Problems with migraine
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People who take acid-reducing drugs to treat symptoms of acid reflux, may have a higher risk of migraine and other severe headache. The study, by researchers at the University of Maryland in College Park, was published yesterday in the online issue of Neurology Clinical Practice.

Acid-reducing medications include proton pump inhibitors such as omeprazole and esomeprazole; histamine H2-receptor antagonists, or H2 blockers, such as cimetidine and famotidine; and antacid supplements. All these medications are used widely to control acid reflux.

“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, 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.”

Acid reflux is characterized by stomach acids that flow into the esophagus, which usually occurs after a meal or when a person lies down. People with acid may have heartburn. It is also associated with the development of ulcers, and in some cases gastroesophageal reflux disease, or GERD, which can lead to cancer of the esophagus.

For the study, the investigators collected data from 11,818 people who provided information on their use of acid-reducing medications and whether they had experienced migraine or other severe headaches in the past three months.

Analysis of the information provided by the study subjects showed that 25 percent of those taking proton pump inhibitors had migraine or severe headache compared with 19 percent who didn’t take them. Similarly, 25 percent of those taking H2 blockers had severe headache, compared to 20 percent of those who were not taking those drugs and 22 percent of those taking antacid supplements had severe headache, compared to 20 percent of those not taking antacids.

Researchers took these raw numbers and adjusted for other factors that could predispose people to migraine including age, sex, and the use of caffeine and alcohol. After these adjustments, the researchers determined that people taking proton pump inhibitors were 70 percent more likely to have migraine than those who didn’t take them; people taking H2 blockers were 40 percent more likely and those taking antacid supplements were 30 percent more likely than those not taking the medications.

“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.

While many of the medications included in the study became available in over the counter versions during the time the study was being conducted, the study only included people who were taking prescription drugs.

While other studies have shown a connection between gastrointestinal conditions and migraine, Slavin noted that relationship is unlikely to explain the association the researchers found in the current study between migraine and the use of these acid-reducing medications. She also said the study does not prove that acid-reducing drugs cause migraine—it only shows an association.

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