit. No disrespect to your superhero intended

living wrote:What do you mean you have no intellect to rely on? Do you mean because you get distracted? You're clearly perfectly intelligent. Silly sausage.

Interesting you say you rely on excitement to motivate you. I do too. Frankly I think that's normal. That's why my thesis is dragging out. It's boring as batshit. No disrespect to your superhero intended

It's definitely normal to rely on excitement to motivate us, but with ADD, that trait is usually exaggerated. Even reading a book within my interest is an often painful chore, because of the amount of concentration required--relative to a video game or movie, there is a lot of heavy lifting required when you read a novel, in terms of comprehension, context, theme, vocabulary, memory, and so on. Not to mention, reading doesn't provide sensory stimulation "for free" like TV or video games. With the constant headache on top of it, forget about it, I rarely even bother with reading novels anymore.

You could also claim I'm just making more excuses. Maybe I am. There's plenty of people with ADD/ADHD who are excellent readers. But there's just as many who wouldn't read a book to save their life, and for many of the reasons I listed here. Perhaps I could belong to that "subtype" of ADD, or maybe I have an unrelated learning issue.

Hey Batman,

Hang in there. This topamax apathy is a shocker but it will pass. If it doesn't after another week or two at the new dose (or when you just don't want to deal with it anymore) remember you can talk to your doctor and titrate right off it again. But in the meantime, just remember that it's completely normal to be unable to concentrate on anything, and to be at a loss more or less completely to function. I remember it took me literally quite a while to even turn my head to respond to someone calling my name! I didn't read a thing during that time - I barely communicated.

You have been ZOMBIFIED! But you're not a zombie...just a dude with some awful head pressure and other issues who's trying to get on top of it. Stick with it if you can, because at least then you won't be wondering in a year or so if you should try it again. And if it works (when you try the Relpax or another triptan) you'll be on your way to getting armed with the arsenal of drugs WE ALL (if we're lucky) arm ourselves with to continue to function despite migraine.

It's a horrible, limiting, annoying situation to be in but you're not alone. Load up the DVD player or the TV and vegetate in front of some old favourites. Just let yourself go through this adjustment period without expecting too much from yourself is my advice.

best wishes!

EDIT: Just seen your post about weaning off - ignore this one!

living wrote:
{snip}
It's a horrible, limiting, annoying situation to be in but you're not alone. Load up the DVD player or the TV and vegetate in front of some old favourites. Just let yourself go through this adjustment period without expecting too much from yourself is my advice.

best wishes!

EDIT: Just seen your post about weaning off - ignore this one!

Here you write me a nice encouraging post and I forget to keep you informed about the new developments--my fault. Kinda feel bad about that one...

Don't feel bad What a bummer that you didn't get any relief yet

Interesting thread.

On NPDH - this is a tough one. I had daily headaches for 2-1/2 years before I started getting more classic migraine symptoms (noise sensitivity primarily, then the severe migraine and move to more one sided pain typical of migraine). Did I have NPDH before, and it transformed into migraine? Or was the earlier experience just a precursor to the more severe problems later? That is are they stages or levels of the same thing? Or are these really two different diseases?

On motion sickness: this is an odd one. Motion sickness is caused by disagreements between different sensory channels. Perhaps those with migraine are over sensitive to various stimuli, and therefore would be more prone to motion sickness? That's the only connection I can see. Incidentally most people get used to what ever is making them motion sick (sea, car, space) with in a few days it goes away. Only about 10% never acclimate. I don't think this is true with migraineurs over-sensitivity ( to noise, light, vibration, etc... ). I've never heard of one of us "getting used to it". It's pretty much there for the duration of the migraine

On the Topomax. I know of very few people this has helped compared to all of those who have had problems with it. Maybe the happy customers don't report in, but I think this drug must have been way over sold by it's manufacturer.