Diagnostik der Migräne

Soyka, D

doi:10.1055/s-2008-1067713

Cited by 6 publications

(1 citation statement)

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“…All 10 studies recruited participants between 18 and 70 years of age (mean ages ranging from 33 to 49 years; one study (Hoernecke 1993) included one participant aged 75 years). Six studies used IHS criteria (IHS 1988; IHS 2004) to diagnose migraine or other criteria which we considered compatible (Ad Hoc 1962; Soyka 1988); four studies (Dexter 1985; Dowson 2000;GL/MIG/001/92; GL/MIG/001A/92) did not report criteria for diagnosis, and we planned to include them, with a sensitivity analysis to determine their effect on results. In fact Dexter 1985 did not provide any usable efficacy data, and the others could not be compared with studies evaluating the same treatment comparisons that did report diagnostic criteria.…”

Section: Resultsmentioning

confidence: 99%

Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults

Derry¹,

Moore²,

McQuay³

2010

Cochrane Database of Systematic Reviews

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Background Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated with migraine. Objectives To determine the efficacy and tolerability of paracetamol (acetaminophen), alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine in adults. Search methods We searched Cochrane CENTRAL, MEDLINE, EMBASE and the Oxford Pain Relief Database for studies through 4 October 2010. Selection criteria We included randomised, double-blind, placebo- or active-controlled studies using self-administered paracetamol to treat a migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Numbers of participants achieving each outcome were used to calculate relative risk and numbers needed to treat (NNT) or harm (NNH) compared to placebo or other active treatment. Main results Ten studies (2769 participants, 4062 attacks) compared paracetamol 1000 mg, alone or in combination with an antiemetic, with placebo or other active comparators, mainly sumatriptan 100 mg. For all efficacy outcomes paracetamol was superior to placebo, with NNTs of 12, 5.2 and 5.0 for 2-hour pain-free and 1- and 2-hour headache relief, respectively, when medication was taken for moderate to severe pain. Nausea, photophobia and phonophobia were reduced more with paracetamol than with placebo at 2 hours (NNTs of 7 to 11); more individuals were free of any functional disability at 2 hours with paracetamol (NNT 10); and fewer participants needed rescue medication over 6 hours (NNT 6). Paracetamol 1000 mg plus metoclopramide 10 mg was not significantly different from oral sumatriptan 100 mg for 2-hour headache relief; there were no 2-hour pain-free data. There was no significant difference between the paracetamol plus metoclopramide combination and sumatriptan for relief of “light/noise sensitivity” at 2 hours, but slightly more individuals needed rescue medication over 24 hours with the combination therapy (NNT 17). Adverse event rates were similar between paracetamol and placebo, and between paracetamol plus metoclopramide and sumatriptan. No serious adverse events occurred with paracetamol alone, but more “major” adverse events occurred with sumatriptan than with the combination therapy (NNH 32). Authors’ conclusions Paracetamol 1000 mg alone is an effective treatment for acute migraine headaches, and the addition of 10 mg metoclopramide gives short-term efficacy equivalent to oral sumatriptan 100 mg. Adverse events with paracetamol did not differ from placebo; “major” adverse events were slightly more common with sumatriptan than with paracetamol plus metoclopramide.

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Section: Resultsmentioning

confidence: 99%

Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults

Derry¹,

Moore²,

McQuay³

2010

Cochrane Database of Systematic Reviews

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Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults

Derry¹,

Moore²

2013

Cochrane Database of Systematic Reviews

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Cochrane Database of Systematic Reviews Adverse event rates were similar between paracetamol and placebo, and between paracetamol plus metoclopramide and sumatriptan. No serious adverse events occurred with paracetamol alone, but more serious and/or severe adverse events occurred with sumatriptan than with the combination therapy (NNH 32). Authors' conclusions Paracetamol 1000 mg alone is statistically superior to placebo in the treatment of acute migraine, but the NNT of 12 for pain-free response at two hours is inferior to at of other commonly used analgesics. Given the low cost and wide availability of paracetamol, it may be a useful first choice drug for acute migraine in those with contraindications to, or who cannot tolerate, non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin. The addition of 10 mg metoclopramide gives short-term e icacy equivalent to oral sumatriptan 100 mg. Adverse events with paracetamol did not di er from placebo; serious and/or severe adverse events were slightly more common with sumatriptan than with paracetamol plus metoclopramide.

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Neurologie

Klußmann¹,

Ackenheil²

2002

Psychosomatische Medizin

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Diagnostik der Migräne

Cited by 6 publications

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Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults

Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults

Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults

Neurologie

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