Rebound, or withdrawal headache does exist, but has generally been overstated as a cause of chronic daily headache (CDH). Headache clinic studies, which tend to be skewed toward the more severe patients, indicate a much higher percentage of rebound than better ‘population-based’ epidemiologic studies. These larger studies indicate that only 15 to 20% of CDH patients have rebound.

Rebound is more likely from the analgesics than from the triptans, particularly the ones with more caffeine (such as Excedrin). Too many patients are told ‘You are causing your own headaches, do not take anything for them for at least one month’.  It is enormously frustrating to patients who say “maybe the Excedrin IS causing my headaches, but I had the same headache BEFORE the Excedrin!”   More on this later…