A MILLION headache sufferers who take common painkillers on a regular basis are actually intensifying their pain by making their brains ‘immune’ to the drugs’ effects, doctors warn today.
They are aggravating their symptoms by relying on medications like aspirin, paracetamol and ibuprofen on an almost daily basis. Five in six of them are women.
Instead of taking these over-the-counter drugs to combat symptoms when they flare up, sufferers should try treatments that help prevent headaches in the first place - including acupuncture - according to official advice from the National Institute for Health and Clinical Excellence (Nice) in the UK.
It is launching new guidance today to help doctors better diagnose and treat different types of headache, which can be difficult to tell apart.
Almost everyone experiences occasional headaches but a fifth of people suffer from much more serious and debilitating types, with some developing intense ‘tension’ type headaches on most days.
Some have what doctors call ‘medication overuse headaches’, due to becoming over-reliant on drugs supposed to help with tension headaches and migraines.
Dr Manjit Matharu, a consultant neurologist who helped develop the Nice guidelines, said: “Patients with frequent tension-type headaches or migraines can get themselves into a vicious cycle, where their headaches are getting increasingly worse.”
Taking normal dose aspirin, paracetamol or anti-inflammatory painkillers like ibuprofen for 15 days or more a month could lead to these headaches, he said.
People could still develop medication overuse headaches even if they took less than the maximum daily dose, he emphasised, although taking low-dose aspirin (75mg) daily to protect against heart disease and cancer would not trigger them.
Taking opioids like codeine, or other powerful painkillers like triptans, ergots or combination analgesic medications for 10 days or more a month could also exacerbate headaches or migraines, he said.
Dr Martin Underwood, a GP and professor of primary care, who chaired the guidelines panel, explained the only remedy was to come off the drugs “abruptly”.
He said: “This is one of the most difficult conversations I have with patients, because the headache will get worse over the next few days.”
Studies indicated most people suffering from medication overuse headaches were those with a family history of migraine, they said. Most were women.
Dr Matharu explained that frequent use of painkillers desensitised the brain to their effects, "and that leads to more pain".
Patients who thought this was happening to them should consult their GPs about preventative medication, he said.
There was strong evidence that the drugs propranolol, topiramate and gabapentin worked to prevent migraines, he advised, but preventing tension headaches was more difficult.
“Acupuncture is the only treatment that we’ve got a good evidence base for.”
The eastern technique was “often not taken seriously enough”, claimed the neurologist, but trials showed it had a real beneficial effect.
By Stephen Adams Telegraph.co.uk