Doxycycline for daily headache?

So how would you feel about taking an antibiotic for your headache?  If you’d be uncomfortable with that, you’re not alone, and I’m proud of you.  🙂

But that’s no reason to ignore the small study that was done by Dr. Todd D. Rozen of the Michigan Headache and Neurological Institute.  In the study he used Doxycycline to treat new daily persistent headache.  Before we get to the results, a quick overview of Doxycycline itself.

Doxycycline is the generic ingredient in a whole host of brand name antibiotics, such as Adoxa, Doryx, Monodox, Periostat, and Vibramycin.  These types of antibiotics work by interrupting the life cycle of the bacteria.  It’s used for a number of different bacterial infections.

New daily persistent headache (NDPH) is one of the most treatment-resistant types of headache.  In fact, the patients in this trial had already tried (unsuccessfully) 5 different preventive treatments.  Interestingly, many patients get NDPH after an infection.  And one theory is that a certain type of inflammation is behind NDPH.

That inflammation chain-reaction can also be stopped by Doxycycline, making it a candidate for treatment.

Only 4 patients were in the trial, but 2 became 100% pain free, 1 had an 80% improvement in daily pain intensity, and the last person had a slight improvement in pain intensity and a more than 50% decrease in severe pain episodes.  On average, patients improved after 3 months (2 daily dosages of Doxycycline, 100mg).  There was only one notable side effect – one patient got a severe sunburn (you have to be careful about your time in the sun when you’re on Doxycycline).  These are very good results for something so difficult to treat!

So the results are pretty positive, and it probably wasn’t because of the antibiotic properties of Doxycycline at all.  If these findings are confirmed by larger studies, it may show that our understanding of NDPH is on target.  And it may open the door to better treatments.

Doxycycline itself may or may not be a good treatment.  Obviously, we need to be cautious about taking antibiotics.  Also, many medications, supplements and foods can decrease its effectiveness, so it needs to be taken properly under the care of a doctor.

This study was brought to my attention by the Headache News Blog.

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  • MaxJerz Dec 5, 2008

    Definitely more research needs to be done… the placebo effect can’t be discounted, and one of the obvious dangers of overuse of antibiotics is developments of “super bugs”.

    Though, as a sister of NDPH (I have CDH) I can certainly understand how eager a daily pain sufferer is to be rid of the pain!

    Be well,
    MJ

  • James Dec 8, 2008

    Yes, you’re exactly right about the antibiotics. But it sounds like there are some real interesting reasons why this may have worked, which is why I spent the time I did talking about it.

    I certainly hope there will be more help for your sister soon (you too!)! 🙂

  • Chris Dec 10, 2008

    “So how would you feel about taking an antibiotic for your headache?
    If you’d be uncomfortable with that, you’re not alone, and I’m proud of you. ”

    Why would you “be proud” of someone for being uncomfortable with taking a treatment that they don’t know anything about – if it hasn’t been properly explained to them yet?

    This is why a doctor / patient relationship is so important when treating chronic headache; explaining the advantages and disadvantages of a new treatment is crucial in treating chronic pain.

    I should also note that new daily persistent headache (NDPH) is very different from chronic migraine. NDPH almost NEVER responds to typical migraine medications, and maintaing a website that encourages people to “be uncomfortable” with treatments that may help their painful condition is not helping anyone.

    You failed to mention that doxycycline is quite frequently taken for extended periods for acne rosacea, a less than life threatening condition.

    What I mean to say, is that people should try to keep an open mind; that is something to take pride in.

  • James Dec 12, 2008

    Why would I be proud of someone for being uncomfortable taking a treatment they know nothing about? Isn’t it obvious?

    That’s exactly my point. Too many people are taking things they know nothing about. Recently the report came out that a huge number of doctors are giving patients antibiotics as a placebo! I’m uncomfortable with that, yes.

    Yes, people should keep an open mind – and people with NDPH mostly do, from what I see. But they should also not blindly take whatever is recommended – they should be cautious, and most people know that.

    Taking an antibiotic requires extra caution. Nowhere in my post am I suggesting people completely avoid antibiotics. I’m pointing out 2 things:
    1) This study is not just about an antibiotic. It may be a breakthrough in understanding how NDPH works, and a doorway to new and better medications.
    2) If someone is going to take an antibiotic, for anything, they need to be cautious. Yes, if they’re taking it without knowing all the facts, they should indeed be uncomfortable, to say the least! (and please note I specifically pointed out that there needs to be a doctor/patient relationship)

    If larger studies show this treatment to be safe, I will have no trouble recommending people talk to their doctor about it. You’re right, this is a very difficult condition to treat, and I’ll celebrate when we can help a larger number of patients!

    But please, get the facts, talk to your doctor, and feel free to get second opinions. And I think we can still be cautiously optimistic about this study.

  • Lisa Jan 7, 2009

    Can you fwd a pointer to the original article?
    Or provide any additional info about what exactly you mean by the
    “inflammation chain reaction” is that is being stopped?

    My neurologist mentioned to me today that there is a growing number
    of reports of success for this treatment. I would like to understand
    more about the mechanism, and the hypothesized impact of the
    antibiotics.

    Long before I ever heard of this, I noticed a correlation that I felt much better, and had far fewer headaches, when on antibiotics for some
    other condition (sinus infection, etc.).

  • James Jan 10, 2009

    Hi Lisa,

    Sorry about the missing link. 🙂 I read about the study in the abstracts from the 50th Annual Scientific Meeting of the American Headache Society. You can access it (it’s a pdf file) here: Program Abstracts

    There is a brief explanation there of how the doxycycline may work. It mentions CNS (central nervous system) inflammation, and how doxycycline may stop CNS inflammation from happening in the first place.

