Caffeine and Headache

Caffeine is a naturally occurring stimulant, found in certain foods and drinks. It is found in coffee, cola, tea and chocolate, among other things. It is also found as an additive in many over the counter and prescription pain medications. A brewed cup of coffee (6oz.) contains about 60-100 mg of caffeine. Soft drinks contain about 30-60 mg per 8 oz. Some common headache medications contain 16.25-65mg of caffeine. Caffeine pills typically contain 200mg of caffeine.

When thinking about caffeine and headache, the relationship is very complex, partly due to the many effects caffeine has on the body. It can increase heart rate, relax smooth muscle, has a diuretic effect, and can affect the brain messaging system (neurotransmitters). It can make you feel more alert, and give a much needed “pick me up”. Caffeine also narrows blood vessels, which is part of the reason it has been used in headache medications. Current data suggest that blood vessels tend to enlarge before the beginning of some headache pain and narrowing the vessel is thought to reduce that pain. The trouble with caffeine is that too much of it, stops helping the headache, and can start to cause a new type of headache – rebound or medication overuse headache. As many regular caffeine users may note, if they abruptly stop taking caffeine, they many not feel well, can be sleepy/drowsy or have a bad headache. It appears that with caffeine, as with many things, moderation and careful use can make it a great tool in fighting headache, but one needs to be cautious and informed on how and when to use it.

About the Speaker

Rachel Colman, MD is an Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai. She received her medical degree from Ben Gurion University of the Negev, Medical School for International Health in Israel. She then completed an internship in Internal Medicine and Residency in Neurology at Case Western Reserve University Hospitals in Cleveland, Ohio. She went on to complete a one-year fellowship in Headache Medicine at Icahn School of Medicine at Mount Sinai. She is board eligible in Neurology by the American Board of Psychiatry and Neurology. She is a member of the American Academy of Neurology and the American Headache Society. Dr. Colman is Board Eligible in Headache Medicine. She is trained in botulinum toxin injections for headache, nerve blocks and trigger point injections, and has a special interest in hormone-related migraines, and headache in pregnancy and lactation.