Caffeine in the management of patients with headache

The Journal of Headache and Pain

Review Article

Hans-Christoph Diener¹  Ketu Patel²  Sandy Yacoub Garas²  Richard B. Lipton³  Matthew S. Robbins³ 

[1] Department of Neurology, University Duisburg-Essen, Essen, Germany;GlaxoSmithKline Consumer Healthcare, Parsippany, NJ, USA;Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, Louis and Dora Rousso Building, 1165 Morris Park Avenue, Room 332, 10461, Bronx, NY, USA;

关键词: Tension-type headache;    Migraine;    Caffeine;    Acetaminophen;    Acetylsalicylic acid;    Ibuprofen;   

DOI  :  10.1186/s10194-017-0806-2

 received in 2017-06-15, accepted in 2017-09-08,  发布年份 2017

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s). 2017