WASHINGTON — Those pain pills you think help your migraines? Take too many, and you could make things worse. Overusing painkillers can spin migraine patients into a rut, spurring more headaches that in turn require more pain medication.
A very unlucky fraction even get what is called chronic migraine, where they’re in pain more days than not. New research suggests certain prescription painkillers, including narcotics, increase that risk.
Don’t misunderstand: Treating migraines, properly, is important.
The bigger message is to try migraine-preventing medicines if the headaches strike regularly — so that you don’t fall into the painkiller rut.
The estimated 30 million Americans who suffer migraines often find the holiday season a time of increased pain. Lack of sleep, tempting treats and the stress of travel are common triggers.
Depending on acute painkillers more than a few days a week can signal overuse.
Overusing any pain medication can cause a rebound headache once it is stopped. But occasionally in frequent migraine sufferers, the brain gradually becomes more sensitive to pain so they worsen even more.
The study tracked 8,200 episodic migraine sufferers for a year and found 2.5 percent worsened to a state of chronic migraine.
Those who took drugs containing narcotics, such as Percocet, or drugs containing barbiturates, such as Fiorinal, were most likely to worsen, reported the journal Headache. Risk increased with higher doses.
Over-the-counter standbys, from acetaminophen to the anti-inflammatories called NSAIDS — ibuprofen, naproxen and their cousins — weren’t linked to chronic migraine.
What specialists advise
• Ask about migraine-prevention drugs. Choices range from blood pressure-lowering drugs called beta-blockers to epilepsy drugs and certain antidepressants, all of which have side effects to be considered. Some patients try Botox injections to quiet overactive nerve endings.
• Quit the overused medication but brace for painful withdrawal. A doctor might advise different short-term medications to help.
• Use a headache diary to pinpoint migraine triggers and learn to minimize them.
