Headache Medication: A Vicious Cycle
The misuse of headache medication can actually lead to more headaches, warns Dr. Theerawat. Known as medication overuse headaches (MOH), this phenomenon occurs when painkillers are taken unnecessarily or excessively, causing the brain to produce more pain receptors. As a result, the brain becomes more sensitive to pain, even in the absence of a headache trigger.
In a recent Facebook post, Dr. Theerawat shed light on the dangers of relying too heavily on pain relievers. He emphasized that common over-the-counter options such as paracetamol and NSAIDs can have serious side effects when taken incorrectly. Paracetamol, for example, can negatively impact the liver, while NSAIDs are known to be toxic to the kidneys. Furthermore, excessive use of these medications can perpetuate the cycle of headaches.
MOH primarily affects individuals who already suffer from recurring headaches, such as migraines. Patients who consume painkillers for more than 15 days a month (for paracetamol and NSAIDs) or 10 days a month (for opioids, ergots, and triptans) are particularly at risk. Additional warning signs include a lack of relief after taking short-acting painkillers or pain worsening after meals.
Treating MOH is not without its challenges. The first step is to stop taking the painkillers responsible for the condition and consult a medical professional for proper headache management. However, this can often result in a period of increased pain as the body adjusts. Prevention is therefore key. Using the appropriate pain relievers and taking them promptly at the onset of a headache can help ward off MOH. Additionally, considering alternative medications known as “controller or anti-headache” drugs can reduce the frequency and severity of headaches, lessening the reliance on painkillers. Simple behavioral changes, such as getting sufficient sleep and avoiding triggers, also play a significant role in managing headaches.
Despite the prevalence of MOH, it remains largely unrecognized, leading many individuals to inadvertently worsen their headaches. To combat this issue, the Headache Study Club has launched a public awareness campaign, coinciding with Migraine Awareness Month in June. With the slogan “More Pills, More Pain,” the campaign aims to educate both the general public and healthcare professionals about the dangers of MOH.
It is crucial to approach headache medication with caution and seek appropriate medical advice to break the cycle of escalating pain. Remember, taking more pills does not always mean finding relief; it can often perpetuate the problem.
The more you take headache medicine, the more headaches you get, Dr Theerawat reveals. Why pain medication causes more headaches It’s called a headache from using more painkillers than necessary.
Today, September 6, 2023, Professor Dr. Teerawat Hamajutha, director of the Center for Health Sciences Emerging Diseases Chulalongkorn University Faculty of Medicine Posted on Facebook Thiravat Hemachudha about the topic The more you take headache medicine, the more headaches you get Why can painkillers cause more headaches? Noting, “We’ve all had a headache at some point in our lives. When there is a headache, we take painkillers that we have at home, such as paracetamol, or we buy drugs in a pharmacy to take. Are these pain relievers safe? In fact, these painkillers are often taken. Does the pain always go away? And can it really cause more headaches than before?
It is well known that Painkillers we take Paracetamol is not completely safe if taken “too much” Paracetamol can affect the liver, and NSAIDs (such as ibuprofen, naproxen, etc.) are toxic to the kidneys. And it can cause stomach ulcers until bleeding or even ergot drugs that we find in the news that can cause ischemia in the hands or feet to the point of amputation. In addition, these headache medicines If used excessively or too often, it still causes more headaches. This type of headache can be called a “medication overuse headache” or “MOH”
What is MOH and who is likely to get MOH?
Over-the-counter headache (MOH) usually occurs in patients who suffer from recurring headaches (such as migraines) and whose painkillers are so overused that their headaches are getting worse more often. For the words “too much” or “more than necessary”, it was found that if it was paracetamol or NSAIDs, it usually means taking the drug for 15 days a month or more. But if it is an opioid, ergot, or triptan, it means taking the drug for 10 days a month or more. In addition, patients can easily notice additional symptoms. that there is a risk of MOH disease, that patients may take short-acting painkillers Or after eating and not get rid of the headache
Why do painkillers cause more headaches?
The mechanism of pathogenesis of MOH is generally believed to be caused by the use of large amounts of painkillers for a reasonable period of time. It will cause the brain to produce more pain receptors. Therefore, when the level of painkillers decreases, the brain automatically becomes more sensitive to pain, even when there is no headache trigger.
How is MOH treated and how do we use painkillers to be safe and prevent MOH?
Treatment for MOH has a simple principle. This is to stop taking the painkillers that cause MOH and see a doctor. To treat the original headache correctly, however, the simple principle is difficult to do in the real world. Because stopping painkillers often causes patients to suffer pain for a period of time.
Therefore, it is better to prevent MOH from the beginning MOH can be prevented very easily by using the right and appropriate pain relievers. and early use of pain relievers at the onset of each headache Most importantly, if the migraine sufferer has an unusually increasing or frequent headache. This can lead to the need for pain medication to be close to the amount that causes MOH (as mentioned above). “Controller or anti-headache medication,” which is a different type of medication than painkillers. Taking these headache medications can help reduce the severity and frequency of your headaches. The patient does not need to take a lot of painkillers. In addition, modify behavior to reduce the frequency of the same headache, such as getting enough sleep. exercise Avoid triggers that trigger headaches. is also important
The fact that MOH is not widely recognized This may be the root cause of many patients who overuse painkillers without realizing that their headaches are getting worse. so this year Especially in June, which is the month of campaigning to raise awareness of headaches, especially migraines. The Headache Study Club therefore planned a campaign to raise awareness of headaches from the overuse of painkillers (MOH) at the same time with a simple slogan: “More pills, More pain” or “The more pills , the biggest headache” to Raise awareness of MOH among the public, including healthcare professionals.
Prakit Anukulwittaya and Assistant Professor Sek Tanprasertsuk, MD Neuropathologist Chulalongkorn Hospital Headache Clinic, President of the Educational Development Department of the Thai Red Cross Society and research president of the Headache Study Club under the Thai Society of Neurology.”
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Thanks for information from Thiravat Hemachudha
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