Doctors face headache of kids overdoing OTC painkillers

Study suggests that children and adolescents, like adults, fall prey to the rebound cycle of headaches and over-the-counter medications.

By Victoria Stagg Elliott, AMNews staff. July 19, 2004.

The teenager was taking six over-the-counter analgesics a day, and the headaches that had once been only occasional visitors were making her life a daily hell. So Allan Bernstein, MD, chief of neurology at Kaiser Permanente in Santa Rosa, Calif., had to convince her that the pills were part of the problem and it was time to wean her off of them.

"I said we could cure her headache, but it takes a lot of educational time to explain that when you stop taking the medicine, the headaches get worse and it's going to take a while before it all goes away," he said.

Headache experts have long acknowledged the adult problem of overuse of OTC painkillers, which can lead to rebound headaches as well as various gastrointestinal ills. Now, a study presented at last month's American Headache Society scientific meeting in Vancouver, British Columbia, confirms what many physicians who care for children have long suspected: It's a kid problem, too.

"I can't tell you how many times I have a family in my office, and the parents say, 'oh that's where all the ibuprofens are going!' " said Paul Graham Fisher, MD, associate professor in neurology at Stanford University. "Kids think it's OK to take eight, 10 or 15 a day. It's over-the-counter so what could be wrong with it?"

According to the study, 22% of children ages 6 to 18 with recurrent headaches presenting to a specialized clinic were taking more than three doses of OTC medications a week and had been doing so for at least a month and a half. The practice was more prevalent among older children than younger ones, and among girls with chronic tension headaches or a mix of migraine and tension headaches.