Causes

Doctors don't yet know exactly why medication overuse leads to rebound headaches. The risk of developing medication overuse headaches varies depending on the medication, but any acute headache medication has the potential to lead to medication overuse headaches, including:

• Simple pain relievers. Common pain relievers such as aspirin and acetaminophen (Tylenol, others) may contribute to medication overuse headaches — especially if you exceed the recommended daily dosages. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) have a low risk of contributing to medication overuse headaches.

• Combination pain relievers. Over-the-counter (OTC) pain relievers that combine caffeine, aspirin and acetaminophen (Excedrin, others) are common culprits.

  This group also includes prescription medications such as Fiorinal, which contains the sedative butalbital. Butalbital-containing compounds have an especially high risk of causing medication overuse headaches, so it's best not to take them to treat headaches.

• Migraine medications. Various migraine medications have been linked with medication overuse headaches, including triptans (Imitrex, Zomig, others) and certain ergots — such as ergotamine (Ergomar, others). These medications have a moderate risk of causing medication overuse headaches. The ergot dihydroergotamine (D.H.E. 45) appears to have a lower potential for leading to this problem.
• Opiates. Painkillers derived from opium or from synthetic opium compounds include combinations of codeine and acetaminophen (Tylenol with Codeine No. 3 and No. 4, others). These medications have a high risk of causing medication overuse headaches.

Daily doses of caffeine — from coffee, soda, and pain relievers and other products containing this mild stimulant — may fuel medication overuse headaches, as well. Read product labels to make sure you're not wiring your system with more caffeine than you realize.