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Medications used in Rebound headaches - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Headache and Migraines
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2584 Questions
User :   I take 20 tylenol a day and I am pregnant. I suffer from rebound headaches, what can I do?
Doctor :   Hi
Doctor :   May I know your age and since when are you having these headaches?
User :   I have been to accupuncture before I was pregnant, tried many prescription headache medicines, yoga, and nothing relives my headaches
User :   I am 25 and have been having headaches since i was 18 after a snowmobile accident but now I know i have rebound headaches from relying on medicine
Doctor :   Ok
Doctor :   Can you describe the pain?
User :   from the back of my neck to the front of my head on the right. It's like I can hear my head throbbing with every pump my heart takes
Doctor :   Ok
Doctor :   Are you on any other medications apart from the paracetamol?
User :   no I used to take klonopin for my tension and anxiety, that helped with the headaches but I was told not to take it anymore
Doctor :   Ok
User :   the neurologist said maybe botox shots in my neck but he said insurance would deny it because of the rebound headaches
Doctor :   Do you have any other medical illness apart from these headaches?
User :   no
Doctor :   Ok
Doctor :   Let me brief you.
Doctor :   Medical Treatment(with drugs) for chronic headaches with pregnancy are restricted due to the effects of these medications on the pregnancy.
Doctor :   Apart from paracetamol other pain killers have effects on pregnancy.
Doctor :   Hence due to this reason, the use of medical drugs such as other NSAID's, Opioids analgesics can be used cautiously.
User :   I already knew this but my life is getting hard to live. I can not do anything because of my constant pain. The tylenol only helps for an hour at most
Doctor :   Along with the tylenol, other stress reducing measures such as regular sleeping habits, restricting caffeine use, yoga and meditations have to be continued.
User :   I would rather not be pregnant and get a handle on my physical health.
User :   Is this much tylenol going to harm me?
Doctor :   The other analgesics for pain relief can be tried after the first trimester when the chances of the fetal defects and other teratogenicity are less.
Doctor :   If not chronic, then the high dose of paracetamol are not known to cause much problems except for the gastritis.
Doctor :   However continued use of high dose can cause effects on the liver functions.
Doctor :   My suggestions for the present problem are
Doctor :   1. Use Tab tylenol only when the headache becomes severe and uncontrollable.
Doctor :   2. Regular sleep and diet ( inadequate sleep and fasting can contribute to the pain)
Doctor :   3. Continue with the other pain relief measures such as yoga, meditations, and if needed the acupuncture techniques.
Doctor :   4. You can consider the use of other headache control medications after the first trimester, if they are still persisting.
User :   how do I get the tylenol out of my system
User :   I am 18 weeks pregnant now
Doctor :   The drug gets metabolised by the liver effectively.
Doctor :   and is removed.
User :   so is it rebound headaches?
Doctor :   Rebound headaches are often caused by the drug dependence and not mainly due to the drug itself.
Doctor :   Hence slowly withdrawl of the analgesics will prevent these headaches.
Doctor :   Have you followed what I have suggested?
User :   yes
User :   this problem has just been ongoing and is getting worse
Doctor :   The exact treatment for this condition is going to be slow and gradual.
User :   I can not concentrate in class and feel I need to withdrawl from school so I can get a handle on this
Doctor :   It would require slow withdrawl of the drug which is responsible for these rebound headaches.
User :   what other medications can I take after the first trimester
Doctor :   along with supplementing alternative pain relief measures during this period.
Doctor :   There are few classes of anticonvulsants drugs which are used in during pregnancy.
Doctor :   though these medications are also a class b and c drugs during pregnancy,
Doctor :   they are used in the treatment of convulsions in pregnancy.
User :   why did the klonopin help my headaches
Doctor :   Certain drugs among this class are also used for the treatment of rebound headaches and may be considered in your instance, if the headaches are severe and unbearable.
Doctor :   Klonopin is also one among the anticonvulsants drugs.
Doctor :   Hence its use in rebound headaches.
Doctor :   Low dosage of these anticonvulsants can be tried under medical guidance and repeated evaluation of the pregnancy status, if the headaches are severe and once you have crossed your first trimester.
Doctor :   Have you followed?
User :   yes
Doctor :   Do you have any other query?
User :   no my understanding is that this will be a slow and ongoing process I have a level two ultrasound monday to see if all this medicine has affected the fetus
Doctor :   The treatment will be a slow and gradual.
Doctor :   The time duration for complete treatment varies among individuals.
Doctor :   And its necessary that you follow the measures suggested by your doctors strictly.

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