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ARTICLES: Ann I. Scher, Walter F. Stewart, and Richard B. Lipton Caffeine as a risk factor for chronic daily headache: A population-based study Neurology 2004; 63: 2022-2027 [Abstract] [Full text] [PDF]

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Reply to Gadoth and Hering-Hanit

Ann I Scher, Walter F. Stewart, and Richard B. Lipton   (1 March 2005)

Caffeine as a risk factor for chronic daily headache: A population-based study

Natan Gadoth, Rachel Herig-Hanit   (1 March 2005)

Reply to Gadoth and Hering-Hanit 1 March 2005
Ann I Scher, Uniformed Services University of the Health Sciences 4301 Jones Bridge Road; Bethesda, MD 20814, Walter F. Stewart, and Richard B. Lipton Send Correspondence to journal: Re: Reply to Gadoth and Hering-Hanit ascher{at}usuhs.mil Ann I Scher, et al.	We thank Drs. Gadoth and Hering-Hanit for bringing their recent publication to our attention. We are also not aware of any other clinical report indicating improvement in chronic daily headache after the withdrawal of only dietary caffeine. Since our study was focused on assessing risk factors in the population at large, we did not focus on results from clinical studies that can be prone to selection bias and, more generally, do not provide a foundation for estimating the risk of CDH attributable to caffeine. Our results suggest that caffeine consumption is a modest risk factor in chronic daily headache in the general population. Our data as well as the results described by Gadoth et al are only suggestive. Ultimately, the extent to which caffeine use (and medication overuse in general) contributes to the onset or maintenance of chronic daily headache in practice remains uncertain until evidence is obtained from a placebo- controlled clinical trial.
Caffeine as a risk factor for chronic daily headache: A population-based study 1 March 2005
Natan Gadoth, Department of Neurology Meir Medical Center,Tchernichovsky St. Kfar Saba 48221, Israel, Rachel Herig-Hanit Send Correspondence to journal: Re: Caffeine as a risk factor for chronic daily headache: A population-based study gadoth{at}post.tau.ac.il Natan Gadoth, et al.	In their recent article, Scher et al reported on caffeine as a risk factor for chronic daily headache. [1] We recently published an article describing this association but this report was not mentioned by the authors. [2] We reported 36 children with daily or near-daily headache who consumed excessive amounts of caffeine in the form of cola drinks. Gradual withdrawal led to complete recovery from daily headaches. As a result we are now routinely asking our patients about their soft drink (especially cola) consumption. This has resulted in prevention of headache associated with excessive caffeine in a significant number of our patients. References 1) Scher AI, Stewart WF, Lipton RB. Caffeine as a risk factor for chronic daily headache: A population-based study Neurology 2004; 63: 2022-2027. 2) Hering-Hanit R, Gadoth N. Caffeine-induced headache in children and adolescents. Cephalalgia 2003; 23:332-335.