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July 27, 1970

Caffeine and Headache

Author Affiliations

San Bernardino, Calif

JAMA. 1970;213(4):628. doi:10.1001/jama.1970.03170300072029

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To the Editor.—  One type of headache practically never diagnosed is that caused by caffeine.Caffeine and the other methylxanthines are used by most of us so frequently that we seldom suspect them as a cause of headache or other symptoms. Insomnia, nervousness, and cardiac arrhythmia are occasionally produced by coffee, tea, cola, cocoa, chocolate, analgesics, and awakeners. The symptoms are usually ignored.A patient of mine suffered from constant headaches day and night for more than two years. She took compound aspirin tablets constantly even though they provided incomplete relief. Exhaustive investigation by several physicians provided no diagnosis. Tension was suspected, but when the psychiatrist failed to find tension in her home life, he suggested that the headaches might have been caused by too much serenity in the home!Unable to accept that, as a last resort all medications and all sources of caffeine were discontinued. The patient has