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Incidence and Characteristics of Potential
Analgesic Rebound Headache in a University-Based
Headache Clinic Population
AR Malapira, JF Rothrock
Posted January 2001
American Headache Society, June 2000

Objective: To determine the frequency of potential analgesic rebound headache in a series of patients presenting to a university-based headache clinic and to identify variables influencing the presence or absence of analgesic overuse.

Results: Eighty-nine percent of the 83 patients were female. Mean age was 42 (range 14-77). Sixty-three (76%) patients had chronic daily headache, and 20 (24%) had frequent episodic migraine (FEM). Analgesic rebound headache was potentially present in 37% of patients overall (41% of patients with daily headache vs. 25% with FEM) and was most common (60%) in the subgroup with chronic daily headache (CDH) type II (new daily persistent headache with migrainous features). Potential rebound was more common in patients >age 40 (58% vs. 42%) and in patients with CDH of >1 year’s duration (60% vs. 40%).

Conclusion: Although overuse of analgesic medication is common in this population and may influence the incidence and prognosis of pervasive headache, a minority of patients reports overuse. Overuse is apparently more common in older patients with CDH of >1 year’s duration.