Help! How Can I Not Overuse Migraine Medications?
|One of the biggest issues facing those of us with frequent Migraines is that of medication overuse headache (MOH), aka rebound. As with most things related to Migraines, the susceptibility to and which medications cause MOH can vary from person to person. The International Headache Society has gathered research and set diagnostic and classification criteria for MOH that are quite complete in listing which medications can cause MOH:
As you can see, any acute medication (medication used to treat a Migraine when it occurs) can, if overused, cause MOH. Even alternating the types of acute medications leaves us vulnerable to MOH (see 8.2.6 above). Most specialists recommend limiting use of any acute medications to no more than two or three days per week to avoid MOH. They have good reasons for that recommendation. Dr. Fred Sheftell of the New England Center for Headache told me:
Simply put, medication overuse headache is avoided by not using medications for the relief of Migraine and/or headache too frequently. That statement might seem quite simple to someone who doesn’t have frequent Migraines. However, it leaves those of us who have or have had frequent Migraines with an obvious and sometimes urgent question:
How can I not overuse Migraine medications?
Another issue not to overlook is the use of comfort measures. These can be especially important if there are days when you have to forego acute medications to avoid MOH. Often helpful comfort measures include:
When taking acute medications stops the pain, it’s tempting to take them despite the risk of developing MOH. Two points helped me resist that temptation:
It can be very difficult to not overuse acute Migraine medications, but it’s essential if we want to make progress in our efforts to control our Migraines. Our doctors should be willing to help and encourage us. If they’re not, it’s probably time for a new doctor, probably a good Migraine specialist. If you’re wondering about a new doctor, take a look at my post Is It Time for a New Migraine Doctor?