Did you know that you are likely to get migraines more often if you overuse pain medications? It seems certain medications can contribute to the change of sporadic migraines into chronic migraines. According to a study published in the journal Headache, barbiturates and opiates, such as OxyContin and Percocet, can increase your chance of getting chronic migraines when used to treat headaches. Those types of drugs should not be a first-choice headache pain reliever.
Triptans, commonly used migraine treatments including Imitrex and Zomig, do not increase headache frequency, and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin can, under certain circumstances, protect against the development of chronic migraines. The researchers also suggested that men are more susceptible to developing chronic migraines.
In their study, the researchers used data collected from 120,000 people in the American Migraine Prevalence and Prevention study, which asked people to fill out a questionnaire about their headaches and use of pain medications. The scientists focused on two years of data from 8,219 people who in 2005, experienced episodic migraines–defined as fewer than 15 headaches per month. They examined the patterns of medication usage among these people, and then took a look at how many of the individuals began to experience chronic migraines–defined as more than 15 headaches per month–in 2006.
They found that 209 of the 8,219 people with episodic migraines in 2005 had developed chronic migraines by 2006–a rate of 2.5 percent. Compared to acetaminophen as the baseline drug, pain relievers containing barbiturates and opiates doubled the risk of developing chronic migraines. Triptans caused no appreciable increase in the risk of chronic migraines.
In terms of NSAIDs, people who experienced fewer than 10 headaches per month and took NSAIDs actually reduced their risk of developing chronic migraines. However, people who experienced greater than 14 headaches per month and took NSAIDs did increase their risk of developing chronic migraines. From these data, it seems that NSAIDs can protect against the development of chronic migraines, but only in people with infrequent episodic migraines.
It should be noted that participants self-reported their symptoms and estimated the average number of times per month they used each class of medication, which is a less accurate than clinical assessment by professionals.
We can all benefit from the knowledge that taking certain pain medications for headaches is a slippery slope. The best advice may be to take an aspirin or ibuprofen if you have a headache, but only up to 10 times per month. In the long run, it may be worth suffering through the occasional migraine to avoid more of them in the future.