Agbakwuru Deborah

IS PARACETAMOL A CULPRIT IN MEDICATION OVERUSE HEADACHE? Image link- https://images.app.goo.gl/2MuUUB2oZ42RPV9C6 People often wonder if the popular over the counter (OTC) pain relief medication, Paracetamol, can actually cause Medication Overuse Headache (MOH) since it’s actually used to manage headaches. The simple answer to this is “YES”. When overused (abused), Paracetamol can cause headaches. Paracetamol, also known as acetaminophen is one of the most popular over the counter medications used to relieve pain and reduce fever. Paracetamol, however, has no anti-inflammatory properties. Over the years, Paracetamol has been used to relieve mild to severe headaches. However, the Journal of Headache and Pain establishes the fact that the use of Paracetamol in combination with caffeine is one of the first-line treatment for migraines and tension headaches. The recommended daily dose of Paracetamol in adults for mild to moderate pain is 1 gram every 4-6 hours with a maximum of 4 grams per day. This simply means 2 tablets every 4-6 hours with a maximum of 8 tablets per day. Going beyond this is already overuse. It is important to consult your doctor or pharmacist if you have any underlying liver impairment as the recommended doses would be different. The Migraine Trust reported that acute pain relief medicine use of more than 2 or 3 times a week or more than 15 days out of the month for 3 months and more can establish a cycle called “Medication- Overuse Headaches (MOH)”. MOH is a dull steady headache which is present on most days, at least 15 days per month or part of the day and especially intense in the morning, upon awakening. However, only persons that are prone to headaches or have family history of migraines usually develop this. MOH has prevalence which ranges from 1-2% with a 3:1 female to male ratio and usually occurs in the middleaged. In simple words, taking more than 8 tablets of Paracetamol for more than 2-3 times a week and more than 15 days out of the month can cause medication overuse headache in adults that are prone to headaches or have family history of migraines. TREATMENT The treatment of choice for medication overuse headache (MOH) is the discontinuation of the overused medication which is Paracetamol in this case. Preventive treatment targeted at the background primary headache disorder should be started during or just after the withdrawal of the offending agent. The American Migraine Foundation says that the patient should know that when the overused medication is stopped, they are likely to undergo a period where the headaches will worsen. Restlessness, constipation, nausea, vomiting or insomnia may be the other withdrawal symptoms. The gladdening aspect is that the headaches will eventually become better. The overused medication could be discontinued abruptly or tapered down slowly. The headache cycle will eventually be broken in about 6 months. Now that you know this, wouldn’t it be great if you stop abusing the popular OTC pain relief medication, Paracetamol? If you think you need help you can always visit your doctor or pharmacist. COMPILED AND WRITTEN BY AGBAKWURU DEBORAH-