Rebound, or drug withdrawal, headache is a popular diagnosis given to many chronic daily headache sufferers. It occurs later on in the day, or the next day, due to the effects of a drug(usually high caffeine containing meds, such as Excedrin, or opioids/butalbital). The problem is, this diagnosis is given too often and is not always accurate.
The true problem is that we do not have adequate drugs/solutions for frequent headaches. I have done studies indicating that only 46% of chronic daily patients, over the long-term, can find a preventive that is effective and tolerated(study on this site in Archives). So, roughly half of the CDH folks scramble to find other remedies(usually daily pain meds/anlagesics, or daily triptans). We need better pain and headache preventives.
Neurologists often give the “drug rebound” diagnosis to a patient because they believe it to be true, and it is convenient(some of us blame the poor patient, when it is our side that does not have adequate meds/remedies for the CDH sufferer). That being said, some people do have headaches from these analgesics, and withdrawing them off does help minimizing the headaches.
The doctor often says “don’t use this pain med, don’t overuse that, take analgesics only 2 days a week”….and the poor suffering patient says”ok, I agree, but what do I do about these severe headaches every day??”
The fact is that rebound/drug withdrawal headache is a very complex subject: who gets them? from which drugs?? how much do genetics play a role?? how about psychological factors(anxiety/depression: some people are actually medicating these via the pain drugs…pain meds are not a good way to approach anxiety/depression).
So, when a doc says you are overusing analgesics and getting rebound headaches, it may be true, or it may be just that you have severe frequent headaches and need the drugs…..

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