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        Cluster Headache Help and Support >> Cluster Headache Specific >> Rebound Headaches
        
(Message started by: SophiaK on Jul 27th, 2006, 10:37am)
Title: Rebound Headaches
Post by SophiaK on Jul 27th, 2006, 10:37am
I often see reference to 'rebound headaches' but I need to  have a better idea of what they are, like, are they worse?  Does that mean one gets more episodes?  How many hours or days do they last once one stops taking the med that maybe causing them.  I appreciate any input on this subject. Thanks, :)
Title: Re: Rebound Headaches
Post by nani on Jul 27th, 2006, 10:42am
Hi Sophia.  :)
I've been wondering how you were doing.
We discuss 2 different types of rebound headaches here. One is actually called MOH (medication overuse headache) and it's caused by overusing NSAIDS (like aspirin, tylenol, etc) Some people keep adding more of them to overcome pain and end up getting more headaches (not clusters, though) as a result. I'll look for a link to something and post it later.
Others, CH sufferers, report an increase in CH attacks when using imitrex.
Off to find a link...
pf wishes, nani

here's a link that describes both;
http://headaches.about.com/od/allheadpaintype1/a/med_overuse_ha.htm
Title: Re: Rebound Headaches
Post by sailpappy on Jul 27th, 2006, 10:47am
Here is a link to the information you seek!

http://www.mayoclinic.com/health/rebound-headaches/DS00613  pappy :-/
Title: Re: Rebound Headaches
Post by CHTom on Jul 27th, 2006, 11:12am
I've researched rebound headaches and they do not occur with cluster headaches; they generally occur when someone with a normal, everyday common headache takes too many Tylenols or whatever, which prevents the headache from running its' course and when the meds where off the HAs come back with a vengence.  The best "cure", if you get one, is to ride it out, don't take any OTC meds or any other for it and eventually it will go away, no damage done.  The next time that you get a HA, a "normal one" that is, either don't take anything or don't exceed the recommended dose of the medication that you are taking (usually on the side of the box and on a printout inside the box).  All of the professional articles that I have read about rebounds DO NOT mention clusters; clusters are a unique HA and run their course.  If your doc manages to find a medication that will stop a cluster, it will stop and not return until your cycle starts up again.

A personal note:  back in 1998, my internist wanted to see if I was suffering from rebound HAs, so what we did was, for a two week period, I did not take ANY sort of analgesic and it was hell.  When I returned to see him, left eye all bloodshot, tearing and I jumped off the table when he shone that evil little light into my left eye, he pronounced that:  "Well, I guess that you dont have rebound headaches!"  I was then, finally, referred to an excellent pain clinic which continues to help me so many years later.
Title: Re: Rebound Headaches
Post by nani on Jul 27th, 2006, 11:14am
Read my link. It mentions triptans and primary headache disorders.
Title: Re: Rebound Headaches
Post by seasonalboomer on Jul 27th, 2006, 11:16am

on 07/27/06 at 11:12:50, CHTom wrote:
 If your doc manages to find a medication that will stop a cluster, it will stop and not return until your cycle starts up again.


Huh? What about abortives that stop a single cluster attack?
Title: Re: Rebound Headaches
Post by CHTom on Jul 27th, 2006, 11:28am

on 07/27/06 at 11:16:37, seasonalboomer wrote:
Huh? What about abortives that stop a single cluster attack?


Then you will be pain free until your next attack, unless you are one of the few who has attacks that are spaced very far apart (my first attack was in 1980, lasted about a month, then I didn't have another when until 1988 and things went downhill from there and I turned chronic in 1996).
Title: Rebound Headaches
Post by SophiaK on Jul 27th, 2006, 11:29am
OK, here's what it's all about. I found that taking 1/2 a 10 mg ambien and 2 advil give me a great night's sleep. When I do that I get 4 hits in a 24 hour period. I don't take advil unless I'm going out and don't want to get hit. I took 6 advil in a 8 day period. It's the only method I've been able to use and get some very needed rest. However, the doctors are afraid of a 'bleed' since I take warfarin. The neuro put me on 10 mg nortriptyline to be taken at night. When I take that I get slammed during the night and are getting 12 hits a 24 hour period. So, in reading the link (thanks sailpappy) I don't seem to be suffering from advil use. They stress 'overuse' I never at any one time took more then 6, perhaps on 2 occassions in the last month, which is the recommended most one can take. I get my blood checked frequentley and the count is fine. I have this feeling when I talk to my doctors they're not listening. The neuro said I could take advil 3 times a week safely.  I've been cursed with head pain every day since December. Like most of you working hard to exist and get some quality of life. Thanks for listening and your input.
Title: Re: Rebound Headaches
Post by thomas on Jul 27th, 2006, 11:32am

