Oct 16, 2020
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Medication headache

Can pain relief from painkillers appear? And how.

Medication-overuse headaches are a reality. It is described in the International Classification of Headache (ICHD-3). In another way, it is called an abusal headache, from the English abuse - to abuse.

2% of the world's people suffer from this problem every year. Abuse headache is often accompanied by depression and anxiety, which aggravates the patient's already serious condition.

Most often, an abuse headache is caused by pain relievers, which people take specifically for the headache.

What are you talking about? Pain relievers no longer work?

Painkillers work. But if you go too far with the number, they will not only stop helping, but also provoke a new wave of pain.

Which pills cause headaches?

Any headache medication can cause abusal pain in patients with primary headaches. (Primary in this article, we call pain that a person had before the onset of pain reliever abuse).

These medications can be:

  • Non-steroidal anti-inflammatory drugs (NSAIDs). For example, ibuprofen, paracetamol, or aspirin.
  • Opioid analgesics. Such as codeine or tramadol. In Russia, they can only be obtained by prescription.
  • Triptans are special anti-migraine medicines.
  • Ergotamine-containing preparations. They are also used for migraines.

If you take analgesics for other diseases, will you get abusal pain?

Yes, overuse of pain relievers for any reason can cause overuse pain. But such trouble occurs mainly in those who are already suffering from primary headaches - migraines or tension headaches. Patients without cephalalgias from NSAID abuse can develop other side effects, but they probably won't get headaches.

How many should you take to get a headache?

They counted everything. If you drink painkillers monthly more than 15 days a month, and live in this mode for three months, you may experience abusal pain. In the case of taking NSAIDs, it may take longer to appear. If combined analgesics are abused - which contain more than one active ingredient - they can develop after taking 10 tablets per month.

How to understand that the head hurts precisely from drugs?

The ICHD-3 has criteria for abusal headache:

  • Having a chronic headache that lasts 15 days a month.
  • The use of analgesics exceeds the daily dose and lasts longer than three months.
  • An improvement in the condition occurs within a month after the withdrawal of painkillers.

Why is this pain developing?

There is a theory that the trigeminal nerve (it plays a role in the onset of migraines) becomes more sensitive if it is regularly exposed to pain relievers. Pain occurs more often because nerve fibers have become thinner to respond to stimulus signals. In response, we increase the dosage and frequency of drug intake and find ourselves in a vicious circle of abusal headache.

What to drink so that the pain goes away?

The most effective treatment is abrupt and complete withdrawal all pain relievers. Studies have shown that as long as the patient continues to take analgesics, it will not be possible to cure abusal pain.

Stopping taking the pills "from the head" can cause withdrawal symptoms. It lasts about a week and includes the following symptoms:

  • withdrawal headache;
  • nausea and vomiting;
  • decrease in pressure;
  • tachycardia;
  • sleep disturbance;
  • anxiety and nervousness.

The withdrawal phase is much shorter if the patient is only abusing triptans.

Fear of headaches complicates treatment. It's hard to believe that pills are no longer a hope of salvation and become a problem. Antidepressants and tranquilizers may be prescribed to support the withdrawal period. They relieve anxiety symptoms and help to wait for relief. In the case of severe withdrawal, antiemetics, antipsychotics or, in extreme cases, an analgesic that was not the cause of the abusal headache may be prescribed.

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