When patients come to you presenting with migraine headaches, you might share with them the latest information from a Consumer Reports (CR) health research report: their headaches may be caused by the drugs they’re taking to treat them!
“It’s not uncommon for people to experience medication-overuse headaches,” said Orly Avitzur, MD, medical adviser, Consumer Reports Health, and a practicing neurologist. “It often comes as a surprise to my patients when I tell them that overuse of an over-the-counter medication such as ibuprofen or aspirin may be causing their headaches. We all keep these OTCs in our medicine cabinets and I think many of us are so accustomed to them that we may underestimate the risk of overmedicating,” Dr. Avitzur added.
The popular WebMD website concurs: “Many commonly used pain relievers, when taken in large enough amounts, can cause rebound headaches. Drugs once thought of as ‘safe’ are turning up as the likeliest culprits,” warns one WebMD medical reference article. The “culprits” listed include:
- Sinus relief medications
- Acetaminophen (Tylenol)
- Non-steroidal anti-inflammatory medications (such as Aleve)
- Sedatives for sleep
- Codeine and prescription narcotics
- Over-the-counter combination headache remedies containing caffeine (such as Anacin, Excedrin, Bayer Select)
- Ergotamine preparations (such as Cafergot, Migergot, Ergomar, Bellergal-S, Bel-Phen-Ergot S, Phenerbel-S, Ercaf, Wigraine, and Cafatine PB)
- Butalbital combination pain relievers (Goody’s Headache Powder, Supac, fiorinal, fioricet)
The CR report took a particularly close look at a group of drugs called the triptans, which have become the most commonly prescribed drug for migraine patients, despite the fact that MDs are unclear as to how they work (it’s believed they affect how the nervous system handles serotonin, which is involved in pain processing).
It’s no wonder triptans are so extensively prescribed. They’re expensive and extremely profitable for drug makers. A single dose ranges in cost from $21 to $157, depending on the dosage and the form the medication comes in (tablets, nasal spray, or injection).