Brief Answer:
Very challenging situation you present---BUT THE GOOD NEWS IS----read on

Detailed Answer:
Good afternoon young lady...I'm Dr. Saghafi, practicing adult neurology in XXXXXXX OH and a headache specialist. Your question is a common since the vast majority of the people I treat suffer from what we NOW call MEDICATION OVERUSE HEADACHE (MOH). Older terms are "analgesic rebound", " medication rebound" and there may be another 1 or 2. You are correct that these headaches are believed to be an entity unto themselves. However, there is no way known to us to perfectly guarantee that a person with headaches of this type won't "suffer" during the transition phase between overuse and and rational use.

Let me first start by giving you the numbers that we always quote when it comes to this sort of problem.

Medications that are believed to cause MOH are those which are taken for ACUTE headaches and they can be both prescription and OTC. Unfortunately, doctors are as much to blame for this problem as patients and as much to blame as pharmaceutical companies who know what the potential risks are when putting these analgesics on the market but they have no interest in labeling with warnings or trying to educate the public as well as the medical communities on MOH.

Therefore, people naturally assume that since it's OTC it must be safe. More than that, sometimes their own doctors will give them the green light to take "as much ibuprofen or acetaminophen as necessary to keep the headaches down." Nothing can be further from the truth and getting someone detached from this problem can be very challenging. However, I can tell you that in the clinic that I run and have run for over 12 years at the VA Hospital and in my private practice the vast majority of people who I treat and who are truly dedicated to the notion of doing whatever it takes to "kick the habit" are successful. All realize that I have no magical suggestions to accomplish but they have faith in the plan and fact that things are usually worth having come at a price and sometimes that price is a little pain and suffering.

Having said that there are organized and medically supported protocols that can clearly lessen the pain burden on people going through MOH transitions. It all starts by filling out a headache diary so that we can analyze and get a good baseline of your headache activity with respect to your symptoms, duration of your headaches, and some other vital parameters that can be tracked once we recommend and start making changes or applying interventions.

If you would like to engage in this plan....it's a process....no short term fix....but if you commit to the process and the notion that you can get over this with proper guidance and supervision and also discipline yourself not to fall into the MOH trap again then, I believe you will be perfectly successful....I can't promise a painLESS process but that temporary compared to the pain you will have to endure in the future if you nothing about this problem and simply continue to follow the same course. Eventually the Excedrin dosing will become ridiculous and at some point it will not work AT ALL...not that it likely is working that well anyways....since you are taking it multiple times daily.

If you'd like to provide me your email address I will respond by providing you with the headache diary I give to all my clinic patients and then, we go through some training on the log and you're off to hopefully a new lifestyle and new quality of life....

If this information has been helpful and I've answered your question satisfactorily would you do me the favor of some written feedback and a STAR RATING of the answer. Should you have no further questions or comments to place- CLOSING THE QUERY would be greatly appreciated as well.

In the future I'm happy to answer more concerns personally if you'd allow me this privilege by going to the following website and sending me your questions:

bit.ly/drdariushsaghafi

This query required 113 minutes of physician specific review, research, and final draft documentation for envoy.

---