ANALGESIC REBOUND HEADACHE IN CHILDREN AND ADOLESCENTS

For more than a decade, the frequent use of analgesics has been recogn ized to lead to daily headaches in adults. To date, no studies on the occurrence of analgesic rebound headache have been done on the pediatr ic population. We retrospectively reviewed all charts of patients with the diagnosis of headache seen in our pediatric headache clinic betwe en January 1996 and May 1997. Among the 98 patients seen, 46 (47%) suf fered from daily or near daily headaches; 30 of them were consuming da ily analgesics. Twenty-four patients (mean age 12.1 years, and mean fo llow-up 6.2 months) successfully discontinued their analgesics. Twenty -two patients were also placed on amitriptyline. A significant reducti on in the frequency (80%), severity (47%), and number of school days m issed (74%) were seen. In conclusion, this data is comparable to previ ous observations reported in adults, and suggests that the daily use o f analgesics might result in daily or near daily headaches in the pedi atric population. Discontinuing; daily analgesics, with the concomitan t use of amitriptyline, is an effective treatment for analgesic reboun d headache in this population.