Drug-induced headache belongs to the group of secondary headaches, which are usually caused by painkillers or other drugs. This type of headache can be unilateral or bilateral. Medication-induced headache is generally treatable.
What is drug-induced headache?
A drug-induced headache is present if the headache occurs on at least 15 days per month. These headaches are present after taking painkillers more than 10 days per month for more than three months. See AbbreviationFinder for abbreviations related to Definition of Drug-induced Headache.
Medication-induced headache is not a primary, i.e. independent headache such as B. migraines or tension headaches. However, the primary headache is a prerequisite for a drug-induced headache to develop.
There are three types of drug-induced headache: chronic migraine, chronic tension headache and chronic combination headache.
In addition to analgesics (painkillers), other drugs can also trigger drug-induced headaches. It must be taken into account whether the medication was primarily used to treat headaches or for another disease, since medication-induced headaches can also occur as a side effect of long-term medication.
The cause of drug-induced headache is a headache that has been overtreated with painkillers. Migraines and tension headaches are usually the primary headaches.
Not every form of headache automatically leads to drug-induced headaches. Cluster headaches usually only lead to drug-induced headaches in exceptional cases, even if analgesics are taken to excess.
It should also be noted that painkillers taken for rheumatic diseases, injuries and other diseases are not considered to be the cause of drug-induced headaches.
Since a specific cause for drug-induced headaches has not yet been identified, it is assumed that a genetic predisposition is an option.
Typical Symptoms & Signs
- oppressive dull to stabbing (also throbbing) headache
- sensitivity to light
- flickering before the eyes
- noise sensitivity
Diagnosis & History
Medication-induced headaches are diagnosed by general practitioners and neurologists. After a detailed anamnesis, the person concerned is usually recommended to keep a so-called headache diary over a longer period of time.
Furthermore, a general physical examination and a blood analysis are carried out. The neurologist examines the patient’s neurological status using EEG and other neurological examination methods.
If there are any abnormalities in the blood analysis, an internist can also be consulted. Kidneys and liver can be damaged, especially after years of painkiller abuse. The condition of the internal organs is determined with the help of further blood tests. Furthermore, imaging methods such as ultrasound are used to determine whether and to what extent damage to the organs is present.
The course of medication-induced headache can be described as good. With adequate therapy, the success rate is 80 percent.
Depending on how long the medication-induced headache has been present or how long the pain and medication have been abused, complications can arise in the further course. In addition to the liver and kidneys, stomach ulcers and stomach tumors can occur. Those affected with medication-induced headaches also often have depression, which can be treated well with behavioral therapy.
This complaint causes the patient to have a very severe headache. In most cases, this pain is usually stabbing or pressing and can thus significantly reduce the quality of life. The concentration and coordination of the person concerned is also reduced by this complaint.
The pain often spreads from the head to other regions of the body and can also cause problems there. Sometimes there is also sensitivity to light, so that the headaches are intensified even further by bright light. Sensitivity to noise can also occur. Patients often have flickering in front of their eyes and are no longer able to carry out their usual activities.
The symptoms themselves can be limited simply by discontinuing the respective medication or replacing it with another. Above all, those affected must avoid painkillers. Withdrawal symptoms can also occur. If this complaint is not treated, it can also lead to inflammation of the stomach or, in the worst case, to kidney failure, which can be fatal if left untreated. As a rule, life expectancy is also reduced by the disease if this condition is not treated.
When should you go to the doctor?
If headaches occur repeatedly after taking a medication, the first step is to read the side effects listed in the package leaflet. If several medicines are taken at the same time, the information about possible interactions of the preparations should also be read. If the headache occurs repeatedly or increases in intensity, the treating doctor should be asked about the side effects. A self-determined interruption of the treatment plan is not recommended, since the underlying disease must be treated. Possible alternative medications should be discussed with the doctor so that there is no further deterioration in the general condition.
If there is sensitivity to light, a flickering perception in front of the eye or a blurred field of vision, the observations should be discussed with the doctor. If there is a sensitivity to noise, a further decrease in well-being or sleep disorders, a doctor’s visit is necessary. A doctor is needed in the event of inner restlessness, a decrease in physical and mental performance and a disturbance in attention. If medication is taken over a longer period of time, the headaches can develop slowly and continuously increase in intensity. This is an insidious process of drug-induced headache. A doctor should be asked about the inconvenience
Treatment & Therapy
Successful treatment of a drug-induced headache requires that the triggering painkillers and drugs are stopped right at the beginning.
