Caffeine in the management of patients with headache

Richard B. Lipton, Hans Christoph Diener, Matthew S. Robbins, Sandy Yacoub Garas, Ketu Patel

Research output: Contribution to journalReview article

13 Citations (Scopus)

Abstract

Caffeinated headache medications, either alone or in combination with other treatments, are widely used by patients with headache. Clinicians should be familiar with their use as well as the chemistry, pharmacology, dietary and medical sources, clinical benefits, and potential safety issues of caffeine. In this review, we consider the role of caffeine in the over-the-counter treatment of headache. The MEDLINE and Cochrane databases were searched by combining “caffeine” with the terms “headache,” “migraine,” and “tension-type.” Studies that were not placebo-controlled or that involved medications available only with a prescription, as well as those not assessing patients with migraine and/or tension-type headache (TTH), were excluded. Compared with analgesic medication alone, combinations of caffeine with analgesic medications, including acetaminophen, acetylsalicylic acid, and ibuprofen, showed significantly improved efficacy in the treatment of patients with TTH or migraine, with favorable tolerability in the vast majority of patients. The most common adverse events were nervousness (6.5%), nausea (4.3%), abdominal pain/discomfort (4.1%), and dizziness (3.2%). This review provides evidence for the role of caffeine as an analgesic adjuvant in the acute treatment of primary headache with over-the-counter drugs, caffeine doses of 130 mg enhance the efficacy of analgesics in TTH and doses of ≥100 mg enhance benefits in migraine. Additional studies are needed to assess the relationship between caffeine dosing and clinical benefits in patients with TTH and migraine.

Original languageEnglish (US)
Article number107
JournalJournal of Headache and Pain
Volume18
Issue number1
DOIs
StatePublished - Dec 1 2017

Fingerprint

Caffeine
Tension-Type Headache
Headache
Migraine Disorders
Analgesics
Nonprescription Drugs
Ibuprofen
Dizziness
Acetaminophen
MEDLINE
Nausea
Abdominal Pain
Aspirin
Prescriptions
Therapeutics
Anxiety
Placebos
Databases
Pharmacology
Safety

Keywords

  • Acetaminophen
  • Acetylsalicylic acid
  • Caffeine
  • Ibuprofen
  • Migraine
  • Tension-type headache

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Caffeine in the management of patients with headache. / Lipton, Richard B.; Diener, Hans Christoph; Robbins, Matthew S.; Garas, Sandy Yacoub; Patel, Ketu.

In: Journal of Headache and Pain, Vol. 18, No. 1, 107, 01.12.2017.

Research output: Contribution to journalReview article

Lipton, Richard B. ; Diener, Hans Christoph ; Robbins, Matthew S. ; Garas, Sandy Yacoub ; Patel, Ketu. / Caffeine in the management of patients with headache. In: Journal of Headache and Pain. 2017 ; Vol. 18, No. 1.
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