I think my BT meds are giving me headaches

Hi All,

I have been getting more headaches lately and think they correlate with my hydrocodone use -- 4-6hrs after taking a dose, I end up with a headache, made worse if I take another. I haven't found this when I use oxycodone.

I wasn't having this problem a year or more ago, but seems to have started to emerge in the past few months.

I do recall, from 4 or more years ago, if I took more than a small dose, I would have a headache the next day. But that was resolved by drinking more water. Water still seems to help, but I'm wondering if others have had this issue -- some change in the way their bodies metabolize the opioid after taking it regularly for a number of years.

I'll talk to my PM about it, but I wonder if he'll see it as bizarre or if some change in how the body responds (beyond just tolerance) is a known phenomenon.

Hi SE,

I don't think it is TMJ (I don't have that problem thankfully). But I wonder if the hydrocodone is the direct cause or if it mediated by something else.

I'm now quite confident that the hydrocodone is playing some causal role as the drug holidays I've taken and the various days where I don't take any hydrocodone correlate with my hypothesis.

The headache issue also seems to have started in the early Fall, roughly when I went through a bout of vertigo. That may or may not be relevant.

My fear is that despite the low dose, some byproduct of the metabolization is causing the symptoms, or as my receptors have adjusted, the hydrocodone itself is now affecting them in such a way as to cause the headaches.

Just a lot of guessing right now.

I would like to stop the hydrocodone for a month to see what happens. But I'll end up using most of my oxycodone instead. My PM is not particularly happy about my taking 2 BT meds, but since I only need an oxycodone refill every 9-12 months, it isn't a big deal for him. However, he might be more troubled if I ask for a refill so soon (the last was in October).

If I were to avoid hydrocodone for at least two weeks, that may be realistic. I might go through 10-15 oxycodones. Or, I might go back to my old routine of not allowing myself to take any BT meds two days in a row.

Cognito...I think you might be right, I would definetly talk with your PM and see if you can make that change. If you can go without them until you see your doc I would. I am sending you some positive thoughts and hope you get this is resolved soon.

Take care, Amy

I'm currently using 10/325 so the tylenol is low.

For about 6 years, I never had a problem, but during those years, I almost never took any BT meds two days in a row. Over the last year or so, I've abandoned that rule.

I do plan on discussing it with my PM, but I want to be more sure. Today, I haven't used any BT meds yet and no headache. I already record all my BT med use. I'm now going to start keeping records of my headaches and see whether the correlation holds.

It is very frustrating to lose the benefit that hydrocodone has been offering -- or at least exchanging its shorter term relief for a subsequent headache.

I've tried googling various search strings, but couldn't find any related studies.

Hi Cogito. I think that it could definitely be causing your headaches. It sounds like you're on top of things regarding figuring out if it is (by documenting). I think that is the best way to find out.

If it is indeed causing them, could your doctor possibly make the oxycodone your primary breakthrough/immediate release medication, and prescribe the hydrocodone once every 6-9 months--meaning switching the prescriptions?

I get headaches (migraines and regular ones), and the thing that helps me most for the regular headaches is Excedrin. For some reason, the aspirin helps better than any other OTC/prescription headache medication.

Despite the liter of water, I ended up with a headache again.

I just did some more research and it does seem that there is about a 1% prevalence of "Medication Overuse Headaches" from opioids.

The threshold seems to be about 12 days per month for more than three months. A year ago, I averaged about 15 days of use per month. Now I'm at about 21. It looks like I may have cross a threshold and triggered the condition.

The only recommended treatment is discontinuation, though there are some other options, depending upon the cause of the headache (some studies connect it to serotonin levels impacting dilation/constriction of blood vessels in the brain, others to inflammation).

I also found:
Recent studies indicate that having lower than normal levels of the mineral magnesium can influence serotonin and nitric oxide release, blood vessel size, and inflammation. It’s also thought that people with mitral valve prolaspe have lower than normal levels of magnesium.

Which is further pertinent to my situation.

So, it looks like I will have to discontinue or at least cut my hydrocodone use by roughly 50%.

Thanks for the suggestion.

The headaches also correlate with my moving from 10/500 to 10/325 hydrocodones. So upping the tylenol may help.

But I've now added 800mg of magnesium as a supplement and if that or the tylenol does not help, I'm going to have to significantly cut back hydrocodone for BT pain.

I too get headaches and my PM also said it was from the hydrocodone. I take ibuprophen and that usually helps my headaches.

Take care,
Bill

I'm really at a loss regarding what is going on... and have been vacillating between the opioid hypothesis and something related to cervical issues.

The headaches are compounded now with a feeling of fullness/pressure in the head, and some vertigo -- which I went through during the summer. I had a negative CT scan.

With the recurrence of these symptoms, I'll all the more frustrated. Over the last week, I've cut back on BT use, without any improvement. I find myself apprehensive about taking any meds, but just can't work while in so much pain.

I stayed in bed today until noon, until my dog started to nudge me because she wanted out.

Thanks Linda.

The OTC analgesics haven't really made a difference.... and I'm still even not sure about the cause. Yesterday, I took no BT meds, but had a headache & head pressure. I'm beginning to migrate back to the hypothesis of my PT, that it is caused by the cervical scoliosis, somewhere impacting neck proprioceptors or even bloodflow to the brainstem.

Thanks but they are different from rebound headaches.

When I first started hydrocodone in 2005, I recall having them -- at that point 10mg was a big dose. They would hit me the next day.

But these occur just hours after taking the BT med.

Nevertheless, I'm still not sure if the meds are the cause or not. But something is triggering nearly daily headaches, a feeling of pressure in my head and a bit of vertigo.