Caffeine can be a double-edged sword for those with headache. It can serve as a treatment or, in some cases, can cause withdrawal or a phenomenon known as medicine overuse or "rebound" headache. The important thing to remember is that with education and moderation, caffeine can be an effective treatment for headache.
Caffeine as a headache treatment
Caffeine is a common ingredient in many prescription and over-the-counter headache drugs (see list below). Because analgesics (pain relievers) work more quickly and more efficiently with caffeine, patients are able to take less medication.
Caffeine additives make pain relievers 40% more effective. Caffeine also helps the body absorb medications more quickly, allowing the patient to feel relief sooner. By adding caffeine and, in turn, taking less medication, the patient reduces the risk for potential side effects and reduces the risk of habitual or addictive usage.
Common over-the-counter drugs that contain caffeine:
- Anacin Maximum Strength: 32 mg.
- Anacin Tablets and Caplets: 32 mg.
- Aspirin-Free Excedrin Caplets: 65 mg.
- Excedrin Extra Strength Caplets and Tablets: 65 mg.
- Excedrin Migraine: 65 mg.
- Goody's Extra Strength Tablets: 16.25 mg.
- Goody's Extra Strength Headache Powder: 32.50 mg.
- Goody's Cool Orange Powder: 65 mg.
- Midol Menstrual Maximum Strength Caplets: 60 mg.
- NoDoz Maximum Strength: 200 mg.
- Pain Reliever Plus Tablets: 65 mg.
- Vanquish Caplets: 33 mg.
- Vivarin: 200 mg.
Common prescription drugs that contain caffeine:
- Ergotamine/Caffeine Suppositories (Migergot): 100 mg.
- Ergotamine/Caffeine Tablets (Cafergot): 100 mg.
- Fiorinal Capsules: 40 mg.
- Fiorinal with Codeine Capsules: 40 mg.
- Fioricet Tablets: 40 mg.
- Orphenadrine Citrate, Aspirin and Caffeine (Norgesic): 30 mg.
- Orphenadrine Citrate, Aspirin and Caffeine (Norgesic Forte): 60 mg.
- Synalgos-DC: 30 mg.
Note: The drugs listed are some of the more common drugs containing caffeine; all medicines containing caffeine are not included. Always check the labels of over-the-counter drugs for caffeine content. You can ask your health care provider or pharmacist about the caffeine content of your medicines.
- Chocolate milk, chocolate milkshakes, hot chocolate, and chocolate drinks
- Cocoa mix, malt powder, chocolate flavoring
- Cola and other sodas, like Mountain Dew (regular and diet)
- Chocolate or coffee liqueurs
Note: Caffeine-free and decaffeinated beverages also contain small amounts of caffeine.
- All chocolate products, including brownies, cake, etc.
- Chocolate candy, including fudge and chocolate-covered coconut, raisins, and peanuts
- Chocolate-covered graham crackers (or chocolate-flavored graham crackers)
- Chocolate ice cream or pudding
Caffeine and withdrawal
Caffeine withdrawal from normal caffeine usage is rare. However, with excess use (more than 500 mg daily, or approximately 5 cups of coffee) over a long period of time, sudden cessation could cause symptoms of withdrawal. Patients can avoid caffeine withdrawal by limiting their daily consumption, being educated about sources of caffeine, and by gradually decreasing the caffeine intake rather than ending use abruptly.
Caffeine and rebound headache (medication overuse headache)
Rebound headache is a condition that develops from the overuse or misuse of any headache medicine, including those that have caffeine. Medicines that contain caffeine can be beneficial. However, when these medicines are combined with consuming caffeine from other sources, you may be more vulnerable to a rebound headache.
Patients should limit caffeine consumption to the equivalent of 2 cups of coffee a day and limit pain medications, either over the counter or prescribed, to 2 days a week to prevent medication overuse headache.
Relief from rebound headache can only be accomplished by completely eliminating all headache medication. However, this should only be done under the supervision of a physician.