Trading a stomachache for a headache
By AMERICAN ACADEMY OF NEUROLOGY
The study highlights
acid-reducing drugs including proton pump inhibitors like omeprazole and
esomeprazole, histamine H2-receptor antagonists, or H2 blockers such as
cimetidine and famotidine, and antacid supplements.
The study does not prove that acid-reducing drugs cause
migraine; it only shows an association.
Acid reflux is when stomach acid flows into the
esophagus, usually after a meal or when lying down. People with acid reflux may
experience heartburn and ulcers. People with frequent acid reflux may develop
gastroesophageal reflux disease, or GERD, which can lead to cancer of the
esophagus.
Study Methodology and Results
“Given the wide usage of acid-reducing drugs and these
potential implications with migraine, these results warrant further
investigation,” said study author Margaret Slavin, PhD, RDN, of the University
of Maryland in College Park. “These drugs are often considered to be
overprescribed, and new research has shown other risks tied to long-term use of
proton pump inhibitors, such as an increased risk of dementia.”
For the study, researchers looked at data on 11,818
people who provided information on use of acid-reducing drugs and whether they
had migraine or severe headache in the past three months.
A total of 25% of participants taking proton pump
inhibitors had migraine or severe headache, compared to 19% of those who were
not taking the drugs. A total of 25% of those taking H2 blockers had severe
headache, compared to 20% of those who were not taking those drugs. And 22% of
those taking antacid supplements had severe headache, compared to 20% of those
not taking antacids.
Adjustments and Observations
When researchers adjusted for other factors that could
affect the risk of migraine, such as age, sex, and use of caffeine and alcohol,
they found that people taking proton pump inhibitors were 70% more likely to
have migraine than people not taking proton pump inhibitors. Those taking H2
blockers were 40% more likely and those taking antacid supplements were 30%
more likely.
“It’s important to note that many people do need
acid-reducing medications to manage acid reflux or other conditions, and people
with migraine or severe headache who are taking these drugs or supplements
should talk with their doctors about whether they should continue,” Slavin
said.
Slavin noted that the study looked only at prescription
drugs. Some of the drugs became available for over-the-counter use at
non-prescription strength during the study period, but the use of these
over-the-counter drugs was not included in this study.
Other studies have shown that people with
gastrointestinal conditions may be more likely to have migraine, but Slavin
said that the relationship is not likely to fully explain the tie between
acid-reducing drugs and migraine found in the study.
A limitation of the study is that a small number of
people were taking the drugs, especially the H2 blockers.
Reference: “Use of Acid-Suppression Therapy and Odds of
Migraine and Severe Headache in the National Health and Nutrition Examination
Survey” by Margaret Slavin, Cara L. Frankenfeld, Alexander B. Guirguis and
Elizabeth K. Seng, 24 April 2024, Neurology Clinical Practice.
DOI:
10.1212/CPJ.0000000000200302
