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Complications

By Mayo Clinic staff

Pain Management Advisor

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Sometimes your efforts to control your pain cause problems.

  • Abdominal problems. Certain pain relievers, such as ibuprofen (Advil, Motrin, others), may cause abdominal pain, bleeding and ulcers — especially if taken in large doses or for a long period of time.
  • Rebound headaches. In addition, if you take over-the-counter or prescription headache medications more than nine days per month or in high doses, you may be setting yourself up for a serious complication known as rebound headaches. Rebound headaches occur when medications not only stop relieving pain, but actually begin to cause headaches. You then use more pain medication, which traps you in a vicious cycle.
  • Serotonin syndrome. This potentially life-threatening drug interaction can occur if you take migraine medicines called triptans, such as sumatriptan (Imitrex) or zolmitriptan (Zomig), along with antidepressants known as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Some common SSRIs include Zoloft, Prozac and Paxil. SNRIs include Cymbalta and Effexor. Fortunately, serotonin syndrome is rare.
Preparing for your appointment Risk factors
References
  1. NINDS Migraine information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/migraine/migraine.htm. Accessed March 28, 2011.
  2. Cutrer FM, et al. Pathophysiology, clinical manifestations, and diagnosis of migraine in adults. http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
  3. Boes CJ, et al. Headache and other craniofacial pain. In: Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008. http://www.mdconsult.com/books/page.do?sid=1155758096&eid=4-u1.0-B978-0-7506-7525-3..50111-4&isbn=978-0-7506-7525-3&uniqId=240648610-3. Accessed May 1, 2011.
  4. Migraine. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Migraine. Accessed March 30, 2011.
  5. Headache diagnosis and testing. American Headache Society. http://www.americanheadachesociety.org/assets/NAP_for_Web_-_Headache_Diagnosis_&_Testing.pdf. Accessed April 1, 2011.
  6. Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/headachehope.pdf. Accessed April 1, 2011.
  7. Migraine. Journal of the American Medical Association. 2009;301:2608.
  8. Calhoun AH. Estrogen-associated migraine. http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
  9. Hormones and migraines. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Hormones_and_Migraine. Accessed March 30, 2011.
  10. Bajwa ZH, et al. Acute treatment of migraine in adults. .http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
  11. SSRIs, triptans and serotonin syndrome: What is the risk of serotonin syndrome in migraine? American Headache Society. http://www.achenet.org/education/patients/SSRIsTriptansandSerotoninSyndrome.asp?print=y. Accessed April 1, 2011.
  12. Keeping a headache diary can help your doctor help you. National Headache Foundation. http://www.headaches.org/pdf/How_Keep_Headache_Diary.pdf. Accessed April 1, 2011.
  13. Gilmore B, et al. Treatment of acute migraine headache. American Family Physician. 2011;83:271.
  14. Migraine prevention: A guide to the latest methods and treatments. National Headache Foundation. http://www.headaches.org/educational_modules/migraine_module/page_home.htm. Accessed March 31, 2011.
  15. Fenstermacher N, et al. Pharmacological prevention of migraine. British Medical Journal. 2011;342:540.
  16. Bajwa ZH, et al. Preventive treatment of migraine in adults. http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
  17. Cruse RP. Management of migraine headache in children. http://www.uptodate.com/home/index.html. Accessed March 28, 2011.
  18. Chaibi A, et al. Manual therapies for migraine: A systematic review. Journal of Headache and Pain. 2011; epub Feb. 5.
  19. Exertional headaches. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Exertional_Headaches. Accessed March 31, 2011.
  20. FDA approves Botox to treat chronic migraine. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm229782.htm. Accessed April 14, 2011.
DS00120 June 4, 2011

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