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.

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.).

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.

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.

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

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