    Again, this was a very small “open label” study, which means the patients were aware of the treatment (as opposed to a blind of double blind study).

    For more on problems with antibiotics, here’s an article from the FDA in the USA on the reasons for antibiotic resistance in society. Basically, the problem is on a personal and a worldwide scale. Taking antibiotics only kills certain strains, and so can allow resistant strains to flourish. The result is that an individual may take longer to get better, or may need different kinds of antibiotics as time goes by. On a worldwide scale, the concern is that new strains (perhaps a “super-bug”) may emerge, and we won’t have the right kinds of antibiotics to fight it.

    Thanks for your questions – hopefully that will start you on your research! This is really just an early phase of study, and we’ve a long way to go before we understand how it works, or even if it will work significantly for a good percentage of people.

  • CL May 11, 2009

    I have monthly hormonal migrains (severe) and rosacea. For the rosacea I am on doxycycline (works pretty good!), but now really curious if it will help with the migraine as well, as both are, as I understand, related to inflammation of the vessels. Wouldn’t surprise me! But I’ll let you know if it works.

  • SJW Sep 1, 2009

    i am 53yr old female. i have suffered from migraines since i was
    in my late twenties, i also suffer from severe depression. In the last 4-5 yrs, my migraines have skyrocketed. I have horrible pain everday, I live on Imitrex, I know that can’t be healthy. i also have severe neck pain which i did find out were two bulged discs. doctors assure me it is not severe enough to cause my headaches! I have even had cortizone injected into my neck to help the pain, it didn’t help much and of course it wears off fairly quickly. I am at my wits end. i don’t think i have left my house all summer. i walk outside and the heat hits me like an oven, the sun almost blinds me and i get sick very quickly. it starts with profuse sweating, my face turns red and feels like its on fire, then i get a horrible migraine. so i stay in my air conditioned house with shades drawn in the dark, but now i am still getting migraines everyday. i feel overwhelmed. my family doctor seems a litte disinterested in treating me.
    so i ask:
    what type of doctor should i see?
    what should i take with me when i go?
    i would also like to hear from anyone who has aquired a good treatment plan.
    thank you SJW

  • ally Feb 13, 2012

    please share more info. I was just at the dr and I was prescribed Doxycycline. I am afraid to take this on a long term. I have had headaches when I contracted Bacterial Meningitis. My headaches have not gone away since the onset of the meningitis and have gotten real bad. Please help with any information. I want a fix not a bandaid for a short term.

  • Linda Jan 7, 2013

    I have rosacea and took doxycycline for many years. I stopped taking it on my own about 2 years ago. Consequently that is about the same time my migraines began. I’m wondering now if there is something to this study.

  • Jennifer Jan 8, 2013

    I am uncomfortable being on antiseizure drugs long term. Kidney stones, birth defects, heart troubles- the side effects of medications commonly prescribed scare me more than any antibiotic.

  • Stacey Feb 12, 2015

    I have suffered with weekly migraines for most of my life. I was put on this medication for skin issues several weeks ago and haven’t had a Migraine since. The only change I’ve made recently is taking this medication. I stumbled across the article in my research so there must be some truth here.

  • Julia Lilly Jun 22, 2015

    Is there any new information about using doxy and singulair for NPDH? i’ve had it for 1 1/2 years and the only thing that helps is amitrityline. i’m getting a lot of hesitation from the headache clinic i’m going to. I think they know very little about my headache and keep asking me to try different drugs. I’d like to give them some evidence that it has helped a lot of people and they need to know it might take more than a month. thank you for your information.

  • Fred Arcoleo Jul 10, 2015

    Hi, everyone. It’s almost 17 months for me with NDPH, and I’m still looking for a cure. I’m wondering if anyone can supply with an up-to-date link for that Doxy study. The link that James kindly supplied seems to be defunct. I’d appreciate it! I want to present it to my neurologist and see if I can get him to get my insurance to approve it.

    There was an article about Botox helping with NDPH as well: http://www.nyheadache.com/blog/botox-relieves-new-daily-persistent-headaches/. All the best to you all! Feel free, please to write.

    AND…for MORAL RELIEF, listen to a SONG I just recorded (I’m a musician) called “STORMS,” which is apropos for what we are all going through: “I will not fear the storm,” written by my dear departed friend, Tom Ryan. It’s on my website above. Let me know what you think…

    Enjoy! And forward!

  • Manuel R. Lazo, MD May 28, 2016

    Claro que los antibioticos suprimen la migraña puesto que esta causada por una bacteria que hace una infeccion en todo el cuerpo y causa la NEURITIS del cuero cabelludo, pero los antibioticos necesitan tomarse durante 4 meses. Ustedes pueden ver mas informacion en hospitalmexico.org

  • Patricia Drewry Jan 17, 2017

    Hi i have suffered from daily headaches, tension headaches and migraine for many years. Things have been so bad that i have been hopitalized on a number if occasion and tried every treatment going over the years with very little results.
    I was given doxycycline for a persistent chest infection and never had this antibiotic before, straight waway i found that my headaches completely stopped! Believe me in a number of years i have barley had a day headache free! Still no headache a week in and even a couple of weeks follwing the course im visiting my gp this week to see about long term treatment as im not sure of the effects but to be headache free for the first time in years from a treatment i just happened to stumble upon is amazing. More research needs to be done!!