咖啡因在头痛疾病中的作用。

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY Current Opinion in Neurology Pub Date : 2024-06-01 Epub Date: 2024-02-07 DOI:10.1097/WCO.0000000000001249
Andrew Charles
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引用次数: 0

摘要

审查目的:众所周知,咖啡因对头痛症患者既有益处也有不良影响。本综述介绍了咖啡因与头痛疾病相关的最新研究结果,并将这些研究结果与临床治疗相结合:临床前研究表明,咖啡因对睡眠、脑血流量和颅内压有复杂的影响,这些影响可能取决于摄入咖啡因的时间与睡眠-觉醒周期的关系。咖啡因的新陈代谢可能存在显著的个体差异,从而影响其治疗效果和/或不良反应。咖啡因对某些原发性头痛疾病有急性治疗作用。对偏头痛而言,这种益处主要体现在不伴有皮肤异感症的轻度头痛中。大量摄入咖啡因可能会导致头痛疾病恶化。含咖啡因的复合镇痛药通常会引起药物过度使用性头痛。在医院环境、宗教和文化禁食以及妊娠等情况下,突然减少咖啡因的摄入量可能会诱发偏头痛。根据现有的证据,合理的方法是将饮食中咖啡因的摄入量限制在适量范围内,并在中午之前持续摄入,对于较轻微的头痛,可少量使用含咖啡因的复合镇痛药。
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The role of caffeine in headache disorders.

Purpose of review: Caffeine is known to have both beneficial and adverse effects in individuals with headache disorders. This review describes recent findings regarding caffeine that are relevant to headache disorders and puts these findings into the context of clinical management.

Recent findings: Preclinical studies show that caffeine has complex effects on sleep, brain blood flow, and intracranial pressure that may depend on the timing of caffeine intake relative to the sleep-wake cycle. Caffeine metabolism may have significant inter-individual variation that influences its therapeutic and/or adverse effects. Caffeine has acute therapeutic benefit for some primary headache disorders. For migraine, this benefit is predominantly in milder headache without cutaneous allodynia. High levels of caffeine intake may contribute to progression of headache disorders. Caffeine-containing combination analgesics commonly cause medication overuse headache. Abrupt reduction in caffeine consumption is a trigger for migraine that may be important in situations including the hospital setting, religious and cultural fasting, and pregnancy.

Summary: There is not sufficient evidence to support universal guidelines for the use of dietary and medicinal caffeine in headache disorders. A sensible approach based upon available evidence is to limit dietary caffeine intake to moderate amounts with consistent timing before noon, and to use caffeine-containing combination analgesics infrequently for milder headache.

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来源期刊
Current Opinion in Neurology
Current Opinion in Neurology 医学-临床神经学
CiteScore
8.60
自引率
0.00%
发文量
174
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​Current Opinion in Neurology is a highly regarded journal offering insightful editorials and on-the-mark invited reviews; covering key subjects such as cerebrovascular disease, developmental disorders, neuroimaging and demyelinating diseases. Published bimonthly, each issue of Current Opinion in Neurology introduces world renowned guest editors and internationally recognized academics within the neurology field, delivering a widespread selection of expert assessments on the latest developments from the most recent literature.
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