Migraine is a chronic disorder, and
caffeine has been linked with
migraine for many years, on the one hand as a trigger, and on the other hand as a cure. As most of the population, including migraineurs, consume a considerable amount of
caffeine daily, a question arises as to whether it influences their
headaches. Indeed, drinking
coffee before a
migraine attack may not be a real
headache trigger, but a consequence of premonitory symptoms, including yawning, diminished energy levels, and
sleepiness that may herald a
headache. Here, we aim to summarize the available evidence on the relationship between
caffeine and
migraines. Articles concerning this topic published up to June 2020 were retrieved by searching clinical databases, and all types of studies were included. We identified 21 studies investigating the prevalence of
caffeine/
caffeine withdrawal as a
migraine trigger and 7 studies evaluating
caffeine in acute
migraine treatment. Among them, in 17 studies,
caffeine/
caffeine withdrawal was found to be a
migraine trigger in a small percentage of participants (ranging from 2% to 30%), while all treatment studies found
caffeine to be safe and effective in acute
migraine treatment, mostly in combination with other
analgesics. Overall, based on our review of the current literature, there is insufficient evidence to recommend
caffeine cessation to all
migraine patients, but it should be highlighted that
caffeine overuse may lead to
migraine chronification, and sudden
caffeine withdrawal may trigger
migraine attacks.
Migraine sufferers should be aware of the amount of
caffeine they consume and not exceed 200 mg daily. If they wish to continue drinking caffeinated beverages, they should keep their daily intake as consistent as possible to avoid withdrawal
headache.