Since over the months and years of the illness it is often addiction-related, detoxification or withdrawal is the method of choice. The prerequisite for this, however, is that the patient wants this 100 percent, because by not taking painkillers, a so-called rebound effect sets in, which means that the pain intensifies when the medication is stopped. These withdrawal headaches can usually last up to three weeks.
Since depression is often present in those affected in addition to the medication-induced headache, it is advisable to undergo inpatient withdrawal. In addition to treating the pain and other withdrawal symptoms with special medication, behavioral therapy is an important factor in ensuring the success of the treatment.
Once symptoms have subsided, it is important to identify and treat the cause of the headache. The therapy already begins during the withdrawal and is continued in the long term in the following months. In addition to adequate pain therapy and psychological behavioral training, it is important that physiotherapeutic measures are taken, especially if tension headaches are the cause of the medication-induced headache.
Medication-induced headache treatment also includes treatment of the consequences of painkiller abuse. The excessive use of painkillers primarily damages the stomach, liver, kidneys and blood vessels. Stomach inflammation, gastric ulcers, hepatitis and renal failure are just a few of the diseases that can occur as a result of drug-induced headache.
Outlook & Forecast
The prognosis for drug-induced headache is good. After discontinuing the medication used, the symptoms gradually subside. Normally, a symptom-free status is achieved within one day. Spontaneous healing can therefore be expected if the person affected no longer uses the painkillers they have taken in the future.
The affected person can increase the intake of liquids to support this. This helps ensure that the medication taken is transported out of the body and excreted. If the active ingredients that caused the health impairments in the organism are reintroduced into the body, the symptoms can be expected to return. The person concerned should therefore permanently resort to alternative preparations. It is advisable to discuss the side effects that have occurred with the doctor treating you. The treatment plan for the therapy of the primary disease is revised and adjusted accordingly.
If there is no underlying disease, it is sufficient to dispense with the painkillers administered. Nevertheless, it is advisable to seek medical treatment to clarify the cause of the pain. In order to ensure that medication-induced headaches are permanently free of symptoms, the active ingredients in prescribed or purchased medicines should be checked over the course of the patient’s life. A long-term renunciation of the triggering elements is necessary.
Medication – induced headaches are easy to prevent. The most important point is that in the case of headaches, painkillers and migraine medication should not be taken for more than three consecutive days and for no more than ten days per month.
If there is a primary headache, you should only take painkillers in the permitted dosage and duration according to the package insert. If the headache does not subside within 48 hours, a doctor should be consulted who may be able to prescribe other, more effective medication.
Since a medication-induced headache is a consequence of other headaches, it is advisable to keep a so-called headache diary. This can make it easier to diagnose and find the cause. In addition, the diary serves as a monitoring organ, so that accidental or intentional overdose of painkillers can be avoided.
Since primary headaches are often triggered by tense muscles (tension headaches), it makes sense to take physiotherapeutic measures so that the primary headache does not become a drug-induced headache.
You can do that yourself
Patients with drug-induced headaches can try alternative pain management options. Relaxation techniques have proven to be particularly helpful. After learning certain exercises, these can be carried out independently and at your own discretion at any time. The mental strength of the person concerned is built up using different techniques and stress can be reduced. Methods such as meditation, autogenic training or yoga have proven to be beneficialshown. Many patients have successfully managed to reduce the dose of painkillers or to switch to a drug with less active ingredients.
In addition, there are various natural remedies that have proven themselves in the fight against pain. They include devil’s claw, ginger, willow bark, arnica and curcumin. If the pain can be relieved, the pain medication can also be switched and changed.
In the event of a headache, the patient should, if possible, sleep sufficiently and in good conditions. Sleep hygiene must therefore be optimized and the daily routine must be tailored to the needs. Another way to reduce or stop taking painkillers is through acupuncture. Depending on the cause of the pain, the patient can achieve relief from the symptoms through naturopathic treatment. This can lead to freedom from pain so that medication is no longer needed.