Causes of a Migraine Medication Overuse Headache

If you’re prone to migraines, overdoing it on certain medicines can create a headache … literally.

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If you feel a migraine headache coming on, you may reach for medicine, such as ibuprofen or an acute migraine medication, to relieve your pain. If it made you feel better, you’ll likely keep it on hand to help with the next attack. However, if you take these medicines too often, it can backfire.

“There's a variety of reasons people sometimes take more than the recommended amount of medications to treat acute migraines. For some people, it can become an anxiety thing. The migraines can be so bad that when you feel anything coming on, you just run to take that acute treatment to turn it off,” says Sylvia Mohen, MD, neurologist in New York City.
Here’s the problem: If you do this too frequently, it can be a hard cycle to break.

What Is a Medication Overuse Headache?

“Medication overuse headache is actually classified as having 15 headache days or more for three months associated with overusing an acute migraine treatment. Really what it is is you're using the acute treatment so frequently that you're just having more headaches,” says Dr. Mohen.

In other words, those same medications that initially helped relieve your headache pain can actually trigger headaches if they are used too often. But why would pain medicine cause headaches to be worse? Research suggests that frequent pain medicine use can lower your threshold for experiencing pain, and reinforce the pathways that process pain.

Medications That May Cause Overuse Headaches

Certain migraine medications and stimulants are associated with medication overuse heachaches. These include:

  • Pain-relievers, such as acetaminophen or NSAIDs like ibuprofen
  • Combination pain relievers, which may have caffeine in them
  • Triptans and ergotamines
  • Opioids
  • More than 200mg of caffeine per day, which is about 2 cups of coffee

It’s important to note that acute migraine medications are not the same as oral preventive migraine medicines, which should be taken daily. “The acute treatments are really trying to turn off the headache that you're experiencing right now, whereas the preventative medications are really preventing you from having headaches to begin with,” says Dr. Mohen.

Treating Medication Overuse Headaches

Medication overuse headaches may seem like a difficult cycle to break, but with your doctor’s help, you can find relief. “We do get people through these headaches and people do very well once they come off of the medications that are actually causing the problem,” says Dr. Mohen.

You can prevent migraine medication overuse headaches by understanding your prescription. Be sure to ask your doctor how often to take your acute migraine treatment, and what to do if your prescription isn’t effectively keeping your migraines at bay. Needing to rely on your acute treatment that often is a sign that it’s not the best fit for you.