Do Acid Reflex Drugs Include Increased Migraine Risk?

Clinical relevance: Acid-reducing drugs might increase vulnerability to migraines, but researchers conceded that they didn’t establish causation.

The study focused on proton pump inhibitors, H2 blockers, and antacid supplements.
Roughly 25% of those on proton pump inhibitors experienced migraines, compared to 19% not taking them.
Adjusted analysis revealed a 70% increased migraine risk for proton pump inhibitors, 40% for H2 blockers, and 30% for antacid supplements.

People who take acid-reducing drugs could be vulnerable to migraines and other severe headache than those who aren’t on those meds, according to new research.

The paper, which appeared in the latest online edition of Neurology Clinical Practice, focused on proton pump inhibitors, such as omeprazole and esomeprazole, histamine H2-receptor antagonists, such as cimetidine and famotidine, and ordinary antacid supplements.

The authors, however, are quick to point out that the study results don’t demonstrate that acid-reducing drugs cause migraines. The research simply reveals a link.

“Given the wide usage of acid-reducing drugs and these potential implications with migraine, these results warrant further investigation,” lead study author Margaret Slavin, PhD, of the University of Maryland in College Park, explained. “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.”

Migraine Methodology

According to the American Migraine Foundation, migraines plague at least one out of every four U.S. households and more than 1 billion people worldwide.

For the study, the research team pored over the health data of nearly 12,000 who submitted information on their use of acid-reducing drugs and whether they had migraine or severe headaches anytime over the previous three months.

The researchers found:

Roughly a quarter of the study participants on proton pump inhibitors admitted to a migraine or severe headache. That compared to 19% of those who weren’t taking the meds.
Additionally, 25% of those taking H2 blockers had severe headaches vs. 20% of those who weren’t taking them.
Finally, 22% of those taking antacid supplements recalled severe headaches, compared to 20% of those not taking anything.

When researchers adjusted for other factors that account for increased migraine risk – such as age, gender, and caffeine and alcohol consumption – they discovered that people taking proton pump inhibitors were 70% more likely to have a migraine than people not taking them. Those taking H2 blockers were 40% more likely and those taking antacid supplements were 30% more likely.

A Few Caveats

“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 added.

Slavin noted that the study only covered prescription drugs. Some of the drugs became available for over-the-counter use at non-prescription strength throughout the study period. But the researchers excluded those from the study.

The study’s authors conceded that earlier studies showed that those with gastrointestinal conditions might be more susceptible to migraines, but Slavin said that doesn’t completely explain the connection her team found.

Slavin also added that this study’s sample size was small and that future research should consider a larger participant pool.