The Ambiguous Role of Caffeine in Migraine Headache: From Trigger to Treatment.

Magdalena Nowaczewska,Michał Wiciński,Wojciech Kaźmierczak

doi:10.3390/nu12082259

Magdalena Nowaczewska, Michał Wiciński + Show 1 more

Open Access

https://doi.org/10.3390/nu12082259

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Abstract

Migraine is a chronic disorder, and caffeine has been linked with migraine for many years, on the one hand as a trigger, and on the other hand as a cure. As most of the population, including migraineurs, consume a considerable amount of caffeine daily, a question arises as to whether it influences their headaches. Indeed, drinking coffee before a migraine attack may not be a real headache trigger, but a consequence of premonitory symptoms, including yawning, diminished energy levels, and sleepiness that may herald a headache. Here, we aim to summarize the available evidence on the relationship between caffeine and migraines. Articles concerning this topic published up to June 2020 were retrieved by searching clinical databases, and all types of studies were included. We identified 21 studies investigating the prevalence of caffeine/caffeine withdrawal as a migraine trigger and 7 studies evaluating caffeine in acute migraine treatment. Among them, in 17 studies, caffeine/caffeine withdrawal was found to be a migraine trigger in a small percentage of participants (ranging from 2% to 30%), while all treatment studies found caffeine to be safe and effective in acute migraine treatment, mostly in combination with other analgesics. Overall, based on our review of the current literature, there is insufficient evidence to recommend caffeine cessation to all migraine patients, but it should be highlighted that caffeine overuse may lead to migraine chronification, and sudden caffeine withdrawal may trigger migraine attacks. Migraine sufferers should be aware of the amount of caffeine they consume and not exceed 200 mg daily. If they wish to continue drinking caffeinated beverages, they should keep their daily intake as consistent as possible to avoid withdrawal headache.

Highlights

Migraine has emerged as a great public health concern, and the World Health Organization (WHO)has classified it as the third most common disease worldwide, with over a billion people estimated to suffer from it [1,2]
The aim of this review is to examine the relationship between caffeine and migraine, and to check whether caffeine is a migraine trigger and avoiding it may be of benefit to certain patients, and to find out if caffeine may be helpful in migraine treatment
It may be challenging to distinguish between migraine triggers and premonitory symptoms, as drinking coffee or an energy drink before an attack may be due to yawning, diminished energy levels, and sleepiness that may herald a headache

Summary

Introduction

Has classified it as the third most common disease worldwide, with over a billion people estimated to suffer from it [1,2] This type of primary headache usually presents with recurrent, typically unilateral and pulsating attacks of severe headaches, lasting from 4 to 72 h, with accompanying symptoms including photophobia, phonophobia, nausea, and vomiting [3]. Some migraine sufferers ask their doctors about dietary recommendations regarding their intake of caffeinated beverages. They demand specific information regarding whether they are allowed to drink coffee or should avoid it, and whether it will be beneficial for their migraine if they stop drinking it

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