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Wednesday, May 15, 2024

These Incredibly Popular Drugs Have Been Linked to Migraines

Trading a stomachache for a headache 

By AMERICAN ACADEMY OF NEUROLOGY 

According to research published in Neurology Clinical Practice, an official journal of the American Academy of Neurology, individuals who use acid-reducing medications may face a greater risk of experiencing migraines and other severe headaches compared to those who do not use these drugs. 

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