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13 Sep 2006

Which OTC med's 4 severe headaches
I am F/50 years of age. Both my paternal grandfather, father and myself seem to have problems with extreme headaches which if I do not deal with it in the early stages - it ends up becoming a migraine. (Nausea, vomitting,dizziness,sensitivity to light.)

I consulted with an 'expert' four years ago who put me onto a migraine prescription headache medication (sorry, cannot remember the name) but this medication made me extremely hyper, anxious and incredibly nauseous so stopped it after 3 months.) Two other similar med's made me equally ill.

I have been treating the beginnings of a head ache with Compral for a number of years. My G.P. feels though that taking Syndol is a better option as he is against long term, high dose use of asprin due to possible stomach complications. He also feels that codeine is a better pain reliever for my headaches.

Please, could you tell me what would you advise for someone like me to use OTC? I am trying to avoid having to step up to higher and more addictive type drugs if I can avoid it but am uncertain as to just what analgesic is actually the 'safest' to take. On bad days I might take 6 Syndols.... On other days only one or zero....depends on my pain level.

I am aware of the 'rebound' situation and have tried at various times during my life to only use Panado or nothing at all but my life comes to a total halt then as the pain stops me from being able to function.

Thank you kindly for your advice.
Answer 308 views
Headache expert
headache expert

01 Jan 0001

Dear Joanne,

You have been given the worst advice possible, and there are no OTC or even prescription headache medications that do not cause rebound headache.

If you are aware of rebound, then I won’t lecture you on it, but codeine in headache medications is one of the worst causes of rebound headache. It is vital that you get off all pain killers, and this is eminently possible. You have to reclaim your quality of life. You have to be properly diagnosed so that the causes of your headache can be identified and treated, so that you no longer need the “rescue” medication.

To get to the root of the problem, you need what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
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