Medication withdrawal therapy is a treatment strategy for chronic daily headaches associated with the paradoxical induction of headaches by the frequent, long-term use of immediate relief medications such as aspirin, NSAIDs, acetaminophen, caffeine, codeine, ergotamine, and sumatriptan. Headache diaries kept for 1 to 3 months during and after withdrawal showed that 56% of the patients had at least a 50% reduction in headache days after removal of overused drugs. A commonly used preventive medication is amitriptyline. Other therapies for treating chronic daily headache include the skeletal muscle relaxant tizanidine (Zanaflex) and beta blockers. Stress management, acupuncture, botulinum toxin, behavioral therapy including relaxation therapy, biofeedback have all been studied.
Valguarnera F, Tanganelli P. The efficacy of withdrawal therapy in subjects with chronic daily headache and medication overuse following prophylaxis with topiramate and amitriptyline. Neurol Sci. 2010 Jun;31 Suppl 1:S175-7. doi: 10.1007/s10072-010-0319-0. PMID: 20464616.