Table 1.
Studies evaluating the role of caffeine as an analgesic in the acute treatment of migraine.
| Reference | Method of Study |
No. of Patients | Treatments | Outcome |
|---|---|---|---|---|
| Lipton et al., 1998 [43] | double-blind, randomized, placebo-controlled | 1220 (AAC—602, placebo—618) |
aspirin 500 mg + acetaminophen 500 mg + caffeine 130 mg (AAC) versus placebo | Patients in the AAC group had a significantly greater reduction in migraine headache compared to those in the placebo group. Pain decreased to mild or no pain 2 h post-dose in 59.3% of patients in the AAC group versus 32.8% of patients in the placebo group. |
| Goldstein et al., 2006 [44] | double-blind, randomized, placebo-controlled | 1555 (AAC—669, IB—666, placebo—220) |
Acetaminophen 250 mg + aspirin 250 mg + caffeine 65 mg (AAC) versus ibuprofen 200 mg (IB) versus placebo | Both active treatments were significantly better at relieving pain and associated migraine symptoms than placebo. AAC was superior to IB in terms of pain relief, pain intensity reduction and pain response to the drug. The median time to pain relief (all aspects) was 20 min shorter for AAC than for IB. |
| Goldstein et al., 2005 [45] | randomized, placebo- controlled | 171 (AAC—69, sumatriptan—67, placebo—35) |
acetaminophen 500 mg + aspirin 500 mg + caffeine 130 mg (AAC) versus sumatriptan 50 mg versus placebo | AAC was found to be more effective than sumatriptan in the early treatment of a migraine attack. This is indicated by a greater difference in the cumulative assessment of pain before and after drug administration. The cumulative assessment of pain included pain intensity, pain relief, sustained analgesic response, symptom relief, reliever medication use, disability relief and global efficacy rating. |
| Pini et al., 2012 [46] | double-blind, randomized | 92 (264 migraine attacks were evaluated, 131 PCF and 133 sumatriptan) | paracetamol 1000 mg + caffeine 130 mg (PCF) versus sumatriptan 50 mg | Similar treatment effects (pain relief) and drug tolerance in the patients’ assessment. |
| Láinez et al., 2007 [47] | double-blind, crossover clinical trial | 229 (EC—115, almotriptan—114) | ergotamine 2 mg + caffeine 200 mg (EC) versus almotriptan 12.5 mg | Almotriptan was more effective and safer than EC. |
| Peroutka et al., 2004 [48] | randomized, double-blind, placebo-controlled | 72 (12 in each of 6 treatment sequences) | diclofenac sodium 100 mg with or without caffeine 100 mg versus placebo | Diclofenac in combination with caffeine was most effective in treating a migraine attack (in 41% of patients). |
| Baratloo et al., 2001 [49] | prospective quasi-experimental study | 70 (35 patients in each group) | intravenous caffeine citrate 60 mg versus intravenous magnesium sulfate 2 g | Both medications significantly reduced the severity of migraine pain, but magnesium sulfate was more effective. |