on 07/27/06 at 11:12:50, CHTom wrote:
I've researched rebound headaches and they do not occur with cluster headaches; they generally occur when someone with a normal, everyday common headache takes too many Tylenols or whatever, which prevents the headache from running its' course and when the meds where off the HAs come back with a vengence.  The best "cure", if you get one, is to ride it out, don't take any OTC meds or any other for it and eventually it will go away, no damage done.  The next time that you get a HA, a "normal one" that is, either don't take anything or don't exceed the recommended dose of the medication that you are taking (usually on the side of the box and on a printout inside the box).  All of the professional articles that I have read about rebounds DO NOT mention clusters; clusters are a unique HA and run their course.  If your doc manages to find a medication that will stop a cluster, it will stop and not return until your cycle starts up again.

A personal note:  back in 1998, my internist wanted to see if I was suffering from rebound HAs, so what we did was, for a two week period, I did not take ANY sort of analgesic and it was hell.  When I returned to see him, left eye all bloodshot, tearing and I jumped off the table when he shone that evil little light into my left eye, he pronounced that:  "Well, I guess that you dont have rebound headaches!"  I was then, finally, referred to an excellent pain clinic which continues to help me so many years later.



Triptan use/abuse/overuse causes rebound HAs.  That's a fact for many people.  I know if I take a shot of trex, I will have another CH hit in exactly 2 hours.  EVERY TIME.  If I use too much zomig, the number of hits I get a day will increase dramatically, in number and intensity.
Title: Re: Rebound Headaches- -abortives
Post by SophiaK on Jul 27th, 2006, 11:40am
In my past posts I gve my history with meds.  I had a adverse reaction to topamax, was given predisone, depakote, the Dr. gave me a prescription for zongran which is a member of the sulfa family, I'm highly alergic to sulfa and lucky topamax didn't kill me, of course I didn't take it after checking on this board and the pharmacy.  I don't go to him anymore and on my 3rd neuro.  I tried oxygen, thanks to a CH member, unfortunatley it didn't work for me. The meds caused a enormous rise in liver enzymes, necessitating me having to eliminate all  meds. I am instructed to not take any med that will cause a rise in liver enzymes. I will not describe all the tests and hospital stay.  I am what's referred to as 'late onset' because of my age. I sure would like to get my life back. thanks all.
Title: Re: Rebound Headaches
Post by Charlotte on Jul 27th, 2006, 1:45pm
This is a valid problem, but when I hear the phrase, I think of it as a cop out.

My only experience with this phrase was in 2000 when a new dr refused to give me any medications at all and let me suffer for 4 or 5 months before referring me to a neurologist who tapped my leg, had me walk a straight line, prescribed Depacote, and said a gp could have done it.

The new dr had thought abuse of meds had caused the large amount of headaches.  I had the same pattern without any meds.  I learned how to ride the wave, but I didn't learn to like it.

Charlotte
Title: Re: Rebound Headaches
Post by SophiaK on Jul 27th, 2006, 1:51pm
the more I learn the more I agree with you.   There is an answer I just haven't found it yet. :)
Title: Re: Rebound Headaches
Post by Bob_Johnson on Jul 27th, 2006, 2:38pm
Neurology. 2006 Jul 11;67(1):109-13.

Medication-overuse headache in patients with cluster headache.

Paemeleire K, Bahra A, Evers S, Matharu MS, Goadsby PJ.

Headache Group, Institute of Neurology, Queen Square, London, UK.

OBJECTIVE: Medication-overuse headache (MOH) in cluster headache (CH) patients is incompletely described, perhaps because of the relatively low prevalence of CH. METHODS: The authors describe a retrospective series of 17 patients (13 men, 4 women) with CH who developed MOH in association with overuse of a wide range of monotherapies or varying combinations of simple analgesics (n = 9), caffeine (n = 1), opioids (n = 10), ergotamine (n = 3), and triptans (n = 14). The series includes both episodic (n = 7) and chronic (n = 10) CH patients. RESULTS: A specific triptan-overuse headache diagnosis was made in 3 patients, an opioid-overuse headache diagnosis was made in 1 patient, and an ergotamine-overuse headache diagnosis was made in 1 patient. In approximately half of the patients (n = 8), the MOH phenotype was a bilateral, dull, and featureless daily headache. In the other 9 patients, the MOH was characterized by at least one associated feature, most commonly nausea (n = 6), exacerbation with head movement (n = 5), or throbbing character of the pain (n = 5). The common denominator in 15 patients was a personal or family history, or both, of migraine. The 2 other patients gave a family history of unspecified headaches. Medication withdrawal was attempted and successful in 13 patients. CONCLUSIONS: Medication-overuse headache is a previously underrecognized and treatable problem associated with cluster headache (CH). CH patients should be carefully monitored, especially those with a personal or family history of migraine.

