What Causes Medication Overuse Headache? - Chromatography Investigates

Many of us get headaches. For most people it is simply a case of popping a couple of aspirin or paracetamol and we can continue with life as the headache slowly fades into the background. But for some people, the act of taking medication can bring on more pain in the form of a headache. The medical term for this type of headache is medication overuse headache.

Currently, doctors do not know why some people suffer from medication overuse headaches. But research is ongoing. A paper published in Cephalalgia – the journal of the International Headache Society – reports on a study by researchers in Italy to try and understand some of the biological mechanisms underlying the condition. Read on to see how chromatography is helping researchers get to the bottom of the problem.

Medicine can be a right pain in the head

Medication overuse headaches are also known as rebound headaches. They are caused by regular and long-term use of medication that is used to treat headaches. People who have to use pain relief medication for headaches more than two or three days a week can set off medication overuse headaches. As each dose of pain relief eases, patients take more medication to ease the pain. The repeated taking of pain relief can stop helping to ease the pain and cause a new headache.

Medication overuse headaches are developed by people who are already prone to getting either headaches or migraines. People on pain relief for other conditions do not usually develop it. For the sufferers, stopping the medication can cause withdrawal symptoms including a chronic headache. And the cycle starts all over again as the patient takes medication to ease the pain of headache.

Doctors are not sure why overuse of some medications cause rebound or overuse headaches. Simple pain relievers including aspirin and acetaminophen, alone or in combination with each other or caffeine, are known to cause the headaches.  Opiate based painkillers including codeine-based formulations are also known to cause the headaches. The risk of ibuprofen causing medication overuse headaches is thought to be very low.

Chromatography investigates the cause

The researchers behind the study referenced above were interested in changes in serum proteins between patients who suffer from the headaches and healthy patients. The samples were evaluated using gel electrophoresis followed by liquid chromatography-tandem mass spectrometry. The use of LC-MS/MS to analyse difficult samples is discussed in Separation of the 4 Enantiomers of the Fungicide Spiroxamine by LC-MS/MS.

The team found several proteins were elevated in patients who suffer from medication overuse headaches. The use of LC-MS/MS allowed the researchers to identify some of the proteins including retinol binding protein and alpha-1-antitrypsin. They conclude that: The investigation of the serum proteome can offer a better understanding about biological mechanisms underlying medication overuse headache.