Acute drug treatment of migraine attack

Abstract

The availability of an effective drug for attack treatment is a main need of migraine patients. Symptomatic therapy of migraine now includes three main classes of drugs: ergot alkaloids, nonsteroidal antiinflammatory drugs (NSAIDs) and triptans. Clinical randomised placebo-controlled trials affirmed the efficacy and tolerability of these drugs, when used at the recommended doses and in the absence of contraindications. The efficacy data from comparative trials showed a trend in favour of triptans vs. ergot alkaloids, but failed to show significant differences between triptans and NSAIDs. However, clinical practice experience of most headache clinicians suggests that triptans provide superior efficacy in comparison with nonspecific agents, mainly in that they better satisfy migraine patient expectations. In fact, these selective specific antimigraine drugs are an advance in acute migraine treatment.

Times to pain relief and pain freedom with rizatriptan 10 mg and other oral triptans

“…Migraine is typically manifest by episodic disabling headache lasting hours or days, with an average attack frequency of one per month (2). Triptans, the ergot alkaloids and non‐steroidal anti‐inflammatory drugs (NSAIDs) are the three main classes of drugs used to treat the pain and associated symptoms of a migraine attack (3).…”

“…The objective of the current study is to investigate the effectiveness of rizatriptan 10 mg compared with the oral triptans usually taken by patients in a naturalistic setting. Given the bioavailability differences exist among oral triptans, comparison group was further categorised into (1) other oral triptans (2), sumatriptan only (3), fast‐acting oral triptans (i.e. almotriptan, electriptan and zolmitriptan), and (4) slow‐acting oral triptans (i.e.…”

Characteristics, impact and treatment of 6000 headache attacks: The PAMINA study

“…The efficacy of triptans has been proven in a large series of randomized placebo-controlled trials as well as in head-to-head trials (Narbone et al, 2004;Ferrari et al, 2001). The efficacy of triptans has been proven in a large series of randomized placebo-controlled trials as well as in head-to-head trials (Narbone et al, 2004;Ferrari et al, 2001).…”

“…The question whether triptans are superior to other compounds in acute treatment of migraine attacks is still unsolved. The efficacy of triptans has been proven in a large series of randomized placebo-controlled trials as well as in head-to-head trials (Narbone et al, 2004;Ferrari et al, 2001). In contrast, the number of studies comparing triptans to other compounds is rather small.…”

“…In contrast, the number of studies comparing triptans to other compounds is rather small. Among six controlled studies comparing triptans to NSAIDs only one demonstrated superiority of the triptan (for review see Narbone et al, 2004). Hence, patients using triptans have a higher likelihood of satisfaction with their migraine therapy than those using other compounds (Ceballos Hernansanz et al, 2003).…”