ArticleFrontiers in neurology
Caffeine use disorder and analgesic dependence in medication-overuse headache: insights into an underrecognized relationship.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Caffeine plays a dual role in headache disorders, acting as an analgesic adjuvant while potentially contributing to headache chronification. Its relationship with medication-overuse headache (MOH) and the severity of analgesic dependence remains insufficiently characterized. The study aimed to compare MOH and non-MOH patients in terms of headache burden, psychological characteristics, and caffeine use, and secondarily to assess whether caffeine use disorder is associated with severity of dependence on analgesics in MOH. Methods: This is a cross-sectional study conducted on adults with primary headache disorders. Participants were asked to complete the following validated questionnaires: caffeine food frequency (C-FFQ), caffeine use disorder (CUDQ), headache impact test-6 (HIT-6), Severity of Dependence Scale (SDS). Depression Anxiety Stress Scales-12 (DASS-12), and Substance Use Risk Profile Scale (SURPS). Headache diaries were reviewed to document monthly headache days (MHD) and acute medication days (AMD); subsequently, patients were divided into MOH or non-MOH groups, according to ICHD-3 criteria. Results: Among 482 patients with primary headache disorders, 160 (33.2%) fulfilled ICHD-3 criteria for MOH. Patients with MOH had significantly higher MHD, AMD, HIT-6 scores, DASS-12 and SURPS total scores than those with non-MOH (all Conclusion: Patients with MOH had significantly greater headache burden, psychological distress, and caffeine consumption compared with those without MOH. Caffeine use disorder is significantly associated with greater severity of analgesic dependence in patients with MOH. These findings highlight the importance of assessing caffeine-related behaviors when evaluating patients with MOH and suggest that caffeine use disorder may represent a clinically relevant behavioral factor associated with medication dependence severity.
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