Introduction and question about rebound headaches

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New Member

Date Joined Mar 2012
Total Posts : 6
   Posted 3/27/2012 2:54 PM (GMT -6)   
Hi all

This is my first post so I will fill you in on the background. I'm 46, married with no kids and have been having migraines since my early 20s. I don't get aura, and initially they were almost exclusively triggered by alcohol so it took several years for them to be diagnosed (I thought 2 days in bed, unable to keep even water down, was just a bad hangover!). I get 2 different types of migraine. The most common is in the left temple, really intense stabbing pain and once it starts I know it will only get worse and worse. During these I'm sensitive (but not excessively so) to light/noise and to perfumes. I also sometimes get a headache in the right temple which is always much duller, but which can go on for days - I'll go to sleep with it and wake up with it still there. These days I never vomit, although I feel nauseous with both types.

I gave up red wine totally about 20 years ago and these days drink alcohol infrequently (and little) as I often (but not always) get a migraine when I do. Now the trigger is more likely to be stress and/or missing a meal. I work from home but am in constant contact with an office in London (including a small team that reports to me) and I'm usually at my desk from 9am to 7pm, sometimes later, although I take the dog out for 30 mins at lunchtime.

I discovered years ago that triptans work like magic for me (first Imigran and now Zomig) and my usual pattern used to be to wake up around 4am knowing I was getting a migraine, but before it really hurt. I'd take a tablet, go back to sleep and then get up and get on with my life. Sometimes a migraine develops during the day (especially if I skipped a meal, or simply ate too late) but again the triptans work. Both the left and right pains respond to triptans altho I tend to wait much longer before taking them for a 'right' pain, since I tend to feel that these are not 'proper' migraines since they are not so incapacitating.

To start with I wasn't aware of any connection between migraines and my monthly cycle, but over the years this changed. I was on the combined pill for years, but then switched to the mini-pill because of migraines for several more years and finally, about 3 years ago, to the Mirena coil. That lasted 6 months because it made the migraines so bad! Since then I've not been using any hormonal contraception, and once back on a natural cycle found I often got a right-side headache just before my period. I've now been diagnosed (via a blood test) as 'probably' perimenopausal and currently haven't had a period for 3 months. Although it's varied over the years, until relatively recently my prescribed 12 Zomigs a month has usually been about right. In the past year or so, however, my migraines have been getting much, much worse and I've often had periods of a week or two when I'm taking them almost every day (mostly left side but some right), then just as I start talking to the doctor about rebound headaches, the attacks stops and it's back to one tablet every few days. I'm keeping a regular migraine diary again and in the past 27 days i've had only 10 days when i haven't had to take a Zomig. Bizarrely, 5 of these were consecutively when I was ill with a horrible flu-like virus that has now kept me off work for almost 3 weeks (unheard of for me). Since my husband is travelling overseas for work for several weeks at the moment I've come to stay with my parents which means I'm being looked after (and the dog is being walked!).

The virus is still here and my legs and brain feel like cotton wool. However, I'm increasingly worried that these are rebound headaches, so, since I'm already off work I decided I might as well try a break from the Zomigs at the same time. Yesterday I got a right side headache and didn't treat it. Today I spent the whole day in bed with the pain coming and going, before deciding I would take a couple of paracetamol (which I didn't expect to work) and get up for supper. Strangely, the pain has now eased (due to the paracetamol?? I have to admit to not having taken paracetamol for a migraine in years!) which has slightly negated my primary reason for contacting this forum.

Anyway, I have seen a number of posts from a few years back on here that suggested that if you are trying to combat rebound headaches you don't necessarily need to go 'cold turkey' but can take a tablet 2-3 times a week if the pain continues to be excruciating. Is this still considered the case? Can anyone share their experiences of breaking the cycle? And how can you tell if you are no longer getting rebound headaches rather than actual migraines? Having just done 24 hours without one when I would normally have taken one I don't want to undo all the good work by taking a tablet before I should. But nor do I want to suffer a migraine when I know just one Zomig will get rid of it! And do these sound like rebound headaches or does anyone think it's just hormonal - and if so, is this going to go on until the menopause?!

