Why Is Caffeine Used In Headache Medicine?

Headache is one of the most common of all health complaints, according to Sharon Parmet, M.A., et al., writing in the May 2006 issue of the "Journal of the American Medical Association." Tension headache, migraine, cluster headache --- no matter what you call it --- or the source of the pain, all hurt. Headache remedies abound, both in prescription and over-the-counter form and many contain caffeine.

About Caffeine

When you drink a cup of coffee, you are actually ingesting a drug. Caffeine, the best known constituent of coffee, is a stimulant. While many people immediately connect coffee and caffeine, other foods and beverages contain this slightly bitter substance. Tea, chocolate, cocoa and many soft drinks --- whether regular or diet --- are also caffeine sources. Even decaffeinated tea and coffee still contain small amounts. Caffeine affects a neurotransmitter called adenosine by blocking the receptors to which adenosine attaches. This can affect sleep and movement, electrical activity in the brain or changes in the width of blood vessels.

The Research

Research has shown that caffeine in combination with other pain relievers such as aspirin or ibuprofen is more effective than when either is used alone. Studies done at the Diamond Headache Clinic in Chicago, Illinois, were reported in the September 2000 issue of "Clinical Pharmacology and Therapeutics." Researchers found that caffeine added to ibuprofen helped relieve tension-type headaches. Neither caffeine nor ibuprofen alone worked as well as the combination. In another study from Germany reported in the May 2009 issue of "Headache", V. Pfaffenrath, et al., noted that a combination of acetylsalicylic acid, paracetamol and caffeine was more effective in relieving headache than any of the three alone or when acetylsalicylic acid and paracetamol were given without caffeine.

Caffeine vs. Coffee

It is important to recognize there is a difference between pure caffeine and something like coffee, which contains caffeine but also many other substances. While a strong cup of coffee may help with acute migraine relief, a wide variation exists in caffeine's effects on the body, depending on its usage, according to Drs. Robert Shapiro and Robert Cowan in the American Headache Society. Plus, the amount of caffeine in coffee can vary widely. A cup brewed via the drip method can have 125 to 250 mg of caffeine. For many people, a "cup" may be 12 to 16 oz., while the standard cup used in research is only 8 oz.

Considerations and Warnings

Caffeine is not without its downside. It can cause dependency in as little as seven days and withdrawal symptoms can include headache. Shapiro and Cowan recommend using caffeine for headaches no more than twice a week and suggest that since some people may be genetically susceptible to even very small amounts of caffeine. People who suffer chronic or severe migraines should consider eliminating caffeine entirely for a few months to see if headaches improve.