Medications for Acid Reflux: A Likely Cause for Migraine?

One of the reasons for headache occurrence has been associated with the use of acid-lowering drugs, primarily the proton pump inhibitors (PPIs) (1^✔ ✔Trusted Source
Use of Acid-Suppression Therapy and Odds of Migraine and Severe Headache in the National Health and Nutrition Examination Survey

Go to source). A research study was published in the April 24, 2024, online issue of Neurology® Clinical Practice, an official journal of the American Academy of Neurology, which suggests that individuals who use acid-lowering medications have a higher chance of experiencing migraine headaches and other severe forms of headache compared to those who do not take these medications.

The proton pump inhibitors like omeprazole and esomeprazole, histamine H2-receptor antagonists (H2 blockers or H2RA) such as cimetidine and famotidine, as well as antacid supplements are categorized as acid-lowering medications and also used to reduce acid reflux (2^✔ ✔Trusted Source
Association between Migraines and Prior Proton Pump Inhibitor Use: A Nested Case-Control Study Using a National Health Screening Cohort

Go to source).

The research does not demonstrate a relationship between acid-lowering medications and migraines; it solely indicates a correlation between the two.

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What is Migraine?

Migraine is a commonly prevailing neurological condition distinguished by recurring episodes of pulsating unilateral headaches ranging from moderate to severe in intensity.

Migraines are the most debilitating condition for individuals between the ages of 15 and 49, second to back pain. These migraines not only impact the overall quality of life but also give rise to various health concerns.

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What is Acid Reflux?

Acid reflux occurs when the stomach acid moves back into the esophagus and throat, typically following a meal or while in a reclined position. It generally happens when the individual lies down shortly after dinner (3^✔ ✔Trusted Source
Proton pump inhibitor use: systematic review of global trends and practices

Go to source).

Individuals suffering from acid reflux may encounter symptoms such as heartburn and ulcers and those who often experience acid reflux are at a risk of developing gastroesophageal reflux disease (GERD), a condition that may eventually progress to esophageal cancer.

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Research Study: Use of Acid-Reducing Drugs and Migraines

The author of the study, Margaret Slavin, PhD, RDN, of the University of Maryland in College Park commented, “Given the wide usage of acid-reducing drugs and these potential implications with migraine, these results warrant further investigation,” (4^✔ ✔Trusted Source
Proton pump inhibitor use: systematic review of global trends and practices

Go to source).

Slavin further added, “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.”

The researchers assessed the existing data of 11,818 individuals, regarding their use of acid-lowering medications and history of migraines or severe headaches within the previous three months.

Results of the Study

Among the proton pump inhibitor users, an overall 25% of users reported migraine or severe headaches, as compared to 19% of non-users.

Furthermore, 25% of individuals taking H2 blockers suffered from severe headaches, in contrast to 20% of those who were not using this type of medication.

In addition, it was observed that 22% of participants who consumed supplements for reducing acid experienced severe headaches, compared to 20% of those who did not take these supplements.

In another aspect of the study, the researchers assessed the data after adjusting for age, sex, use of alcohol and caffeine, and other variables that may influence the likelihood of suffering migraine. They discovered that individuals using proton pump inhibitors had a 70% higher chance of developing migraines than those not using them.

Similarly, individuals taking H2 blockers had a 40% increased risk, while those taking supplements for reducing acid reflux had a 30% higher chance of getting migraine.

Slavin mentioned, “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,”.

Limitations of the Study

The limited sample size, particularly regarding the number of participants who were using H2 blockers is one limitation of this study.

Slavin shared his observations that the study had not considered the over-the-counter acid-lowering drugs and that it had only considered the prescription drugs.

Further studies are required to explore the potential link between acid-lowering medications and the risk of migraines. However, with the current study data and the recent recommendations to reduce prescribing PPIs, it is important for the patient to seek medical advice if the symptoms are severe and persistent, to avoid further complications.

References:

1. Use of Acid-Suppression Therapy and Odds of Migraine and Severe Headache in the National Health and Nutrition Examination Survey - (https://www.neurology.org/doi/10.1212/CPJ.0000000000200302)
2. Association between Migraines and Prior Proton Pump Inhibitor Use: A Nested Case-Control Study Using a National Health Screening Cohort - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694889/)
3. Proton pump inhibitor use: systematic review of global trends and practices - (https://www.researchgate.net/publication/372192488_Proton_pump_inhibitor_use_systematic_review_of_global_trends_and_practices)
4. Proton pump inhibitor use: systematic review of global trends and practices - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427555/)

Source-Medindia