Medication Overuse Headache (Rebound Headache) With Chronic Migraine And/Or Chronic Tension-Type Headache
Treatment
- Successful treatment of this headache requires detoxing and weaning off of the overused medications for at least 2 months. This is mandatory for improvement to occur. You can read further on how to do this detoxification process here. This is often done in conjunction with adding a daily preventive therapy (what to take on a daily basis to try to lessen the frequency and/or severity of the headaches). Preventive medicines generally take 4-6 weeks to start working and 2-3 months for full effect, assuming the correct dose of the medication is reached. These are the medications used most commonly, although this is not an all-inclusive list.
- Anti-convulsant (Anti-seizure) medications:
---Topiramate (Topamax)
---Divalproex sodium (Depakote)
---Zonisamide (Zonegran)
---Gabapentin (Neurontin)
- Anti-depressant/Anti-anxiety medications:
---Amitriptyline (Elavil)
---Nortriptyline (Pamelor)
---Venlafaxine XR (Effexor XR)
---Desvenlafaxine (Pristiq)
---Duloxetine (Cymbalta)
- Anti-hypertensive (blood pressure) medications:
---Propranolol (Inderal)
---Timolol (Timol)
---Metoprolol (Toprol)
---Atenolol (Tenormin)
---Nadolol (Corgard)
---Lisinopril (Zestril)
---Candesartan (Atacand)
---Verapamil (Calan)
---Acetazolamide (Diamox)
- Biologics:
---Onabotulinum Toxin A (Botox): This is the only FDA approved medication available for chronic migraine (greater than 15 days per month for 3 or more months, with 8 of those days having more migrainous features).
