, Volume 10, Issue 4, pp 291-293
Date: 15 Apr 2009

Caffeine-withdrawal headache induced by hemodialysis

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Introduction

Caffeine is the most widely used psychoactive substance, and caffeinated beverages enjoy immense popularity around the world. Temporal abstinence from caffeine in habitual users results in the well-characterized withdrawal syndrome, consisting mainly of headache, fatigue, tiredness and decreased alertness.

The formal diagnostic criteria for caffeine-withdrawal headache (CWH) were given in the International Classification of Headache Disorders, 2nd edition (ICHD-II). According to these criteria, the headache is bilateral and/or pulsating, occurs when intake is interrupted or delayed in person with caffeine consumption of ≥200 g/day for >2 weeks, develops within 24 h after last caffeine intake and is relieved within 1 h by 100 mg of caffeine. The obligatory criterion, as for the other secondary headaches, is the improvement or resolution of headache after relief from the causative disorder, e.g. that this headache resolves within 7 days after total caffeine withdrawal. There i