OTC Pain Meds & High Blood Pressure

Over-the-counter pain meds raise the risk of high blood pressure — for men as well as women. A recent study indicates that all painkillers are potential culprits, they include:

This is yet more proof that over-the-counter does not mean safe. Some other problems with OTC painkillers are increased heart attack risk, stomach bleeding and liver damage.

The American Heart Association advised yesterday that doctors be cautious in prescribing painkillers, particularly Celebrex, because of the risks. Today’s New York Times warns that few patients know the appropriate dose of acetaminophen or the havoc it can wreak on one’s liver.

No wonder I try so hard to tough it out.

Grand Rounds at Musings of a Dinosaur

This week’s Grand Rounds is up at Musings of a Dinosaur.

Not familiar with this blog carnival? It’s a weekly glimpse into the medical blogosphere. You can find the Grand Rounds archives on Blogborygmi.

Serotonin Syndrome

Serotonin syndrome, a drug poisoning caused by excessive serotonin in the brain, has made the news again. This is a serious drug reaction that people who take SSRI antidepressants and/or triptans should be aware of. Despite the hype, rest assured that serotonin syndrome is rare in people with headache.

The most important step to prevent serotonin syndrome is to give all your health care providers a complete list of all the drugs that you take — not only prescription meds, but OTCs, supplements and recreational drugs. Today’s NY Times article lists a variety of drugs that can contribute to serotonin syndrome.

When you are given any new prescription or supplement, double-check if it increases your risk of serotonin syndrome. Triple-check this with your pharmacist when you pick up the drugs, whether they are prescription or OTC.

According to the Mayo Clinic’s website, “Signs and symptoms of serotonin syndrome typically occur within several hours of taking a new drug or taking a previously used drug at an increased dosage level. . . .”

From the Archives: Caffeine & Headaches

Espresso_cupThis post is from September 29, 2006.

Caffeine is often cited as a headache trigger, but it can be an effective abortive too. Many headache medicines even contain caffeine. Some books say to avoid caffeine at all costs, others warn that you not go over two cups a day.

As with every other headache treatment, it seems, the answer lies in your knowledge of your body. For years I thought my headaches were caused by withdrawal. Turns out I just have chronic daily headaches and caffeine reduces the pain.

I can drink caffeine daily without apparent ill effects, but I prefer to save it to use as a headache abortive. For many other people, drinking it regularly triggers headaches.

Part of finding the right balance between a helpful level and an excessive amount is figuring out just how much caffeine you consume. There are charts of caffeine levels in foods and drinks, but the solution is murkier than it seems.

  • Sensitivity varies widely from one person to the next. Researchers attribute this to genetics and weight.
  • Consuming caffeine right after eating a meal can slow down its effect.
  • Nicotine is thought to stimulate enzymes that break caffeine down, so smokers can often tolerate higher doses of caffeine.
  • Espresso doesn’t have more caffeine than drip coffee; it just has a stronger taste.
  • Coffee and espresso at Starbucks have a higher caffeine content than what you make at home or get at a fast food restaurant or another coffeehouse.
  • Chocolate has more caffeine than you think it does (at least more than I thought it did).
  • Green tea has less caffeine than black tea. White tea has even less.

I was only able to figure out my body’s relationship to caffeine by going off it. My strategy is to gradually decreasing the amount that I drank until I was caffeine-free. (Some people go cold turkey, but that’s more misery than I care to bear. The nasty withdrawal headache can last from a few days to several weeks.) After that I played around with different levels of consumption.

What are your experiences with caffeine? Does it help, hurt or is it somewhere in between?


“Herbal Supplement 100% Effective Against Migraines”

A headline like this is sure to raise my eyebrows, even when the results are “clinically proven.” Especially then. Come on, no treatment, no matter what it is, is 100% effective.

After listing potential side effects of Western medication (which included vague complaints that are common in everyday life), Migra-Zen‘s makers wrote, “Fortunately, consumers don’t have to choose between the pain of migraines and the dangers of drugs.”

But it’s OK to trust in a treatment that claims to be safe, but contains undisclosed ingredients? Anyone who has read about the presence of a chemical used to develop film in HeadOn knows how harmful having such faith can be.

Plus, they mention the clinical trial to prove the legitimacy of their claims. There was one “trial,” which included 75 participants. No drug from the pharmaceutical industry could be proven safe — which is something that the Migra-Zen folks apparently didn’t even test for — or effective with one trial. It’s not uncommon for future research to contradict findings of any medical study.

Not only should the claim that Migra-Zen is 100% effective make you skeptical, “proprietary blend” is sketchy. In no case does “all natural” mean that a product is safe. Arsenic is natural. Why not take it for your headaches?

Medical Marijuana Group Suing US Government

Medical marijuana* activist group Americans for Safe Access is suing two federal health agencies for arguing that marijuana has no medical benefit. Activists maintain that these are “false and misleading” statements.

Decriminalization of marijuana is not the goal of the lawsuit. Instead, the ASA wants “to get a federal agency simply to acknowledge that pot can help reduce the symptoms of some conditions,” according to the San Francisco Chronicle.

There aren’t a lot of studies to prove whether marijuana is an effective medicine or not. Why not? The required federal approval for medical marijuana studies is granted infrequently. What a convenient tautology.

*This topic is so loaded that I rarely trust what I read on any side of the debate. I link to the Google search results so you can check out some sources yourself.

Tonight: Live Webcast on Women & Migraine

Why Do Women Get More Migraines Than Men? is the topic of tonight’s HealthTalk-hosted webcast. Headache specialists Christina Peterson and Dawn Marcus will discuss this sex disparity and treatments that are particularly helpful for women.

Listener questions will be answered, but you have to register in advance to submit a question (I have no idea how late they’ll will take questions). Registration is not required to listen to the program.

The broadcast starts at 7 p.m. EST (4 p.m. PST). Starting about 10 minutes before the webcast, go to the program’s description page and look for a link that says “Join the Program.”

Sorry for the late notice!