Can medication overuse worsen headaches? Neurologist weighs in

For millions of people, headaches, including migraine attacks, are a regular part of life. In the search for relief, many turn to over-the-counter or prescription medications. But what many don’t realize is that, over time, these treatments can begin to make headaches worse.

Thomas Bravo, MD, neurologist and director of the Headache Center at Loma Linda University Health, says that for some patients, frequent use of as-needed medications can worsen headache disorders over time, a condition known as medication overuse headache or more commonly “rebound headache.” 

“Using certain headache medications more than 10 days per month can trigger a cycle of daily or near-daily headaches,” Bravo says. 

This pattern often develops gradually and, over time, can contribute to worsening symptoms.

Medication overuse

Migraine is the most common disabling headache condition. There are many medication options used as rescue treatments for those experiencing migraine attacks, but those who use medicine too frequently run the risk of worsening their condition.

It’s important to note that not all headache medications lead to this condition. However, a key warning sign is taking as-needed medication most days of the week. 

“Most people who develop medication overuse headaches started taking medication more frequently because their underlying headache condition was worsening,” Bravo explains. “Eventually, the treatment itself begins to contribute to the problem.”

Early diagnosis by a healthcare provider can help develop a preventive treatment plan to reduce the frequency and severity of headaches and to monitor medication intake. 

Lifestyle changes that make a difference

While medication plays an important role, lifestyle and behavioral factors can significantly influence headache patterns, specifically for those with migraine. Bravo recommends the following suggestions for potential headache relief. 

Consistent sleep 
The goal is to have a consistent bedtime and get enough sleep so you feel rested each night.  

Diet 
Eating a balanced, consistent, healthy diet, such as a heart-healthy diet, can help reduce headaches. A good place to start is to emphasize a variety of fruits, vegetables, legumes, and lean proteins while limiting saturated fats and excess simple sugars. Additionally, avoiding excess caffeine, alcohol, and tobacco can help reduce headache burden.

Exercise 
While regular exercise is a healthy practice, the pain of migraine can limit activity during an attack. Bravo recommends starting with an enjoyable, lower-intensity activity and gradually increasing intensity.  

Mood 
A person’s mood can have a powerful impact on pain. Conditions like depression and anxiety can increase headache frequency and severity, making screening and treatment essential.

Treatment without medication 

There is a growing body of evidence supporting behavioral therapies such as biofeedback, cognitive behavioral therapy, and relaxation training for migraine management. 

“These approaches can help reduce migraine frequency and severity and, in some cases, may be as effective as preventive medications in lowering overall headache burden. They can be used on their own or in combination with medication treatments,” Bravo says.

Unfortunately, these therapies are often underused. However, many people who try them find they provide meaningful relief.

A balanced approach to headache care

Even with the best habits, migraines and other headache disorders can still occur. Understanding when to use medication, when to seek preventive care, and how daily habits can support headache management can improve symptoms. 

If headaches are becoming more frequent or interfering with daily life, early intervention can make all the difference. For more information on diagnosis and treatment, contact the Headache Center at 909-558-2880 or visit our website here.