Wednesday August 21, 2019

Drinking Three or More Servings of Caffeinated Beverages a Day Increases Risk of Migraine

In a study published in the American Journal of Medicine, researchers evaluated the role of caffeinated beverages as a potential trigger of migraine

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Drinking three or more servings of caffeinated beverages a day increases the risk of migraine. Pixabay

Coffee lovers, please take note. Drinking three or more servings of caffeinated beverages a day increases the risk of migraine.

In a study published in the American Journal of Medicine, researchers evaluated the role of caffeinated beverages as a potential trigger of migraine.

They found that, among patients who experience episodic migraine, one to two servings of caffeinated beverages were not associated with headaches on that day, but three or more servings of caffeinated beverages may be associated with higher odds of migraine headache occurrence on that day or the following day.

“While some potential triggers – such as lack of sleep – may only increase migraine risk, the role of caffeine is particularly complex, because it may trigger an attack but may also help control symptoms, caffeine’s impact depends both on dose and on frequency,” said Elizabeth Mostofsky from Harvard University.

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Coffee lovers, please take note. Pixabay

During the study, 98 adults with frequent episodic migraine completed electronic diaries every morning and every evening for at least six weeks.

Every day, participants reported the total servings of caffeinated coffee, tea, soda and energy drinks they consumed, as well as filled out twice daily headache reports detailing the onset, duration, intensity, and medications used for migraines since the previous diary entry.

Participants also provided detailed information about other common migraine triggers, including medication use, alcoholic beverage intake, activity levels, depressive symptoms, psychological stress, sleep patterns and menstrual cycles.

To evaluate the link between caffeinated beverage intake and migraine headache on the same day or on the following day, researchers used a self-matched analysis, comparing an individual participant’s incidence of migraines on days with caffeinated beverage intake to that same participant’s incidence of migraines on days with no caffeinated beverage intake.

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The researchers further matched headache incidence by days of the week, eliminating weekend versus week day habits that may also impact migraine occurrence.

Self-matching also allowed for the variations in caffeine dose across different types of beverages and preparations.

“One serving of caffeine is typically defined as eight ounces or one cup of caffeinated coffee, six ounces of tea, a 12-ounce can of soda and a 2-ounce can of an energy drink,” Mostofsky said.

“Those servings contain anywhere from 25 to 150 milligrams of caffeine, so we cannot quantify the amount of caffeine that is associated with heightened risk of migraine. However, in this self-matched analysis over only six weeks, each participant’s choice and preparation of caffeinated beverages should be fairly consistent,” Mostofsky added. (IANS)

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Two Drug Trials May Promise Some Relief for People Who Suffer from Migraine Headaches

An experimental oral drug made migraine pain quickly go away for one in five sufferers

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FILE - A patient describes her migraines at the Venice Family Clinic in Los Angeles, Feb, 16, 2011. VOA

Two drug trials may promise some relief for people who suffer from migraine headaches as well as those who have cluster headaches, a rare but intensely painful type of headache thought to be related to migraine.

According to a study in The New England Journal of Medicine, two injections of the drug galcanezumab reduced the frequency of episodic cluster headaches (ECH). And in a separate study in the same issue of the journal, an experimental oral drug made migraine pain quickly go away for one in five sufferers.

Cluster headaches typically appear at least once a day — often at the same time of the day or night — for weeks or months. The pain is typically around one eye. They eventually go away for a while but can return after an absence of months or years.

In the galcanezumab study, 106 volunteers received two injections of the anti-migraine medicine or a placebo, spaced one month apart. The drug cut the average number of episodic cluster headaches by 51% during the first three weeks of treatment, from 17.8 per week down to 9.1 per week. Placebo injections produced a 30% reduction, from 17.3 per week to 12.1 per week.

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Two drug trials may promise some relief for people who suffer from migraine headaches as well as those who have cluster headaches. PIxabay

Relief for many

Almost three-quarters of participants saw some reduction in headache frequency compared with about half of those on placebo.

“Some patients get completely suppressed and many partially so,” lead author Dr. Peter Goadsby of King’s College London told Reuters Health in an email. “I do not think one can overstate how bad a cluster attack is.”

To be eligible for the study, patients had to have at least one attack every other day but not more than eight per day. The typical volunteer had been dealing with the headaches for more than 16 years. The average age was about 46 years old and more than 82% were men.

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Each 300 mg injection costs about $1,400, according to the website goodrx.com. Galcanezumab is sold under the brand name Emgality by Eli Lilly, and the company paid for the study.

“Patients report ECH attacks as the most severe pain they experience, bar none,” including childbirth and kidney stones, said Goadsby, director of the NIHR-Wellcome Trust King’s Clinical Research Facility and SLaM Biomedical Research Centre.

“Imagine what it’s like to give birth one to eight times a day, every day, for eight to 12 weeks a year. Imagine not a single full night’s sleep for eight to 12 weeks and you know next year it will be the same,” he said. “This development is really important for these patients.”

And it may spark the development of treatments that are even more effective, he added.

Drug, Migraine, Headaches
According to a study in The New England Journal of Medicine, two injections of the drug galcanezumab reduced the frequency of episodic cluster headaches (ECH). PIxabay

The U.S. Food and Drug Administration approved the drug as a first-ever treatment for episodic cluster headaches in June. The company estimates that about 250,000 people in the United States suffer from them.

For many, a migraine per month

In contrast, migraine headaches plague about 39 million people in the U.S., primarily women. Three-quarters of people who have migraines experience at least one per month.

The migraine study looked at Biohaven Pharmaceuticals’ experimental oral drug rimegepant, and was financed by Biohaven.

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Researchers found that 19.6% of the 537 volunteers who took it while suffering from a migraine were free of pain within two hours compared with 12% of the 535 volunteers given placebos.

Half the patients in both groups had their pain relapse two to 48 hours after the dose. Unlike conventional treatment with triptan drugs, taking a second dose doesn’t provide additional relief, lead author Dr. Richard Lipton, director of the Montefiore Headache Center in New York City, told Reuters Health in a telephone interview.

“Triptans are well-established therapies; maybe 25% of people with migraines are currently on a triptan,” said Lipton, who is also in the department of neurology at the Albert Einstein College of Medicine. “If it works well for them, they’re not going to be candidates on this drug. This is for people with contraindications for a triptan” or people who get no relief from triptans.

Triptan therapy costs about $7,000 a year, he said, and when it comes to rimegepant, “I’m very hopeful the drug will be affordable because there are a lot of people who need it.” (VOA)