Ibuprofen Works Just Fine for Headache Relief

Over-the-counter well-known brands ibuprofen Advil and Motrin might be enough to relieve pain for those suffering with migraine headaches, according to a new Cochrane review.

Results demonstrate that about half of those with migraine headaches will have pain relief within two hours after taking ibuprofen.

“We knew that many migraineurs rely on over-the-counter medication to treat attacks and surveys show that while some find them helpful, many are dissatisfied,” said review co-author Sheena Derry, of the Pain Research and Nuffield Department of Anaesthetics at the University of Oxford, in a press release.

Migraine headache manifests as an intense throbbing pain on one side of the head. An attack can last anywhere between four and 72 hours. Symptoms such as nausea, vomiting, aura, and increased sensitivity to light and sound often accompany migraines.

The systematic review was published by The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

According to the Migraine Research Foundation, migraine ranks in the top 20 of the world's most disabling medical illnesses. More than 10% of the population, including children, suffers from the condition.

Migraine may also cause less productivity at work and school. Less than 10% of sufferers are able to work or function normally during their migraine attacks. American employers lose more than $13 billion each year as a result of 113 million lost work days, according to the Migraine Research Foundation.

To relieve their headache pain, almost half (49%) of migraine sufferers use over-the-counter medication only, 20% use prescription medication, and 29% use both, according to the Cochrane review.

The Cochrane review was conducted to help provide a more definitive answer on whether ibuprofen is effective for migraine pain. Additionally, the review delved into the question of whether or not also taking an antiemetic to relieve nausea was better than taking an ibuprofen alone.

“We knew that there were a number of published trials using ibuprofen for acute treatment of attacks,” she said. “Individual trials, however, can be misleading for a number of reasons, and generally it is recognized that using systematic review and meta-analysis is likely to provide a more accurate estimate of the effects of any intervention.”

Nine studies with 4,373 adult participants who had a diagnosis of migraine headache were reviewed. The average age of the participants was 30 to 40 years and all had a history of migraine for at least 12 months before entering the studies.

In total, 414 people with migraines underwent treatment with 200 milligrams of ibuprofen, 1,615 received a dose of 400 milligrams, 208 received a 600-milligram dose and 1,127 received a placebo.

Of the patients taking the 400-milligram dose, 26% were pain free within two hours, compared with 20% who took the smaller dose and 11% who received a placebo. In the same period, 57% who took 400 milligrams of ibuprofen had their pain reduced from moderate or severe to “no worse than mild,” compared with 25% taking a placebo.

“For those who experience these outcomes, ibuprofen is a useful, inexpensive and readily available treatment,” Derry said. “Those who don't experience good outcomes will need to look at alternative treatments.”

Roger Chou, M.D., associate professor of medicine at Oregon Health & Science University and the director of clinical guidelines development at the American Pain Society, said that it is common to use OTC medications such as ibuprofen to treat migraines.

“Migraine sufferers really vary in what they do, in part because the severity and frequency varies so much,” Chou said. “People with relatively mild migraines probably do use over-the-counter medications and so do people who find that they work.”

“Those with more severe migraines, or who don't get relief with over-the-counter medications, or who have very frequent migraines, often end up in the doctor's office and are given various prescriptions.”

Derry and her colleagues also found that the nausea and other symptoms that usually accompany migraines decreased within two hours and fewer participants used rescue medications with ibuprofen compared with placebo. Only mild side effects occurred with the ibuprofen.

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Is Ibuprofen enough for migraines? What are your thoughts?