How long to detox from Medication Overuse Headache?

November 15, 2006 5:20 AM

Detoxification for Medication Overuse Headache (MOH) from OTC medications - how long?

Background - I posted a question earlier this year about headaches. I am still using the Heal your Headache book and overall my headaches are milder, but still daily. I will have insurance and a neurologist appointment in January.

I am on week 5 of a "drug holiday" - no analgesics of any kind. I was only taking OTC NSAIDs such as tylenol, ibuprofen and naproxen.

How long do I need to do this?

This idea is that OTC meds can cause MOH and taking a break is the only way to find out if you have MOH or perhaps chronic daily headache.

I'm doing ok; I think it has helped. I can probably do 2 more weeks pretty easily, but the menstrual cycle headache is a bear.

If I need to continue into week 9, I need to reschedule some commitments so I can stay home and wrestle the bear! Thank you.

posted by egk to health (5 comments total)

I'd say a minimum of two weeks, and preferably a month if you can, to get a sure result.

However, MOH is usually associated with "big gun" prescription meds, like those containing barbituates and codeine. Yes, the book's right in connecting OTC meds to rebound headaches. But it's a syndrome most prescription users suffer from.

While you're cutting out the OTC meds, you might try removing a few headache-connected foods as well -- and caffeine -- and checking out the results.
posted by Gordion Knott at 8:31 AM on November 15, 2006

Are you also detoxing (or have you already detoxed) from caffeine? You don't mention, and I've found varying levels of caffeine from all the usual-suspect sources (coffee/tea, soda, chocolate) have a big influence on headache, so it might complicate your progress. In any case, good luck.
posted by aught at 8:35 AM on November 15, 2006

Sorry, I didn't specify that the book mainly focuses on the diet aspects of things. I am off caffeine and alcohol and I do not eat chocolate, cured meats, aged cheese. I am also avoiding MSG in all its many forms.

I am also avoiding Psudafed. All these changes did help. But after several months of this, I still have a daily headache.
posted by egk at 9:00 AM on November 15, 2006

However, MOH is usually associated with "big gun" prescription meds, like those containing barbituates and codeine

Most patients who develop this do so via the unwitting use of OTC analgesics, typically Excedrin[migraine] or acetaminophen or naprosyn/motrin. Prescription analgesics less so (w/ possible exception of Fioricet/Fiorinal).

Keep off the OTC's, but consider a visit with your doc to discuss other techniques of treating daily headache syndromes.
posted by docpops at 3:16 PM on November 15, 2006

I think I've found what I was looking for. Here's a cite to a study showing that the average time for a patient to achieve six consecutive headache free days was 84 days without any analgesics of any kind. I have just finished week 6, so I am half-way there.

-------------
Warner JS. The outcome of treating patients with suspected rebound headache. Headache. 2001;41:685-692.

Here's a summary of the study:
http://www.neurologyreviews.com/oct01/nr_oct01_litmon.html
posted by egk at 7:42 PM on November 21, 2006