A new headache or a change in the pattern of your chronic headache warrants urgent medical attention. These conditions include medication side effects, high blood pressure (hypertension), infections (meningitis, encephalitis), brain bleeding (subarachnoid haemorrhage) and brain tumours.

Any of the following may be a warning of a serious secondary headache:

•             Confusion

•             Drowsiness

•             Vomiting

•             Nerve symptoms that persist between headaches

•             Fever

•             Headache if you are over 50 years of age

•             Sudden onset headache that wakes you up at night

•             Head injury

•             Severe and debilitating pain

Chronic headache is an adverse side effect of numerous drugs, typically oestrogen (including combined oral contraceptives), calcium- channel blockers, nitrates, non-steroidal anti-inflammatories (NSAIDs, particularly indomethacin), and some erectile dysfunction drugs (sildenafil, tadalafil and vardenafil). In the case of patients with triptan-induced medication headache, the headaches have similar characteristics to the migraines for which treatment was initiated, but often occur on a daily basis.

Treatment for the condition is withdrawal of the offending medication. This should be managed in consultation with a general practitioner to ensure the withdrawal is managed effectively and the possibility of relapse is minimised. Some people will need to be admitted to hospital to wean themselves off the medication.