Fast Five Quiz: Caffeine Clinical Concerns

Mary L. Windle, PharmD


February 12, 2021

Hypnic headache is characterized by recurrent nocturnal episodes that awaken sleeping individuals and is predominantly seen in the elderly. However, younger individuals and even children may experience hypnic headache. Attacks usually last between 15 and 180 minutes, but some patients report headache attacks of up to 10 hours. Almost all patients report motor activity during headache attacks. Caffeine has been shown to produce the best therapeutic response in acute treatment.

The US Food and Drug Administration (FDA) and the American Headache Society have recognized the combination of acetylsalicylic acid, acetaminophen, and caffeine as safe and effective in treating migraine and other acute headaches. This combination is considered safe during breastfeeding

Evidence suggests that caffeine is a useful analgesic adjuvant in the acute treatment of primary headache. Doses of 130 mg have been shown to enhance the efficacy of analgesics in patients with tension-type headaches. Doses of ≥ 100 mg enhance the benefits in migraines.

Oral and intravenous caffeine has been recommended as a therapeutic option in patients with headache after lumbar puncture. Because caffeine acts as a cerebral vasoconstrictor by blocking adenosine receptors, it may play a role in the pathogenesis of lumbar puncture–related headache.

Read more about caffeine and headaches.


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