What is the role of caffeine in the treatment of migraine headaches?

Updated: Jun 14, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Answer

A retrospective study found that for both menstruation-associated migraine and migraine not associated with menses, the percentage of responders (ie, those whose pain intensity was decreased to mild or none) was significantly higher among those receiving an acetaminophen-aspirin-caffeine (AAC) regimen than among those receiving placebo at all time points from 0.5 to 6 hours after administration. [10] Treatment effect was essentially equivalent at all time points for menstruation-associated migraine and migraine not associated with menses.

In both menstruating and nonmenstruating women, AAC treatment yielded improvements in migraine characteristics (eg, photophobia, phonophobia, and functional disability) at all time points from 1 to 6 hours. [10] Both menstruating and nonmenstruating women experienced significant relief from nausea with AAC, but relief appeared earlier in the latter.

Beginning at 3 hours after treatment, both groups of AAC-treated women (menstruating and nonmenstruating) were significantly less likely to require rescue medications than their placebo-treated counterparts were. [10] In both groups, the most commonly used rescue medications were the following:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Prescription combination analgesics-narcotics

  • Prescription migraine preparations

AAC was well tolerated both in women with menstruation-associated migraine and in women with migraine not associated with menses. In general, adverse experiences were similar in the 2 groups. In both menstruating and nonmenstruating women, the percentage of patients who had 1 or more adverse experiences was significantly higher among those receiving AAC than among those receiving placebo. Adverse experiences were similar in type and severity to those previously associated with a single dose of acetaminophen, aspirin, or caffeine.

For related information, see Migraine Headache, as well as the Headache Resource Center.


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