A caffeine-containing drink, such as coffee, tea, caffeinated soda or an energy drink, could represent either a trigger or a treatment for a migraine sufferer. Approximately 12 percent, or close to 37 million, men and women in the United States suffer from migraine headaches.
Caffeine is a central nervous system stimulant. Its effects on the body include increasing a person’s ability to pay attention, stay alert, and think and move fast, while simultaneously improving muscle coordination, decreasing tiredness, and even diminishing the urge for sleep. Some migraine sufferers report that consuming a caffeine drink can stop a migraine from escalating. While few research studies have addressed whether caffeine can actually relieve the pain of a migraine, there is a small controlled study which indicates that caffeine may relieve the pain of migraines.
The pathophysiology of migraines, including what actually causes and perpetuates the debilitating headache pain, is not fully understood. Over the years, theories about the causes of headache pain have pinned the blame on over-dilated blood vessels in the brain. However, the current thinking has shifted to blame improperly-stimulated nerves instead.
Although vascular theory is out and neurological theory is in among headache scientists, it is interesting to note that some of the mainstay prescription medications for migraines, such as the triptans (including Imitrex) and the beta blockers (such as Propranolol), appear to work on vascular processes. However, researchers now believe that these drugs are effective in treating migraines because of receptor site activation instead of blood vessel constriction.
Caffeine may help to alleviate headache pain due to its relationship with adenosine, a naturally occurring molecule that slows down brain activity. Caffeine binds to adenosine receptor sites in the brain and blocks their effects. While caffeine drinks may alleviate migraines by blocking the action of adenosine, precisely how adenosine contributes to headache pain is not yet understood.
Conversely, caffeine drinks may trigger migraines through a rebound, or withdrawal, process. The brain can develop a physical dependence on caffeine in as little as seven days of regular exposure. Rather than the caffeine molecule being the actual headache trigger, it is thought that the withdrawal symptoms resulting from the caffeine dependence account for how caffeine triggers a headache.
Over-the-counter migraine treatment medications, such as Excedrin and Anacin, include caffeine in combination with pain relievers, such as acetaminophen and aspirin. Not only may the caffeine relieve pain on its own, but it speeds up the body’s absorption of other medications as well. Caffeine also has a synergistic effect with other drugs and may optimize the effectiveness of acetaminophen and aspirin by up to 40 percent. Many prescription pharmaceutical treatments, such as Fioricet and Migranal, also include caffeine.
Chronic migraines, defined as more than 15 headache days per month for more than three months, are acknowledged as a source of disability. Migraine headaches have been linked to obesity, hormonal changes, metabolism, genetics, tension, stress and traumatic injury.
Researchers speculate that future studies on migraines will reveal some combination of neurological, endocrine, nutritional/metabolic, genetic and vascular components in a multifaceted causal mechanism. No matter what the root cause of migraines is ultimately determined to be, the condition is complex and perplexing, as illustrated by the fact that a caffeine drink can be either a trigger or a treatment. Nevertheless, the neurological perspective on migraines is giving rise to new treatment options.
Not only are new drugs in development for treating migraines, but existing drugs, such as botulinum toxin (Botox) and the eyedrops used to treat glaucoma, are being used for new purposes in treating migraines. Botox treatments block nerves and neurotransmitters to alleviate headache pain and the eyedrops used to treat glaucoma are actually beta blockers in liquid form, so the drug enters the body faster than when it is taken as a pill.
New research showing the effectiveness of non-pharmaceutical options for treating migraines has resulted in the availability of a medical device for treating headaches and growing mainstream support for mindfulness meditation. Cefaly is a device worn as a headband for 20 minutes each day to electrically stimulate the trigeminal nerve in order to prevent migraine pain. Approved by the FDA in March of 2014, Cefaly is the first transcutaneous electrical nerve stimulation (TENS) device approved by the FDA for use prior to pain onset.
Mindfulness meditation is best known for its effectiveness in reducing stress, and stress is a known trigger for migraines. A small study published in the journal Headache showed that the duration of migraines was significantly shorter among participants who meditated for 30 minutes per day.
Clinical experts agree that recognizing and eliminating migraine triggers, using preventive treatment and staying ahead of migraine pain by treating the headache at its earliest onset is the most effective way to manage migraines. While caffeine is not the only trigger or treatment for migraines, it is considered to be a modifiable risk factor for migraines, and a gradual reduction in its use is highly recommended for migraine sufferers.
Because the effectiveness of different migraine treatments varies widely from individual to individual, it is important for migraine sufferers to keep track of what works for them and what does not. Because caffeine drinks are so wildly popular that even retired soda brands, like Surge, can be resurrected by social media campaigns, it is important for each individual to be aware of whether a caffeine drink will trigger or treat his migraine.
By Lane Therrell