Virtual Headache Specialist

Medication Overuse Headache (Rebound Headache) With Chronic Migraine And/Or Chronic Tension-Type Headache



  1. 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.
    1. Anti-convulsant (Anti-seizure) medications:
      ---Topiramate (Topamax)
      ---Divalproex sodium (Depakote)
      ---Zonisamide (Zonegran)
      ---Gabapentin (Neurontin)
    2. Anti-depressant/Anti-anxiety medications:
      ---Amitriptyline (Elavil)
      ---Nortriptyline (Pamelor)
      ---Venlafaxine XR (Effexor XR)
      ---Desvenlafaxine (Pristiq)
      ---Duloxetine (Cymbalta)
    3. Anti-hypertensive (blood pressure) medications:
      ---Propranolol (Inderal)
      ---Timolol (Timol)
      ---Metoprolol (Toprol)
      ---Atenolol (Tenormin)
      ---Nadolol (Corgard)
      ---Lisinopril (Zestril)
      ---Candesartan (Atacand)
      ---Verapamil (Calan)
      ---Acetazolamide (Diamox)
    4. 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).