Conclusions

Efficacy: A great deal of scientific study has shown that caffeine significantly enhances the analgesic benefit provided by simple analgesics. However, since the vast majority of headache patients (tension-type and migraine) already use single-ingredient, nonprescription analgesics, caffeinated analgesic combinations appear to represent an additional therapeutic opportunity, as they might be used to significantly improve analgesic response among the largest subgroup of headache patients.

Safety: According to numerous studies, moderate caffeine intake has not been linked with any adverse health condition. Moreover, while it is commonly believed that sudden withdrawal from regular caffeine can cause a range of debilitating symptoms, including headache, research suggests that these symptoms may be less common than regularly reported. Still, providers seeking to withdraw patients from caffeine should use a staged approach to avoid any unpleasant reactions, such as headache or tiredness. In addition, despite popular misconceptions, medical professionals should keep in mind that deliberate overuse of caffeine to intoxication is not seen because, unlike drugs of abuse, the effects of caffeine intoxication, which can include anxiousness, nervousness and rapid heartbeat, are all unpleasant.

Education: To alleviate confusion about caffeine and headache, every medical professional should become an active educator. With adequate preparation, providers will be ready to explain that caffeine can enhance analgesia and that abuse of caffeine or caffeinated analgesics is not frequently encountered. They can also counsel any patient who may be chronically overusing caffeine about the causes of any anxiety, sleep loss, irritability, or other symptoms they may be facing. Education about how caffeine can affect headache conditions should be a key part of therapy for all patients. Working together, patients and providers can match therapies to patient needs, ensuring the best possible clinical outcomes.