Caffeine Pills for Headache?

Many people have noticed that a quick shot of caffeine – be it in a cup of coffee or tea, or a cola, or even in a painkiller – may keep a headache at bay. But some people also specifically use caffeine pills to fight headache. But is it a good idea?

Migraine experts have traditionally had a love-hate relationship with caffeine. For those that have few attacks and find that it helps, many doctors do suggest some strong coffee or a Coke to stop a headache. And some patients recognize that there are some benefits to taking a pill instead. For example,

• It’s convenient. You can keep a pill or two on you at all times, and take it when needed.
• Don’t like coffee? No problem – take a pill.
• Pills are less likely to cause heartburn (although they still might).
• You get a predictable, exact amount of caffeine.
• Although you may lose some benefits of tea or coffee, you also cut out some bad ingredients – and added ingredients, such as sugar or artificial sweeteners.

(Here’s an overview of caffeine pills, discussing some of the general pros and cons, from MedicalNewsToday: What to know about caffeine pills.)

Although coffee and tea have benefits, I think that the best advice has always been to keep your caffeine intake low and consistent, and avoid the sweeteners. Drinking coffee every day at the office and then skipping it (or drinking it later) on weekends has always been a prime suspect when it comes to weekend headache.

Now few people would want to take a caffeine pill a day – if you don’t, your caffeine is not consistent. If you feel you do, for headaches, you have a significant problem.

The typical advice you’ll hear is that if you’re taking a pill with caffeine (even a combination drug, such as aspirin+caffeine), you shouldn’t take it more than twice a week. If you do, you’re running into a serious risk of “rebound headache” – in other words, headache symptoms increase and become more frequent not in spite of but because of the caffeine pills.

However, others argue that rebound headache is more of a continuum. In other words, every time you take a pill with caffeine for a headache, you’re increasing your chances of a future headache to some degree. And don’t just count your “migraine attacks” in this – if you have a constant low-level headache, or frequent “tension headaches”, these may also become worse or more frequent.

(This article from the American Headache Foundation uses the “two days a week” line, but also points to some fascinating studies and statistics about caffeine, that should at least make you think twice before considering this to be a good solution to your headache issues. See Caffeine and Migraine.)

So look at it this way. If a couple times a year a strong coffee or a caffeine pill stops a headache, you probably have nothing to worry about. Especially if you rarely have headaches or migraine attacks. But let’s face it, most people like that aren’t reading this article.

If you do feel you need the pills with you, or you’re often reaching for a pill or an energy drink or a coffee to stop a headache – even if it’s a fairly “mild” headache – you can probably find better solutions. First consider gradually lowering your caffeine intake. Next, if your headaches are a regular issue, be sure you’ve talked to a doctor, and if possible a headache specialist. You can find better solutions, and probably avoid worse symptoms in the future.

To give you a little more motivation – in one of our online polls, about 1 in 10 people had tried cutting caffeine out of their diet, and found that it helped with their migraine or headache. So it’s worth trying – but remember, you’re best to lower amounts slowly, and keep them as consistent as possible.

(See also Should Migraine Patients Drink More Coffee? (and a note about aspartame))