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Previous Volume 347:764-766 September 5, 2002 Number 10 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In their review of the treatment of migraine, Goadsby et al. (Jan. 24 issue)¹ did not mention the importance of caffeine in inducing migraine attacks and thwarting treatment efforts. Variations in caffeine levels, which are inevitable in persons with a substantial intake of caffeine, often induce withdrawal or rebound migraine headaches. The elimination of dietary caffeine frequently results in much greater responsiveness to treatment or even makes long-term pharmacologic intervention unnecessary. Patients and physicians often underestimate caffeine intake by misjudging the volume of large mugs of coffee and big containers of soft drinks.

Arnold Werner, M.D.
Michigan . . . [Full Text of this Article]

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