severe headache

I have a 48 year old female M/W/F friend who is have severe headaches. They start at the base of her neck and move up towards her forehead on the rightside. She has also had some nausea with these headaches. She considers herself health, she currently does not have any type of illness. She is taking extra strength Headache Relief, acetaminophen, aspirin and caffeine, Equate Brand. When she first started using this med the relief would last for approximately 4 hours, but now it only lasts for approximately 2 hours. She has had a constant headache for the last 7 days.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

One of the most common causes of headaches in people with chronic headaches is called medication rebound or medication overuse headache. Medications as simple as tylenol or advil if used too much can cause rebound headaches that are even worse then the headaches for which the medications were started for. This is very common and is most likely to occur with use of any medication for your headache more than a few times a week. It can occur with all the commonly used headache medications such as ibuprofen, triptans (such as imitrex), fioricet, and commonly with any type of narcotic such as tylenol #3, dilaudid, percocet, etc. The treatment is difficult, but basically involves weaning off the offending agent and replacing it with another that is later weaned off, combined with a more long-term solution. This should be done under strict guidance by a specialist, preferably a headache specialist, or else the headache will not improve and withdrawal side effects can occur.

I recommend that your friend follow up with her primary physician. If he/she is unable to break the headache cycle, your friend may need to be seen by a neurologist who specializes in headaches.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.