People who regularly take medicines, such as aspirin, paracetamol and triptans could be causing themselves more pain than relief. New guidance from the National Institute for Health and Clinical Excellence (NICE) advises GPs and other healthcare professionals to consider the possibility of “medication overuse” in their patients who have been taking medicines for up to half of the days in a month, over three months.
More than 10 million people in the UK experience regular or frequent headaches, making them one of the most common health complaints. They account for around one in 25 of GP consultations.
While common over-the-counter treatments are effective for easing the pain of occasional headaches, it has been estimated that up to one in 50 people experience headaches caused by medication overuse and that women are five times more likely to get them than men. They occur when people take painkillers or triptan drugs too often for tension-type (“every day”) headaches or migraine attacks. Doing this can reduce their effectiveness and cause further pain.
Martin Underwood, a GP and professor of primary care research at Warwick Medical School who chaired the guideline’s development said: “We have effective treatments for common headache types. However, taking these medicines for more than ten or fifteen days a month can cause medication overuse headache, which is a disabling and preventable disorder.
“Patients with frequent tension-type headaches or migraines can get themselves into a vicious cycle, where their headaches are getting increasingly worse, so they take more medication which makes their pain even worse as they take more medication.
“I hope this guideline will improve awareness of medication overuse headache both in primary care and among the general public because prevention is simple and treatment is difficult. Explaining to patients that they should abruptly stop their medication, knowing that their headache will get much worse for several weeks before it will improve, is not an easy consultation.”