Americans spend some $3 billion a year on over-the-counter headache remedies. But many experts believe some headaches — so-called rebound headaches — are actually caused by the very same medicines people are taking to stop them.
Dr. Fred Sheftell, one of the world's most-respected headache doctors, is upset that the labels on over-the-counter headache remedies offer absolutely no warning about rebound. "There's nothing that I know of where any of these products say anything about the genesis of rebound headaches and chronic daily headache. … I'd like to see that."
A Vicious Cycle
Here's how experts think rebound starts. Normally, when you take a pain reliever for an occasional headache, the medicine turns off pain receptors in the brain. But in a person prone to headaches — especially migraine headaches — pain relievers taken more than two to three days a week on a regular basis can make the pain receptors more sensitive than usual.
Consequently, as soon as the medicine wears off, these hyper-sensitive receptors turn on to produce a new headache. That leads the headache sufferer to take more medicine, which, in turn, leads to more headaches — a truly vicious cycle. Before long, most rebound patients are taking headache medicine every single day.
This vicious cycle nearly killed Eric Peterson, a 26-year-old veterinary student. But what will shock you is how little medicine it took to get him in trouble. Peterson's problems started in high school with migraine headaches that hit him a couple of times a week.
"I think I started with an ibuprofen type. I wasn't finding a tremendous amount of relief with that. And tried Excedrin — found that controlled things nicely for me," Peterson said.
Daily Habit Can Trigger Serious Health Problems
Initially, Peterson was able to manage his headaches by taking two Excedrin just two to three times a week. But that was enough to lead to rebound headaches. Soon, Eric was taking the pain relievers every day, which was very bad for both his head ... and his stomach.
Peterson's health problems became painfully clear last summer at a Chicago Cubs game. "We were walking up the stands to find our seats and I became very dizzy and light-headed and nearly passed out," he said.
Years of taking Excedrin had eaten away at Peterson's stomach lining. He was sitting in the stands slowly bleeding to death. Just four hours later Eric wound up in a hospital emergency room. Doctors were able to save his life, but they told him he could no longer take over-the-counter pain killers.
This was frightening news for Peterson, who had become so reliant on the pain relievers, he was more concerned about he was going to manage his headaches than he was about the damage to his stomach. "I didn't know how I was going to cope from day to day without having to be able to take that medication," he said.
Stop the Medicine, Stop the Pain?
Duane Soderquist, 25 years ago, was in a situation very similar to Peterson's. Soderquist said, "I think I had seven free headache days in 10 years."
It was Soderquist's case that caught the attention of Dr. Joel Saper, a neurologist and founder of the Michigan Head-Pain Neurological Institute in Ann Arbor. A pioneer in the treatment of rebound headaches, Saper said it was Soderquist who first opened his eyes to the fact that over-the-counter medications could imprison a brain in rebound headaches.