Test drug taken before fast could be answer to preventing Yom Kippur headaches

Test drug taken before fast could be answer to preventing them.

By JUDY SIEGEL-ITZKOVICH
Yom Kippur headache Gottlieb 224 88 (photo credit: Courtesy)
Yom Kippur headache Gottlieb 224 88
(photo credit: Courtesy)
Based on the verse in the Book of Leviticus that "You shall afflict your souls," many people believe that Yom Kippur is a day of suffering. But the rabbis disagree, saying you're not meant to suffer, but rather to ignore the physical and focus on the spiritual. If you get a headache, they argue, you can't adequately concentrate on your sins and repentance. Thus headaches on the the Day of Atonement are unnecessary, says Dr. Zev (Jeremy) Wimpfheimer, a senior physician in the emergency medicine department of Jerusalem's Shaare Zedek Medical Center. Wimpfheimer is testing a drug which, taken in pill form before the fast, will hopefully prevent those fasting from developing a headache. He wants about 200 people to try it before the onset of the 25-hour fast Wednesday evening. Performed in cooperation with Dr. Michael Drescher, the associate director of emergency medicine of Hartford Hospital in Connecticut, the study is designed to determine the feasibility of applying a "commonly used and proven-safe drug" to help people fast without getting headaches. The particular drug chosen for the study is a clinically effective anti-inflammatory pain-relief compound with a favorable side effect profile, whose particular qualities make it effective even long after being ingested. "With Yom Kippur lasting for over 25 hours, the effects of this drug, which include headache prevention, remain even at the end of the fast," said Wimpfheimer. While the drug is a COX inhibitor, it's a somewhat different drug from the famed Vioxx (Rofecoxib), and its use is permitted. Vioxx was taken off the market in 2004 because an increased risk of heart attacks and strokes was associated with its long-term, high-dosage use. Drescher told The Jerusalem Post that he and Wimpfheimer had consulted with "many rabbis," who had approved taking the pill to mitigate or eliminate fasting headaches on Yom Kippur because those who observe the fast are not supposed to suffer physically. "The pill won't remove all effects of hunger that come without eating for a day, but it should address related headaches," added Wimpfheimer. Drescher said that at least seven in 10 Israeli adults fast on Yom Kippur. The researchers noted that Muslims, who fast during the day for the 30 days of Ramadan, could also benefit from the pill, if it's proven effective. Drescher said that many people get headaches on Yom Kippur because they don't prepare properly: They don't drink enough water; they don't cut down on their coffee intake during the days before the fast; they don't eat complex carbohydrates (such as whole grains and pulses) and only a little fat during the pre-fast meal. Following these rules could prevent headaches in many people, he said. But many will still get headaches - especially if they suffer from them frequently throughout the year. People like these, he said, are invited to participate in the double-blind trials (which means that half of those who get a pill are getting a harmless placebo rather than an active ingredient.) While initial research seems to support the hypothesis that this drug will help fasters get through the day, this Yom Kippur will be the first time the drug will be available to the general public to provide real validation. Wimpfheimer said that while typically this pill is only provided to patients at a high cost, for the purposes of this study, healthy people living in Israel can get it for free. The single pill is taken orally just before the beginning of the fast and test participants will be asked to fill out a short questionnaire afterwards. Anyone who wants to participate in the study by Wednesday should e-mail ykheadache@gmail.com or call 054-627-2867.