Thank you all for reading - it's wonderful to find a place to meet people who understand what it's like (although I have to say that having read some of the posts on here I do feel that my own problems are minor in comparison).


New Member

Date Joined Mar 2012
Total Posts : 6
   Posted 3/28/2012 2:50 AM (GMT -6)   
Me again. I know my post was a bit OTT but I woke up at 5 today with a 'true' left side migraine and have so far resisted taking zomig. Its now nearly 9am and the pain is now all-encompassing. I would really appreciate any thought on whether I need to put myself thru this. No one I know know anything about rebound headaches.

Veteran Member

Date Joined Jan 2006
Total Posts : 1308
   Posted 3/28/2012 1:47 PM (GMT -6)   
Hi Hellz,

Welcome to Healing well. Sorry to hear you are having such a rough time.

To go cold turkey with meds and rebounds has its good and bad points. You really need support from your Neuro with this as it is difficult to maintain, but it is well worth it as you will save yourself so much suffering in the future!!

The rule of thumb for preventing rebound headaches is to take painkillers (this includes triptans) for 2 days in any one week. That means you can take the allowed dose for a 24 hour period on two days in a week and that gives relief for two days and you ride out the rest!!! This is hard to do but it gets rid of the muzzy heads that are endless and gives a better sense of well being.

The problems arise when you get a virus and need to take such as paracetamol for several days in order to keep you temperature down. For what it is worth my personal opinion is that you have to go with that soemtimes and resume the 2 days a week when the virus has gone. It seems to work for me personally, but not everyone will have the same experience.

My head is always very much worse with a virus.

Can I ask, do you see a Neurologist, and is he/she a Headache Specialist?? If not I would strongly urge you to find one, if you are in the UK you can email me and I can let you have the details of one in your area!

Hope this helps, take care

Co-Moderator of the Migraine/Headache Forum

DX: Hemicrania Continua, Chronic Migraine, IBS, Allergic Rhinitis and Heart Murmur

Meds: Imigran Injections, High Flow Oxygen, Mebeverine, Lansoprazole, Nasonex and Clarityn

Violet Rose
Regular Member

Date Joined May 2011
Total Posts : 48
   Posted 3/28/2012 4:28 PM (GMT -6)   
hi :)
Firstly I want to say your story could be me!  Mine too started in my early twenties and were always triggered by alcohol, I could never understand why my 'hangovers' lasted for 2 days of intense pain and vomiting while all my friends could go shopping the following morning after a night out!  I am now completely teetotal, any tiny amount of alcohol triggers me, even chocolate liquors or alcohol used as preservatives in food can do it.
Anyway, about the rebound headaches.  In the past year I have had to wean myself off triptans and asparin/caffeine for this very reason.  Triptans are a miracle drug for me and like you I can wake up feeling terrible take a Zomig and go back to sleep. I wake up an hour later and feel fine and go on with my day.  HOWEVER....over the course of 10 years of this I found I was taking them more and more, to the point that sometimes I would take them for 3 or 4 days in a doctor would only prescribe me 6 at a time and I was forever at the doctors asking for a repeat prescription, I felt like a drug addict but it was the only way I could carry on with my life.  I knew that without taking them meant 3 or 4 days in bed probably 3 or 4 times a month.
I was also taking asparin with caffeine almost daily for the inbetween tension headaches.
I read on here and on some other migraine forums about rebound headaches and realised this is more than likely what was happening to me.  I am in the fortunate position at the moment of not having to work (am shortly moving back to the UK to am hoping to return to work!) I decided that for a trial period I would only take triptans if it was vital, for example if I had a family event to go to or my partner and I had planned something.  For all the other migraines I had I did not treat them with medication I just let them run their natural course.  The first two were horrendous I thought they would never end.....over a week for each and pretty much bedridden the whole time  BUT I noticed that when they did finally go away I was migraine free for around 2/3 weeks instead of only a few days like before.  I still get tension headaches but now I try to ignore them of I take Ibuprofen without any caffeine. I have also cut caffeine out of my diet completely.
I am now down to taking around 4 triptans a month, which is a huge improvement from the 8-12 a month like before.  I still get a lot of headaches but they are less severe and often do not need medicating.
I know there is a big debate about whether rebound headaches exist or not, all I can say is that if I can tough it out and let my migraine run its course unmedicated then I do have a longer period of headache free time before the next big one, rather than the daily or alternate day migraines as before.
Hope this helps :)

