Medication overuse headache: what you need to know
Taking acute headache medication often? Learn about medication overuse headache—what causes it and the symptoms to watch for.
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Key takeaways
For some, long-term use of acute headache medication may lead to medication overuse headache, also known as rebound headaches.
- Medication overuse headache worsens with excessive acute medication use over time, including over-the-counter and some prescription pain relievers.
- Symptoms can include frequent headaches, nausea, and irritability.
- Overuse of some acute headache medications may alter the brain's pain regulation, causing withdrawal-like symptoms for those with medication overuse headache.
- People at higher risk include smokers and those with high caffeine intake.
If you regularly and often reach for pain relievers to manage headache or migraine attacks, it might be time to take a closer look at how that pattern could be affecting your headaches.
While acute migraine medications can bring short-term relief, for some, using over-the-counter and some prescription pain medications too frequently may actually make things worse over time—potentially leading to a condition known as medication overuse headache, also known as rebound headache. Learn more about acute headache medications.
Understanding this often-overlooked condition can be helpful for anyone managing recurring headaches. Let’s break down what medication overuse headache is, what causes it, and how to recognize the symptoms.
Rebound headaches are caused by the frequent or excessive use of pain-relieving medications.
What is a medication overuse headache?
A medication overuse headache, also known as a rebound headache, is a type of headache that occurs when some acute headache medications are taken too often over an extended period.
Medication overuse headache is defined as a headache occurring on 15 or more days per month in someone with a pre-existing headache disorder, combined with the regular overuse for more than 3 months of one or more drugs that are typically used for the acute treatment of headaches.
Medication overuse headache is considered a secondary headache—meaning it results from treating a primary headache disorder like migraine or tension-type headaches.
An unfortunate cycle can develop: the acute medication intended to relieve headaches ends up becoming the cause of future headaches, prompting further use of acute medication.
A key factor of medication overuse headache is the pattern of acute headache medication use, which reinforces the cycle and leads to frequent and severe headache attacks over time.
What causes medication overuse headache?
Medication overuse headache is caused by the frequent or excessive use of acute pain-relieving medications, including both over-the-counter and some prescription drugs.
While experts don't know exactly why medication overuse headache happens, the theory why it occurs is because of changes in the brain’s pain regulation system.
Over time, the acute headache medication may become less effective, and when it wears off, withdrawal-like symptoms emerge, triggering another headache. People take more medication to treat the headache, the cycle continues, and the baseline frequency of headaches increases.
Test your knowledge
What is a rebound headache?
A headache caused by frequent use of pain-relief medication
A headache caused by not taking enough pain-relief medication
Correct
A headache caused by frequent use of pain-relief medication
Not quite
Correct answer: A headache caused by frequent use of pain-relief medication
What are the symptoms of a medication overuse headache?
Medication overuse headache can vary in intensity and frequency, but some common features include:
- Headaches that occur 15 or more days per month
- Headaches that start shortly after waking up
- Headaches that improve with acute headache medication but return once it wears off
- Nausea, restlessness, or irritability
- Trouble concentrating or memory problems
Because these symptoms overlap with migraine or other headache types, many people may not realize that acute headache medication use is playing a role. That’s why recognizing the pattern—how often you're taking medication and how frequently headaches return—is so important.
Who’s at higher risk for medication overuse headache?
Not everyone who treats their headaches with acute medication will develop medication overuse headache. However, certain risk factors may increase your chances:
- High daily caffeine intake: Caffeine intake is a known headache trigger and can compound medication overuse headache.
- Smoking: Smoking has been associated with a higher risk of medication overuse headache.
- Psychological conditions: Anxiety, depression, and chronic stress can increase the likelihood of acute medication overuse.
- Family history: If you have a family history of headache disorders or substance use disorders, you may be at a greater risk of developing medication overuse headache.
If any of these apply to you, consider talking with a doctor about your acute medication utilization and how often you are experiencing headaches.
Key takeaway: track, reflect, and talk to a doctor
If you find yourself taking acute headache medication often, or if your headaches are becoming more frequent or intense despite treatment, consider preventive therapy and talk to your doctor.
A good first step? Keep a headache diary for a few weeks. Track your symptoms, the medications you use, and how often you’re using them. Then bring that information to your next doctor’s visit. To learn more about how to prepare, check out http://www.pfizerforall.com/migraine/education/headache-or-migraine-doctor-visit .
Together, you and your doctor can determine whether frequent acute medication use to treat your headaches may be contributing to your headache pattern—and make a plan that works better for you in the long term.
References
Ailani J, Burch RC, Robbins MS, the Board of Directors of the American Headache Society. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2021;61(7):1021-1039. https://doi.org/10.1111/head.14153
Fischer MA, Jan A. Medication-overuse headache. In: StatPearls. StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK538150.
Medication overuse headaches. Mayo Clinic. January 10, 2025. Accessed April 10, 2025. https://www.mayoclinic.org/diseases-conditions/medication-overuse-headache/symptoms-causes/syc-20377083.
Rebound Headaches. Cleveland Clinic. July 27, 2023. Accessed April 10, 2025. https://my.clevelandclinic.org/health/diseases/6170-rebound-headaches.