What Are the Clinical Features of Analgesic Rebound Headache?
Fortunately, there are a number of clinical characteristics to assist in identifying rebound headache in our patients with chronic headaches. • The headaches are refractory, daily or near daily. • They occur in a patient who uses immediate relief medications frequently, often in excessive quantities. • The headache varies in its severity, type and location from time to time. • The headaches may be brought on by slight physical or intellectual effort. • The headaches are seen with complaints of nausea and other GI symptoms; restlessness; anxiety; irritability; memory and concentration problems; and depression. • There is a drug-dependent rhythmicity of headaches with the headache emerging as the medication wears off. The patient may report a predictable early morning headache, particularly seen in patients who use large quantities of immediate relief medications. • Barbiturate-containing analgesics (e.g., Fiorinal, Esgic) suppress REM sleep. This is followed by REM rebound and results i
