Medication Overuse

One of the very important reasons why Botox does not work for all Migraine sufferers is because of Medication Overuse Headaches

Medication Overuse has been discussed in the media quite a lot recently. It might at first seem strange and counter-intuitive that taking painkillers for your migraine can actually cause the headache that you are trying to treat, but it is increasingly common and easily missed. Indeed you can still be having migraines mixed in with your medication headache. However Medication Overuse must be dealt with if you are to get the best of any treatment, including Botox, for your migraines
How Migraine Overuse Headaches start
  • It is very difficult for you to tell the difference between a medication overuse headache and a true migraine
  • They occur when you take painkillers all or most of the time, so that tyou don’t have a break in taking them of at least two days between migraines
  • Codeine and other opiate-type painkillers such as Tramadol are an extremely potent cause. Codeine is often mixed with Neurofen and other over-the-counter painkillers and called names such as Neurofen Plus. Migraine sufferers should AVOID these and stay with simple painkillers like Ibuprofen (the active ingredient of Neurofen) and other NSAIDs ( this stands for Non-Steroidal Anti-Inflammatory)
  • Triptan overuse will cause them too
  • Medication Overuse headaches can start even if you’re taking the painkillers for something other than migraines. For instance if you have a painful back and find yourself taking painkillers constantly for an extended period, a Medication Overuse Headache can start if you are predisposed to migraines (a migraneur)
How to avoid Medication Overuse Headaches
  • DO NOT take over-the-counter painkillers containing Codeine or other opiate painkillers
  • DO NOT take painkillers “just in case” because you want to avoid a migraine coming on
  • MAKE SURE that there are periods of at least two days between migraines that you are not taking painkillers
  • DO NOT divide up your doses of Triptans to make your supply last longer so that you are taking the smaller doses on more than 10 days in a month. It is the number of days you take them and not the dosage.You can take higher doses (under medical supervision) during your attacks so that your monthly dosage may be higher but it must still be on 10 days or fewer.
How to stop Medication Overuse Headaches
This can be very difficult, for there is going to be a period when the headaches will get worse before they get better.
There is no one method and the “Cold Turkey” method, though commonly suggested, has little research to back it up. Indeed specialists have called for more research because it is so debilitating and so common. Whatever method you choose, the first step is to stop taking Codeine.
  • In Stages
    • If you are taking NSIADs with Codeine or other opiates then switch to ones without. In rare cases of those addicted to Codeine then withdrawal may have to be managed by a specialist.
  • Cold Turkey – brutal but effective.
    • Before starting this approach make sure you aren’t taking Codeine mixed in with other painkillers.
  • Slow Withdrawal
    • Withdrawal from all opiates
    • create islands of not taking painkillers – start off with 1 day and extend it to two at the times when the headaches are least severe