New Member

Date Joined Mar 2012
Total Posts : 6
   Posted 3/28/2012 6:06 PM (GMT -6)   
Thank you both. The support is so appreciated. Ann, I am in the uk so will mail you later when I've worked out how! I have a gp appointment tomorrow if I can get there.

It's now 19 hours since this started and it's been right back to bing unable to keep even water down. will post again when I'm up to it.

Veteran Member

Date Joined Dec 2008
Total Posts : 2386
   Posted 3/29/2012 2:46 AM (GMT -6)   
You need an ultrasound of your ovaries. It may be an ovary disorder such as PCOS, of which I have. Its no biggy, easy to treat. It is quite normal to have migraines with menstrual time in simple ovary disorders. PCOS is just a big fancy words (PCOS for short) way of saying cysts on ovaries. You reminded me to take my pill though lol. Anyhow, all that I do is take a birth control pill and metformin. Birth control actually helps "ease" menstruation and helps. I prefer nuvaring, as I always forget to take pills.
"The Walking Medical Mystery"

Too many Allergies / Too many RXs & DXs

A Rare Gem for Doctors and Guinee Pig
~Medical Caregiver and Doctors Worse Nightmare~

New Member

Date Joined Mar 2012
Total Posts : 6
   Posted 3/29/2012 2:22 PM (GMT -6)   
Hi all - an update

After 24 hours of debilitating pain and nausea the migraine eased this morning and I have to admit although a bit shaky (I'm still recovering from the virus too) my head does feel clearer than it has done for a while, further confirming that this was rebound. Violet Rose, thanks for sharing your story, it helped me see a way through when things were at there worst last night.

My GP agrees, and has also agreed to refer me to a neurologist specialising in headaches (thanks for the suggestion Ann!). She's going to refer me to the man who gave an inspiring lecture she attended on migraines & rebound headaches recently, and who also does research in this area. Fingers crossed he will be able to take me on (and SmurfyShadow, I'll ask him about PCOS, thanks). She also prescribed me some anti-nausea medication which she said might help (I don't have the name on me) and suggested I try 3x 300mg aspirin at the first sign of a migraine rather than Zomig for now. Any thoughts on either of these from anyone?

Separately, I'm going to look into Bowen Therapy, which other members of my family swear by for pretty much any physical ailment, and talk to a nutritionist, as well as taking steps to improve how I deal with work-related stress. Equally importantly I will be telling my boss about the rebound diagnosis and the fact that in future I may sometimes have to take a day or 2 off when I get migraines (it was refusing to 'give into them' and just taking Zomigs every time that got me into this situation in the first place). I will let you know what, if anything helps!

So I know that I will have to go through the horrors of yesterday again, but I do feel that I am a bit more in control than I was before - and finding this forum was a big part of this, so thank you all.

Violet Rose
Regular Member

Date Joined May 2011
Total Posts : 48
   Posted 3/29/2012 4:41 PM (GMT -6)   
I'm glad your feeling more positive about it :)
one other thing, someone else on here mentioned something that stuck in my mind, she said that some migraines just wanna finish what they started, so taking triptans will suppress it for a while but it always returns the next day to finish!! if you get what I mean, its a good way of explaining it :)
Triptans are described as migraine abortives and sometimes they are but very often for me that are more of a temporary suppressant, eventually I have to deal with the pesky thing!
I have a migraine starting right now, all because I ate a slice of cake that contains alcohol as a preservative (here in Italy all bread/cakes are preserved this way).  The label made no mention of alcohol but as soon as I ate it I KNEW....the taste was really strong.  So annoying!
I am not going out tomorrow so have just taken some Ibuprofen and now off to bed, fingers crossed it gets no worse!
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