It also recommends patients and their doctors consider the generic prescription-drug sumatriptan for those suffering from moderate to severe migraines because studies show it's cheaper than the alternatives in its drug class and often just as effective.
But that's a distinct possibility if you take a higher-than-recommended dose or use the drug for a longer period than what the label advises, according to a new Consumer Reports review of migraine medications. Medication-overuse headaches are typically agreed to be those that occur at least 15 times a month or worsen because of too much treatment.
TOO MUCH OF A GOOD THING
Headache-prone people can end up with "rebound" headaches for a variety of reasons, said Dr. Orly Avitzur, medical adviser for Consumer Reports and a neurologist in Tarrytown, N.Y.
Some patients mistakenly believe they can prevent headaches by continuing to take pain relievers even if their head isn't currently throbbing, she said.
"It's easier to just pop a pill sometimes than maybe go to a doctor and explore what's causing the headaches or what more can be done," Avitzur said.
Patients often seek help when their headaches persist despite self-treatment with over-the-counter medications such as acetaminophen (brand name Tylenol), ibuprofen (brand names Advil or Motrin), naproxen (Aleve), aspirin or aspirin with caffeine (Excedrin), she said.
"By the time they come in to see me, they've converted sporadic migraines into chronic daily headaches," Avitzur said.
What's more, common pain medications including ibuprofen, aspirin and naproxen can produce side effects such as nausea and gastrointestinal bleeding, which can lead to serious health problems if taken for too long.
There are many kinds of headaches - including ordinary tension-type, cluster and migraine headaches - and it can be easy to slide into damaging self-treatment habits in a desperate effort to stay functional. Headaches are a major source of debilitating pain and lost productivity due to missed work and school.
While many have no serious underlying cause, some headaches can signal bigger medical problems that merit prompt professional attention, Avitzur said. Your first or strongest headache, one that's accompanied by speech or language difficulty, weakness, numbness or tingling should send you to a doctor or hospital emergency room, if you think it's stroke-related, without delay.
But the good news for patients with medication-overuse headaches is physicians can help them taper off the meds that are causing the continued or worsening symptoms and start them on preventive therapy, she said.
TARGETING MIGRAINE MISERY
Migraines are a kind of headache marked by a variety of neurological symptoms that can include intense throbbing on one or both sides of the head, dizziness, nausea, vomiting and extreme sensitivity to light, sound and smell.
Migraines affect more than 30 million Americans, according to the Migraine Research Foundation. Attacks affect three times as many women (18 percent) as men (6 percent).
For people with moderate to severe migraine pain, Consumer Reports recommends trying sumatriptan, available by prescription in tablet, nasal spray and injectable form. It's been available in the U.S. since 1993 under the brand name Imitrex and went generic in 2008.
Sumatriptan is the only generic in a class of drugs called triptans. Their safety profile isn't all-inclusive. They're generally suited for men under 40 and women under 50 who have a healthy weight, don't smoke and don't have a heart condition, said Lisa Gill, editor of Consumer Reports' Best Buy Drugs, based in Yonkers, N.Y. Sumatriptan is Consumer Reports' first best-buy drug recommendation for 2010.