For more than a decade, the frequent use of
analgesics has been recognized to lead to daily
headaches in adults. To date, no studies on the occurrence of
analgesic rebound headache have been done on the pediatric population. We retrospectively reviewed all charts of patients with the diagnosis of
headache seen in our pediatric
headache clinic between January 1996 and May 1997. Among the 98 patients seen, 46 (47%) suffered from daily or near daily
headaches; 30 of them were consuming daily
analgesics. Twenty-four patients (mean age 12.1 years, and mean follow-up 6.2 months) successfully discontinued their
analgesics. Twenty-two patients were also placed on
amitriptyline. A significant reduction in the frequency (80%), severity (47%), and number of school days missed (74%) were seen. In conclusion, this data is comparable to previous observations reported in adults, and suggests that the daily use of
analgesics might result in daily or near daily
headaches in the pediatric population. Discontinuing daily
analgesics, with the concomitant use of
amitriptyline, is an effective treatment for
analgesic rebound headache in this population.