Does Caffeine Impact Migraine Treatment?

Patients who completely cut out their consumption of caffeine experienced better efficacy of acute migraine treatment, according to the results of a small study published in The Journal of Headache and Pain.

“Our uncontrolled study suggest that caffeine cessation might be beneficial for acute migraine treatment,” wrote Mi Ji Lee, of Samsung Medical Center, Seoul, South Korea, and colleagues. “Our data showed that the baseline dose of caffeine did not affect the impact of caffeine cessation. That is, high-dose caffeine consumers as well as low- to moderate-dose consumers can benefit from the abrupt caffeine discontinuation.”

In the past, caffeine use has been linked with development of chronic migraine. In this study, Lee and colleagues evaluated if caffeine cessation for 2 weeks or longer could affect outcomes of acute migraine treatment. To analyze this theory, they recruited 108 patients with migraine who consumed caffeine drinks daily. Participants were instructed to discontinue caffeine use and triptans were prescribed for acute treatment. Participants in both groups had a median of 9 headache days per month.

The efficacy of the migraine treatment was assessed at a median of 34.5 days. At that time, 33.3% of patients completely discontinued caffeine consumption (abstinence group) and 66.7% did not. Those patients who completely gave up caffeine had a longer history of migraine (P=0.010).

Excellent efficacy of treatment was reported by almost three-quarters of patients in the abstinence group (72.2%) compared with 40.3% of patients in the non-abstinence group (P=0.002). Patients completed the headache impact test-6 and scores showed a trend toward greater reduction of headache impact among those patients who abstained from caffeine.

The researchers found that caffeine abstinence was independently associated with excellent efficacy of the treatment (odds ratio=3.2; 95% CI, 1.2-8.4; P=0.018). There was no association found with baseline caffeine consumption and caffeine cessation on the efficacy of the migraine treatment.

“Our study results might indicate that migraine patients may benefit from complete abstinence of caffeine, similarly to the abrupt discontinuation of acute analgesics for detoxification in patients with medication overuse headache,” the researchers wrote.

Reference: Lee MJ, et al. Caffeine discontinuation improves acute migraine treatment: a prospective clinic-based study. J Headache Pain. Epub 2016 Aug 5.