There is a strong association between caffeine cessation and increased treatment efficacy in patients using Nortriptyline for migraine.

A randomized controlled trial aimed to compare the treatment efficacy between two groups of migraine patients: one treated with nortriptyline and caffeine cessation, and the other treated with nortriptyline without caffeine cessation.

Seventy-six patients of various genders, aged 18 to 60 years, who had been diagnosed with migraines within the previous six months, were selected for the study. These participants were randomly assigned to two different intervention groups. Both groups received Nortriptyline as part of their treatment, but the experimental group was additionally instructed to abstain from consuming caffeine.

The outcome variable in the study was treatment efficacy, defined as having one or fewer headache episodes per week after four weeks of intervention. The mean age of the patients was 33.5±12.3 years, with 49 (64.5%) female and 27 (35.5%) male participants. Caffeine cessation improved Nortriptyline's effectiveness for migraine relief. The frequency of treatment efficacy was significantly greater in subjects who received Nortriptyline along with caffeine cessation compared to those who received only Nortriptyline without any changes in caffeine intake (Table 1).

Caffeine cessation led to significantly higher treatment efficacy in migraine patients treated with Nortriptyline, regardless of age, gender, body-mass index, disease duration, and headache frequency. These findings emphasize the importance of recommending caffeine cessation to improve treatment response in future clinical practice.