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This article is from the WebMD News Archive

Painkiller overuse 'can make headaches worse'

WebMD UK Health News
Medically Reviewed by Dr Rob Hicks
senior woman with migraine

28th August 2013 - People who have migraine or tension-type headaches should be told about the risk of taking too many painkillers. The medicines watchdog the National Institute for Health and Care Excellence (NICE) says medication overuse can lead to further headaches.

NICE has issued new guidelines to doctors in England for treating headaches in people aged 12 and over. It says an accurate diagnosis of a patient's headache is important in prescribing the right medicine or treatment.

Different types of headaches

Headaches are one of the most common neurological problems seen by GPs, with more than 10 million people experiencing them on a regular or frequent basis. However, there are different types of headaches and a number of underlying causes. These are:

  • Primary headaches - which may be tension-type headaches or migraine attacks
  • Secondary headaches - caused by underlying disorders such as sinus infection, neck injury or stroke

Secondary headaches can also be associated with medication overuse. This happens when people take painkillers or triptan medication too often for tension-type headaches or migraine attacks. Triptan drugs are not the same as painkillers. They cause the blood vessels around the brain to narrow to reverse the widening that is believed to contribute to migraines.

Correct diagnosis 'vital'

Professor Gillian Leng, deputy chief executive at NICE says in a statement: "It is important for people to understand that different headaches require different treatments, and so a correct diagnosis is vital.

"People may not know that overusing some types of medication for treating tension-type headaches or migraines can actually make things worse, causing further pain. This standard aims to raise the bar in the care and support for people with headache and migraine."

In summary the new guidelines for doctors and neurologists say that:

  • People diagnosed with primary headache disorder should have their headache type classified as part of the diagnosis, which will allow people to receive appropriate treatment and prevention for their particular headache. It is recognised that some people will have more than one type of headache and therefore may have more than one classification.
  • People with primary headache disorder should be given information on the risk of medication overuse headache, which may prevent secondary headaches.
  • People with migraine should be offered combination therapy with a triptan and either a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen and aspirin, or paracetamol. Correct treatment can relieve the symptoms of migraine and improve quality of life.

Raising awareness

Dr Fayyaz Ahmed, chair of the British Association for the Study of Headache (BASH) tells us by email: "BASH welcomes the NICE quality standards in raising awareness on headache disorders that for a long time were literally given very little importance.

"Receiving the right diagnosis means patients will receive the right treatment. Medication overuse is highlighted as an important entity and hopefully patients will be warned about its risk at the time of receiving this diagnosis.

"Headache is one of the most prevalent symptoms in the general population and nearly one in six people suffer from migraine. To raise the profile of headache disorder would be very welcomed by the headache sufferers, some of which have to live with debilitating forms of the disorder."

Reviewed on August 28, 2013

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