Antacids Associated with Higher Risk of Migraine, Severe Headaches

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New research suggests that people who take antacids may have a higher risk of migraine attacks and severe headaches. Ingvervanil/Getty Images
  • A study of more than 11,000 adults suggests an association between migraine attacks or severe headaches and acid-suppressing drugs like proton pump inhibitors (PPIs).
  • It is estimated that 20% of adults in the US have GERD, which can cause heartburn and acid reflux. These types of medicines are widely used for their treatment.
  • However, studies have not shown that these classes of acid-suppressing drugs cause migraine attacks or severe headaches.

People who take antacids may have higher risk of migraine attacks and severe headaches, new study finds Study The findings came from using data from more than 11,000 people.

The study, published in Neurology Clinical Practice, [EMBARGOED UNTIL 4PM EST]Identified a possible relationship between Proton Pump Inhibitor (PPI) such as esomeprazole (Nexium) and omeprazole (Prilosec), antacid supplements, and histamine H2-receptor antagonists (H2RAs) such as famotidine (Pepcid AC) or cimetidine.

The risk of migraine and severe headache, compared with those who did not take acid-suppression therapy, was 70% higher for those using PPIs, 40% higher for those using H2RAs, and 40% higher for those taking generic antacids. It was 30% more for those.

All the drugs tested in the study were prescription-only. The data did not include most over-the-counter medications. Some of them were made available in non-prescription capacity during the study, but were not included.

Acid reflux, a condition in which stomach acids and contents can back up into the esophagus, causing burning, belching, and burning pain, is one aspect of reflux of food into the esophagus (GERD).

According to National Institute of Diabetes and Digestive and Kidney DiseasesAbout 20% of Americans have GERD. People who are overweight or obese, pregnant, or smoke or are regularly exposed to smoke are at the highest risk of GERD, but anyone can develop it.

The study used data from adults National Health and Nutrition Examination Survey From the year 1999 to 2004. That survey is a cross-sectional analysis that has been conducted continuously since 1999, but only in those first five years did it include a question about headaches and migraine attacks.

The study results are supportive, so the results do not suggest that antacids are causing migraine episodes or severe headaches.

Dr. Medhat Mikhail, MDa pain management specialist and medical director of the non-operative program in the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study. healthline There is no known link between acid reflux and migraine episodes, but all PPI medications, H2 blockers, and antacids are known to cause side effects such as headaches, nausea, and fatigue.

“One theory is that it’s a problem with the person’s central nervous system or glutamate levels, which is one of the facilitators of the pain pathway, and that may link acid reflux disease and headaches,” Michael said. “When acid is produced and retained in excess, it causes inflammation in the mucosa of the stomach and esophagus.”

He said that there could be several mechanisms behind the triggering of a headache or migraine. The first would be the use of PPIs, as the class of drugs can interfere with the absorption of magnesium and other vitamins, which can then trigger headaches and worsen migraine episodes.

Michael said, “Another theory is that the inflammatory cascade response that begins at the GI level may trigger the central nervous system to facilitate the release of calcitonin gene-related peptides that can trigger migraine. “

Dr. Clifford SegilDO, a neurologist at Providence St. John’s Health Center in Santa Monica, CA, who was not involved in the study, told healthline In general, high levels of stress can lead to GERD or migraine conditions.

Segil said, “In my clinical practice, I have seen countless patients who have increased life stress that is causing their headaches, and for many of these patients, increased life stress also leads to disabling GERD. Is becoming the reason.” “As a neurologist it is challenging to explain why any drug that alters stomach acid levels would cause changes in a patient’s brain to increase or decrease the frequency of headaches or migraines, but as a neurologist It is easy to blame this on patients’ increased life stress. Having migraine headaches and GERD.”

PPIs are a widely used treatment for GERD that can stop acid production and provide relief from heartburn. They take longer to take effect than H2RAs, but their results are more lasting, lasting between four and 12 weeks with intended use.

Michael pointed out that the effect of PPIs on magnesium absorption in the body may play a strong role in the development of migraine episodes or severe headaches, and the fact that this class of medication is frequently used may be a possible connection. .

Segil again cited stress as an important factor but also noted the connection between severe GERD and headaches.

“Proton pump inhibitors are the most powerful acid-reducing drugs available and are newer and work better than older H2 (histamine) blocker drugs and antacids,” Segil said. “Patients with increased life stress would be expected to produce more acid as a stress response, which is what I see in clinical practice. Patients with increased life stress also more often Headaches would be expected.”

He added, “I am not surprised to see that the treatment group that requires the strongest acid-reducing family of medications, PPIs, most often has headache as a co-morbidity. I was surprised to see that the incidence of migraine was highest in the placebo group, the weakest of the stomach acid-inducing drugs, at 20% of the placebo group, compared to 22% of the patients taking antacid supplements.

A study of more than 11,000 adults suggests that migraine attacks or severe headaches and proton pump inhibitors (PPIs) such as esomeprazole (Nexium) and omeprazole (Prilosec), antacid supplements, and histamine H2-receptor antagonists (H2RAs) such as There is an association between famotidine (Pepcid). ac) or cimetidine.

It is estimated that 20% of adults in the US have GERD, which can cause heartburn and acid reflux; These medicines are widely used to treat them.

Studies have not shown that these classes of acid-suppressing drugs cause migraine episodes or severe headaches; It is a collaborative search from existing data.