Limitations of acetaminophen, aspirin, and caffeine in alleviating migraine.

نویسنده

  • M Maizels
چکیده

T he conclusions of Lipton et al 1 that the combination of aspirin, acetaminophen, and caffeine was highly effective for the treatment of migraine headache symptoms requires further comment. They acknowledge in their “Patients and Methods” section that the most severely disabled segment of migraineurs was excluded. However, they do not tell us what percentage of the potential population was excluded for this reason. In a previous article by the first 2 authors of the current study, severe disability was identified in 50% of migraineurs who had been diagnosed by a physician and 25% of migraineurs who had not been previously diagnosed. The lack of relapse data is surprising in any study of an acute headache treatment and is a major limitation of this study. I would suggest the conclusion should be limited to say that, for migraineurs who are not usually severely disabled, the combination of aspirin, acetaminophen, and caffeine produces significant headache relief for up to 6 hours. Finally, while the authors emphasize the “excellent safety profile” of the medication, they neglect to mention that caffeine-containing combinations are particularly prone to causing drug rebound headache. Most experts on headache would limit the use of these compounds to 2 days per week. The availability of this combination over-thecounter, with aggressive advertising from the manufacturer, is likely to lead to a significant increase in the “unrecognized epidemic” of drug rebound headache.

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عنوان ژورنال:
  • Archives of neurology

دوره 55 12  شماره 

صفحات  -

تاریخ انتشار 1998