Neurology\Drug Rebound Headaches

Question 1

When should you consider the diagnosis of a drug rebound headache?

Answer 1

• Routine ingestion of medications for headache.(approximately three times per week).
• Symptoms are refractory to acute and prophylactic interventions.

Question 2

which medications can cause rebound headaches?

Answer 2

• any acute headache medications can cause these headaches.
  Eg paracetamol, butalbital-aspirin-caffeine, aspirin ergots, opioids, triptans.

Question 3

What is the management for drug rebound headaches?

Answer 3

• stop all chronically used acute headache medications.
• Use transitional agent during detoxification.
  
  • Intra nasal or intramuscular dihydroergotmaine
  • long acting triptan e.g naratriptan or frovatrriptan
  • a short course of steroids
  • long acting NSAIDS
• Start preventive medications.