Are your headache medications causing more headaches?

Acute medication overuse (AMO) is the overuse of acute or abortive headache medications and can be common among individuals with migraine or tension-type headache who experience frequent attacks. The threshold number of days that defines medication overuse depends on the medication. For opioids, butalbital-containing medications (Esgic, Fioricet), triptans, ergots, or combination analgesics, using 10 or more days per month would be considered AMO. For simple analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, using 15 or more days would be considered AMO. 

Medication-overuse headache (MOH) is a secondary headache disorder occurring on 15 or more days per month in a patient with a pre-existing primary headache disorder (such as migraine or tension-type headache), and developing as a consequence of AMO for more than 3 months. MOH usually resolves after the overuse is stopped. 

Patients can have AMO but also not meet criteria for MOH because they experience less than 15 headache days per month. Correcting AMO should be under the guidance of a physician or experienced provider, and not performed abruptly, or cold turkey.