One study suggests that 40 percent of people who do not eat or drink during a religious fast end up with a headache. In an article scheduled for publication in the journal Headache, a doctor from Hartford Hospital reports that he has discovered one pill that can prevent or reduce the severity of fast-related headaches.

But not unlike the pursuit of peace in the Middle East, it turns out that preventing the Yom Kippur or Ramadan headache is not quite as simple as it seems.

Two years ago, Dr. Michael J. Drescher and medical student Yoni Elstein set out to test a sort of urban myth that swallowing a Vioxx tablet with the pre-fast meal can prevent the headache.

Then working at a hospital outside Tel Aviv, Israel, Drescher recruited 105 volunteers. On Yom Kippur eve, the start of the fast, he gave half of the volunteers a Vioxx pill. The rest of the group got an inactive sugar pill.

The results were striking. In a survey after the fast, 60 percent of the volunteers who got a dummy pill said they got a headache during the fast. Only 18 percent of those in the Vioxx group got a headache, and even those who did said it was mild.

But two days after the study was finished drug maker Merck pulled Vioxx off the market following reports that it could cause heart attacks in patients who took it daily for 18 months or longer.

Drescher, now the associate chief of emergency medicine at Hartford Hospital, called the recall frustrating. There are no painkillers available in the United States that are as long lasting and easy on an empty stomach as Vioxx, he said. And widely used painkillers such as ibuprofen would wear off too quickly.

He is hoping to repeat his Yom Kippur study soon using another drug, Arcoxia, that is available in Europe and Israel, but is not yet FDA approved in the U.S.

Meanwhile, Drescher recommends drinking plenty of water and eating a balanced meal that includes complex carbohydrates, such as grains and starchy vegetables, before the start of a fast. He also suggests cutting back on coffee, tea and caffeinated soda days before.

Although several studies of Ramadan and Yom Kippur fasting failed to find a strong association between dehydration, caffeine withdrawal or low blood sugar and a headache, experts said reducing coffee consumption does seem to help.

Although the Bible commands that Yom Kippur, the Day of Atonement, should be a time of affliction, that does not mean worshippers should endanger their lives, rabbis said.

“The person who is healthy should fast on Yom Kippur and if there’s some discomfort, it’s not a bad thing,” said Rabbi Yitzchok Adler, of Beth David, an orthodox synagogue in West Hartford.

CC