Maux de tête et café : bon ou mauvais ménage ?

Headaches and coffee: good or bad combination?

Aug 16, 2023

Study Explores Effectiveness of Caffeine Consumption for Headaches: Trigger or Cure?

Caffeine is a natural methylxanthine mainly found in coffee. It is also present in tea, energy drinks and chocolate. Caffeine may be the most consumed psychoactive compound in the world.

Caffeine consumption, whether occasional or regular, has a significant effect on the nervous system. Although several studies have indicated that caffeine consumption impacts headaches , the mechanism underlying this effect is not fully understood.

Interestingly, caffeine plays a dual role. It can both induce headaches and remedy them. For example, it triggers headaches associated with migraine but alleviates hypnic headaches , spontaneous intracranial hypotension and postdural puncture headaches.

Read also: Migraine and its triggering factors

The study

For the study, all relevant articles were obtained from various databases, such as PubMed, Google Scholar and MEDLINE, published between 1990 and May 2023. Different types of adult human research articles, c i.e. cross-sectional articles, observational articles, clinical trials and case studies, were included in this analysis.

Consuming caffeine in moderate amounts, i.e. around 200-400 mg per day, is considered safe for healthy, non-pregnant adults .

It has been observed that consuming 50 to 100 mg of caffeine increases alertness, energy, precision of reactions and the ability to concentrate better. Additionally, it improves cognitive performance, mood, physical fitness and short-term memory, and reduces fatigue.

Nevertheless, many adverse effects , such as anxiety , nervousness, tremor, insomnia, and tachycardia, have been associated with the consumption of high doses of caffeine, i.e., 400 to 800 mg. once.

People with a history of seizures or hypotension are advised not to consume excess caffeine , as it may induce adverse effects. Regular consumption of high doses of caffeine has also been associated with central nervous system toxicity and atrial fibrillation in high-risk patients.

Caffeine - a headache inducer

Migraine is a recurring headache that can last up to 72 hours . This headache is characterized by throbbing, one-sidedness and moderate to severe intensity. A migraine can be made worse by routine physical activity.

In some cases, headaches are accompanied by photophobia, phonophobia and/or nausea. Chronic migraine is associated with headaches that last more than 15 days and can sometimes persist for three months.

Long-term caffeine consumption triggers a cascade of physiological processes in migraine patients, leading to different consequences, including worsening headaches.

The sleep

Abnormal sleep patterns and the pathophysiological role of the hypothalamus are two of the common factors in inducing migraine. A previous study showed that a sleep disorder , namely familial advanced sleep phase syndrome, caused by mutations in the casein kinase Iδ gene, leads to sleep problems that trigger migraines.

As caffeine prolongs wakefulness, it could trigger migraine attacks through the aforementioned mechanism. A structural similarity between caffeine and adenosine has been established, as well as the fact that adenosine significantly affects the development of migraine .

Adenosine induces vasodilation and modulates endogenous release of calcitonin gene-related peptide (CGRP). Several studies have indicated the antagonization of adenosine by caffeine, which could lead to the development of migraine attacks.

Although caffeine withdrawal can be beneficial in treating migraines, it can trigger another type of headache, namely caffeine withdrawal pain. This pain is associated with the “rebound” mechanism of cerebral vasodilation .

Caffeine - a therapeutic agent for headaches

Hypnic headaches are recurring headaches that appear during sleep and cause you to wake up . This type of headache lasts between 15 minutes and 4 hours, and usually begins in patients around the age of 50.

The exact cause of this headache is still unknown. Caffeine has been observed to stop acute hypnic headaches . In this case, patients are asked to take caffeine prophylactically before going to bed to prevent the onset of pain.

The analgesic effects of caffeine in humans may be related to central dopaminergic mechanisms, with caffeine increasing dopamine release.

Compared to their decaffeinated counterparts, the majority of patients showed better effectiveness to the combination of caffeine with paracetamol , acetylsalicylic acid, ibuprofen and acetaminophen in the pharmacotherapy of tension headaches.

Postdural puncture headaches are caused by a lumbar puncture performed for diagnostic or therapeutic purposes. This type of headache develops within five days after the dural puncture.

A double-blind randomized clinical trial reported that the introduction of caffeine (1000 ml of saline and 500 mg of sodium caffeine benzoate) reduces the incidence of post-dural puncture headache.


Caffeine can both trigger and alleviate headaches. Although an appropriate dose of caffeine can alleviate migraine and postdural headaches, excessive use can lead to chronic forms of tension headaches and migraine attacks. In the future, additional research will be needed to better understand the role of caffeine and its safety in medicine.

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