Medication-Overuse Headache – When Medications Cause Headaches

11. Dec 2025 | General, Live healthier

Headaches are among the most common health problems worldwide. Two types occur particularly frequently: tension headaches and migraines. Migraines are recurring, usually one-sided, pulsating headaches that are often accompanied by nausea and sensitivity to light and sound. Tension headaches, on the other hand, tend to manifest as a pressing, bilateral pain without accompanying symptoms. Both conditions are often treated with medication for acute relief. But what happens when these medications themselves become the trigger for chronic headaches? This is exactly what happens with medication-induced headaches, a condition known as medication-overuse headache (MOH).

Medication-induced headache is a secondary headache disorder. It develops as a result of excessive use of medications for acute pain treatment in cases of existing migraine or tension headaches. According to current estimates, MOH affects about one percent of the general population in Germany. People with chronic headaches are particularly affected. The International Classification of Headache Disorders defines chronic headaches as headaches that occur on at least 15 days per month and persist for at least three months. MOH, on the other hand, is defined as the regular overuse of symptomatic headache medication in addition to the criteria for chronic headaches. The decisive factor is therefore the excessive use of certain medications for acute treatment. These include, in particular, triptans, which are used specifically for migraines, ergotamine preparations, which are used less frequently, combination preparations with caffeine, and classic painkillers such as acetylsalicylic acid (aspirin), ibuprofen, or paracetamol. In the case of triptans, ergotamine, and combination preparations, taking them for around ten days per month is enough to cause MOH. With non-opioid painkillers such as ibuprofen or paracetamol, the threshold is around 15 days.

The reason why medication-induced headaches develop is not yet fully understood. It is believed that repeated medication use leads to changes in the brain’s pain processing system. This reduces the effectiveness of the medication while increasing sensitivity to pain. Those affected then take the medication even more frequently, which further reinforces the cycle.

Besonders gefährdet sind Frauen, Personen mit bereits bestehender Migräne sowie Menschen mit psychischen Begleiterkrankungen wie Depressionen oder Angststörungen. Social factors such as a low level of education or limited access to healthcare can also increase the risk. The diagnosis is often delayed because many sufferers do not recognize the link between taking medication and an increase in headaches.

The most important measure for MOH is to reduce or completely stop taking acute medication for headaches. At the same time, educating those affected plays a central role: it is important to raise awareness of the link between regular medication use and increasing headache frequency. Studies show that a complete withdrawal of acute medication often reduces the frequency of headaches. Accompanying prophylaxis to reduce the number of headache days can also be useful.

To avoid MOH, it is advisable to consistently document headache days and medication intake. A headache diary or digital tools can help you identify patterns in good time. Digital applications such as the mediteo app help you to systematically document your symptoms, keep track of the medication you have taken, and work with your doctor to develop a suitable treatment plan.

 

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