PMID: 16832088  
Title: Re: Rebound Headaches
Post by Bob_Johnson on Jul 27th, 2006, 3:09pm
Curr Pain Headache Rep. 2005 Dec;9(6):430-5.

Medication-overuse headache.

Pageler L, Savidou I, Limmroth V.

Department of Neurology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany

Medication-overuse headache (MOH) can be caused by almost all anti-headache drugs including analgesics, ergots, triptans, and combined preparations The prevalence of chronic daily headache (CDH) appears to be between 2% and 4% in the general population. Current epidemiologic studies suggest that MOH accounts for approximately 50% of these cases. The pathophysiology of MOH remains unclear. The only therapy is withdrawal from the overused substances. Prednisone decreases the duration of headache in the first days of withdrawal therapy. The only strategy to reduce the prevalence of MOH is to prevent the development of MOH in the first place by restriction of anti-headache drugs and constant education of patients.

Publication Types:
Review

PMID: 16282044 [PubMed
Title: Re: Rebound Headaches
Post by Charlotte on Jul 27th, 2006, 3:35pm
Also, if you want to know how much is too much, ask a pharmacist and you will get a straight answer.

Charlotte
Title: Re: Rebound Headaches
Post by thomas on Jul 27th, 2006, 3:38pm

on 07/27/06 at 14:38:08, Bob_Johnson wrote:
 the MOH was characterized by at least one associated feature, most commonly nausea (n = 6), exacerbation with head movement (n = 5), or throbbing character of the pain (n = 5)  



Good find Bob.  I just have issue with this part here.  When I was on trex, after 2 hours I got another CH hit, no nausea or any of that other stuff, a real CH hit.
Title: Re:  Rebound Headaches
Post by TimJohnson on Jul 28th, 2006, 1:47am

on 07/27/06 at 11:29:32, SophiaK wrote:
OK, here's what it's all about. I found that taking 1/2 a 10 mg ambien and 2 advil give me a great night's sleep. When I do that I get 4 hits in a 24 hour period. I don't take advil unless I'm going out and don't want to get hit. I took 6 advil in a 8 day period. It's the only method I've been able to use and get some very needed rest. However, the doctors are afraid of a 'bleed' since I take warfarin. The neuro put me on 10 mg nortriptyline to be taken at night. When I take that I get slammed during the night and are getting 12 hits a 24 hour period. So, in reading the link (thanks sailpappy) I don't seem to be suffering from advil use. They stress 'overuse' I never at any one time took more then 6, perhaps on 2 occassions in the last month, which is the recommended most one can take. I get my blood checked frequentley and the count is fine. I have this feeling when I talk to my doctors they're not listening. The neuro said I could take advil 3 times a week safely.  I've been cursed with head pain every day since December. Like most of you working hard to exist and get some quality of life. Thanks for listening and your input.



AMBIEN WILL GIVE YOU HEADACHES.  I had to stop taking it.
Title: Re:  Rebound Headaches
Post by CHTom on Jul 28th, 2006, 3:27am

on 07/28/06 at 01:47:29, TimJohnson wrote:
AMBIEN WILL GIVE YOU HEADACHES.  I had to stop taking it.


Didn't give me headaches-guess we have to try it for ourselves to see what it does.
Title: Re: Rebound Headaches
Post by SophiaK on Jul 28th, 2006, 1:00pm
Took my 2 advil and 1/2 Ambien, slept like a contented puppy all through the  night and never got up once.  Had a short kip4  slam about  2 hours later, got some kudzu, took it. having small shadows.  Sure hope it works.
Interestingly I found that after taking my evening regimen for going to bed I have a milder day the next day. I feel great right now. Sleep is a wonderful thing.
Wish the best day for all of you. Much thanks to a special person, you know who you are. :)


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