Ann IScher, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road; Bethesda, MD 20814ascher@usuhs.mil
Walter F. Stewart, and Richard B. Lipton
Submitted March 01, 2005
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.
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.