Caffeine for Headaches: Helpful or Harmful? A Brief Review of the Literature.

Consumption of caffeine in the diet, both daily and occasional, has a significant biological effect on the nervous system. Caffeine, through various and not yet fully investigated mechanisms, affects headaches. This is especially noticeable in migraine. In other headaches such as hypnic headache, post-dural puncture headache and spontaneous intracranial hypotension, caffeine is an important therapeutic agent. In turn, abrupt discontinuation of chronically used caffeine can cause caffeine-withdrawal headache. Caffeine can both relieve and trigger headaches.

The Pathogenetic Role of Melatonin in Migraine and Its Theoretic Implications for Pharmacotherapy: A Brief Overview of the Research.

Migraine is a chronic disease of global concern, regardless of socio-economic and cultural background. It most often and intensely affects young adults, especially women. Numerous mechanisms of a migraine attack have been identified (disturbances in the reaction of vessels, functions of neurotransmitters, cortical neurons, ion channels, receptors, the process of neurogenic inflammation), and many of its symptoms can be explained by activation of the hypothalamus and disturbances in its communication with other brain regions (including the brainstem). Numerous neuropeptides and neurochemical systems also play a role in migraine. One of them is melatonin, a hormone that allows the body to adapt to cyclically changing environmental and food conditions. In this article, we present the pathophysiological basis of melatonin release from the pineal gland and other tissues (including the intestines) under the influence of various stimuli (including light and food), and its role in stimulating the brain structures responsible for triggering a migraine attack. We analyze publications concerning research on the role of melatonin in various headaches, in various stages of migraine, and in various phases of the menstrual cycle in women with migraine, and its impact on the occurrence and severity of migraine attacks. Melatonin as an internally secreted substance, but also present naturally in many foods. It is possible to supplement melatonin in the form of pharmaceutical preparations, and it seems, to be a good complementary therapy (due to the lack of significant side effects and pharmacological interactions) in the treatment of migraine, especially: in women of childbearing age, in people taking multiple medications for other diseases, as well as those sensitive to pharmacotherapy.

Variability in melatonin concentration in blood serum of patients with episodic migraine: a pilot study.

AIM OF STUDY: This study was aimed at assessing the possible effect of melatonin concentration on migraine. The serum concentration profile of melatonin in patients with diagnosed episodic migraine in the interictal period was compared to the profile in patients without migraine. Then, a correlation between the frequency and duration of migraine attacks, and the possible relationship between these parameters and melatonin levels in individual patients, was established. CLINICAL RATIONALE FOR STUDY: Melatonin secretion is related to migraine pathophysiology in many different ways. MATERIALS AND METHODS: The study was conducted in a group of 58 subjects (48 women and 10 men). The study group comprised 29 patients (24 women and five men) diagnosed with migraine according to the International Classification of Headache Disorders (ICHD-3 beta), within the framework of the Outpatient Clinic at Bielanski Hospital in Warsaw and the Clinical Department of Neurology of the 2nd Faculty of Medicine (now known as the Faculty of Medical Sciences) at the Medical University of Warsaw, Poland. The control group consisted of 29 subjects (24 women and five men) with no headache. Blood samples for the determination of melatonin were collected at midnight, 2am, 3am, 4am and 6am. Melatonin level in a frozen serum of venous blood was determined by a radio-immuno-enzymatic method at the Department of Histology and Embryology of the Faculty of Veterinary Medicine at the University of Warmia and Mazury in Olsztyn, Poland. RESULTS: No statistically significant differences between the levels of melatonin and the averaged advances of melatonin profiles were observed in the examined and the control group. There were demonstrated medium negative correlations between the maximum value of melatonin and the duration of migraine (R = -0.4, p = 0.03). There were also observed statistically significant differences (p = 0.01) between the averaged advances of melatonin profiles, depending on the duration of migraine. CONCLUSIONS AND CLINICAL IMPLICATIONS: Our study showed no abnormalities of melatonin secretion in patients with migraine during the interictal period. The results of studies available in the literature depend on the nature of the headache (episodic or chronic) and the time of measuring the concentration of melatonin (during a headache attack or in an interictal period).