The role of caffeine in the headaches: Attenuating or aggravating factor?

Introduction: Caffeine is often used in the treatment of headaches, either on its own or with other medications. Its constrictor effect in cerebral vessels is well known, but the extent to which it aggravates or improves other mechanisms is still unknown. Objectives: To review the indication of caffeine in the treatment of headaches and to question its role as an attenuating or aggravating factor. Methods: The literature concerning the action of caffeine in the central nervous system, the main sources of caffeine and its use in the treatment of different types of headache were reviewed. Conclusions: Caffeine is an attenuating factor and is used to treat hypnic and postdural puncture headaches, caffeine withdrawal and headaches attributed to spontaneous intracranial hypotension. It is used as a therapeutic aid in the treatment of acute migraine attack and tension-type headache. It worsens headache caused by excessive use of analgesics and aggravates cluster headache attacks.

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