Painkillers Create 'New Headaches'—1 in 9 Headache Medication Users Overuse Them. Data from App 'Zutunote' Created by Headache Specialist Revealed

1 in 9 headache medication users overuse them"

Iris Wellness Inc. (Shinagawa-ku, Tokyo, CEO: Hirotaka Maekawa), which provides the headache diary app "Zutunote," analyzed user data and found that approximately 1 in 9 (10.9%) headache medication users took acute headache medication for 10 or more days in a given month. This exceeds the threshold for suspected "medication overuse headache (MOH)." Following the iOS version released in June, the Android version has now been launched, making the app available on iOS, Android, and the web. Zutunote was developed by CEO Maekawa, a headache specialist, and is completely free to use with no advertisements.

Overusing painkillers creates new headaches

When headaches are severe, over-the-counter painkillers and triptans can be very helpful. However, frequent and continuous use can paradoxically lead to chronic headaches. This condition is known as "medication overuse headache (MOH)."

According to the International Classification of Headache Disorders (ICHD-3), MOH is diagnosed when triptans or combination analgesics are used for 10 or more days per month, or simple analgesics like OTC medications are used for 15 or more days per month, for over three months. It is more common in people suffering from headaches, with a general prevalence of 1-2%. Although it is a common condition, it is difficult because both patients and medical professionals tend to overlook it.

"Overuse" revealed in user data

Data from 862 Zutunote users who recorded their medication usage was compiled.

Approximately 1 in 9 headache medication users (10.9%) used acute headache medication for 10 or more days in a given month (exceeding the threshold for suspected MOH).

1.3% of users had continued to use medication for 10 or more days per month for over 3 months (a level strongly suspected of MOH, aligning closely with the general prevalence of 1-2%).

On the other hand, the average number of usage days was 3.2 days per month, with most users staying within appropriate limits.

While many people have no issues, some individuals unknowingly enter the realm of overuse. This tendency, which is difficult to recognize through memory alone, emerged from the records.

Distribution of monthly acute headache medication usage days. 10 days or more (orange) is the threshold for MOH.

Comment from Headache Specialist Maekawa

Overusing headache medication makes the brain's pain-sensing circuits hypersensitive. This phenomenon, called central sensitization, causes headaches to occur even with minor stimuli. The dangerous aspect of MOH is falling into a vicious cycle of "it doesn't work, so I take it again."

The basic treatment is to stop the causative medication. However, the period of withdrawal often involves a temporary worsening of headaches, which is extremely difficult for patients. Therefore, what I always advise is to reduce medication *before* reaching that point. It's about noticing the frequency of use while still having some leeway and gradually reducing it. The first step is to accurately know how many days per month you are using headache medication. Many people underestimate this number based on memory alone. Only when it's visible as a number can you take the first step towards a solution.

Recording makes the data visible to your doctor

When you record your daily headaches and medication intake in Zutunote, the number of headache days, medication frequency, pain intensity, and duration are automatically compiled and displayed in graphs. Medication frequency, which tends to be vague from memory, becomes visible as numbers, allowing you to notice overuse yourself.

As you record more, headaches and medication use become visible as numbers

Treatment effects and medication history are visualized

If a user sets a "primary care institution," this compiled data is sent directly to the doctor's consultation screen. You can discuss reducing medication or preventive treatments while looking at the same data. Note that only medical institutions registered with Zutunote can be selected as primary care institutions.

To Medical Institutions

The sharing with primary care physicians mentioned above is available when medical institutions are registered with Zutunote. Registration is free. When a patient sets a medical institution as their "primary care," their headache diary and medication records are sent to the consultation screen, aiding in the identification of MOH and decisions regarding medication reduction and preventive treatment. Registered medical institutions are also listed on our "For Medical Institutions" page. For more details, please inquire through the "For Medical Institutions" page.

About the Data (Survey Overview)

Survey conducted by: Iris Wellness Inc.

Target: 862 users of the headache diary app "Zutunote" who record their use of acute headache medication.

Methodology: Calculated the "number of days acute headache medication (triptans or analgesics) was used" per month for each user.

Threshold: Based on ICHD-3, "10 or more days of acute headache medication use per month" was used as the threshold for MOH.

Period: Service launch to July 2026 / Based on user data as of the compilation date.

Note: Records are based on user self-reporting. As the target users are those suffering from headaches using this app, the distribution differs from the general population. These results are not medical diagnoses but indicate trends.

Developer Profile

Developer: Hirotaka Maekawa (Neurologist, Headache Specialist)

Hirotaka Maekawa

— Neurologist, Headache Specialist / CEO, Iris Wellness Inc.

・Certified Specialist, Japan Society of Neurology / Certified Specialist, Japan Headache Society / Certified Specialist, Japan Internal Medicine Society

・After initial training at Tokyo Metropolitan Bokutoh Hospital, joined the Department of Neurology at The University of Tokyo Hospital. Broadly treated conditions from acute cases like cerebral infarction to neurodegenerative diseases such as Parkinson's disease and ALS. Currently engaged in home-visit care and specialized headache clinics.

・Driven by his own experience with headaches, he continues to practice headache medicine as his life's work. In 2025, he began developing apps independently from scratch with no prior programming experience, creating "Zutunote" and "Med-Tasuki (Regional Medical Collaboration Platform)."

Service Overview

Service Name: Zutunote

URL: https://zutsu-note.iris-wellness.jp/

iOS Version: https://apps.apple.com/jp/app/id6780531423

Android Version: https://play.google.com/store/apps/details?id=jp.iriswellness.zutsunote

Usage Fee: Completely free (no ads)

Company Overview

Company Name: Iris Wellness Inc.

Location: Shinagawa-ku, Tokyo

Representative: CEO Hirotaka Maekawa

Business Activities: Development of medical web applications, support for in-hospital DX, consulting

URL: https://www.iris-wellness.jp/

Inquiries Regarding This Matter

Iris Wellness Inc.

Email: contact@iris-wellness.jp