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Painkillers may make headaches worse.

Strong evidence suggests that people with chronic headaches actually are doing themselves more harm than good by taking too many prescription or over-the-counter painkillers. According to researchers at St. Louis University School of Medicine, analgesics-aspirin, ibuprofen, acetaminophen, narcotics, and various combinations of these medications--taken sparingly are effective and decrease the severity of headaches, but overuse of the drugs may increase their frequency in many patients.

"It's really a paradox," points out Paul N. Duckro, associate professor of psychiatry and human behavior and director of the Biobehavioral Treatment Center. "People who suffer from headaches are typically taught to rely on medication for their pain, but we've found that the regular use of analgesic medication can contribute to the transformation of an occasional headache into the nearly constant pain of a chronic daily headache" (one that lasts 20 or more days a month).

It is easy for people to fall into an analgesic trap. A headache sufferer may take and benefit from a painkiller, then begins to use it more freely, perhaps even to prevent pain. As medication and headache pain increase together, the individual begins to find that the analgesic is less effective, so he or she takes more or tries new ones. In the end, the person gets a headache whenever the medicine is not being taken.

The analgesic overuser usually is not an addict. "Patients are just trying to cure a headache and they think only medicine can help. In their frustration, they take pills that unwittingly make their problems worse. They cling to the medication in desperation, but it's like clinging to the tail of the tiger."

Duckro suggests that the first step in treatment is to get the person to withdraw from the analgesics, which sometimes requires inpatient care. Previous studies have found that a large proportion of chronic headache sufferers temporarily benefited just from the withdrawal of medication. Complete treatment, however, includes finding a medication that will serve to prevent the pain and reduce the frequency of headaches. This often may be a drug the patient tried in the past, but was rendered worthless by the overuse of other medications. Finally, adequate, psychological support should be provided, including behavior modification, relaxation therapy, emotional support, and education.
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Publication:USA Today (Magazine)
Date:Oct 1, 1993
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