How medicine for headache or migraine relief could make pain worse: a neurologist explains ‘medication overuse headache’ and advises on treatment
- Regularly taking painkillers for headache or migraine relief could cause medication overuse headache (MOH), a sort of chronic rebound pain
- Writer Anthea Rowan describes her lifelong struggle with migraine, how she developed MOH – and how she is successfully dealing with it so far
I have suffered headaches for as long as I remember. For vomit-inducing migraine attacks from the age of four, my mother dispensed tiny orange baby aspirin the size of sweeteners, which didn’t help.
My husband has had one headache in his life. I can have one a day. I’m one among the billion people worldwide who battle with migraine, a leading cause of disability globally.
Hong Kong neurologist Dr Terrance Li says that for people with debilitating headaches, particularly migraines, preventive medication is key – especially in patients who have frequent attacks. This can reduce the number and intensity of headaches, and as a result, the patient will take fewer painkillers.
I have tried preventive measures, including taking propranolol, a beta-blocker; the antidepressant amitriptyline; and an assortment of recommended vitamins, including riboflavin (vitamin B2).
None of those worked for me.
Modern preventive treatments include new calcitonin gene-related peptide (CGRP) inhibitors, taken in the form of an injection every one to three months or an intravenous infusion over 30 minutes administered in clinic.
These drugs work by blocking a protein in the brain and nervous system that may contribute to migraine episodes. Used to treat migraine, they can also be used to prevent headaches.
