Naproxen Sodium in Menstrual Migraine Prophylaxis: A Double‐Blind Placebo Controlled Study

Sances, Grazia; Martignoni, E.; Fioroni, L.; Blandini, Fabio; Facchinetti, Fabio; Nappi, Giuseppe

doi:10.1111/j.1526-4610.1990.hed3011705.x

Cited by 138 publications

(76 citation statements)

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“…In a double-blind, placebo-controlled study, short-term preventive treatment with naproxen sodium, at doses higher than those used in our study (550 mg twice daily vs. 500 mg once-daily in our study) reduced the incidence of headache attacks by 33%, with a lesser headache intensity and duration in patients receiving this drug as compared to placebo [19]. In our study neither transdermal oestrogens nor naproxen sodium altered the incidence of headache as compared to the control period.…”

Section: Discussionmentioning

confidence: 99%

Frovatriptan vs. transdermal oestrogens or naproxen sodium for the prophylaxis of menstrual migraine

et al. 2007

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Section: Discussionmentioning

confidence: 99%

Frovatriptan vs. transdermal oestrogens or naproxen sodium for the prophylaxis of menstrual migraine

et al. 2007

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“…52 Naproxen 550mg once or twice daily perimenstrually between days -7 and +6 has shown efficacy with good tolerability. 53 Mefenamic acid 500mg, three to four times daily, may be started two or three days before the expected onset of menstruation and continued through the heaviest days of bleeding. It can be effective even when started on the first day of bleeding, which is useful if periods are irregular.…”

Section: Nsaidsmentioning

confidence: 99%

Diagnosis and management of menstrual migraine

MacGregor¹

2011

Prog Neurol Psychiatry

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Despite affecting one in seven of the UK population, migraine is underdiagnosed and undertreated. 1 Prevalence is highest during the peak reproductive years with a female predilection, affecting one in five women compared with one in 13 men. 1 The diagnosis of migraine is based on recurrent episodic headaches lasting between four and 72 hours associated with photophobia, nausea and limitation of normal function in an otherwise healthy person. 2 Prevalence of menstrual migraineMenstruation is a significant risk factor for attacks of migraine without aura, with 50-60 per cent of women reporting a link between their menstrual periods and migraine. [3][4][5] Most women with menstrual exacerbation of migraine also experience attacks at other times of the month ('menstrually-related' migraine). 6,7 Fewer than 10 per cent of women report migraine exclusively with menstruation ('pure' menstrual migraine). [5][6][7][8][9] Characteristics of menstrual migraine Timing of attacks Compared with all other phases of the menstrual cycle, attacks of migraine without aura are most likely to occur during a five-day window that starts two days before the onset of menses and continues through the first three days of menstruation. 8,10-12 Studies suggest that women are over 70 per cent more likely to have migraine in the two days before menstruation and more than 2.5 times more likely to have attacks during the first three days of bleeding. 12 How attacks differ from non-menstrual attacks Menstrual attacks last longer, are more severe, are more likely to relapse, are less responsive to treatment, and are associated with greater disability when compared with attacks at other times of the cycle. 5,[11][12][13][14][15][16][17][18][19] DiagnosisThe International Headache Society (IHS) recognises two types of menstrual migraine: menstrually-related migraine, which is migraine without aura that regularly occurs on or between two days before menstruation and third day of bleeding (days -2 to +3), with additional attacks of migraine with or without aura at other times of the cycle; and pure menstrual migraine, which is migraine without aura that occurs only on or between days -2 to +3, ie with no attacks at any other time during the cycle. 6,20 To confirm the diagnosis, migraine attacks during the day -2 to +3 window must occur in at least two of three menstrual cycles to establish a relationship that is greater than chance alone. Relying on the history to confirm the diagnosis can be misleading. 21 Use of a three-month diar y to record migraine patterns can reveal the predictable patterns associated with menstrual migraine, aiding diagnosis. PathophysiologyResearch has found an increased risk of migraine associated with oestrogen 'withdrawal'. This occurs during the late luteal phase of the natural menstrual cycle and also during the hormone-free interval of combined hormonal contraceptives. 17,22 Prostaglandins have also been implicated in menstrual migraine. There is a three-fold increase in prostaglandin levels in the uterine endometriu...

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“…Nonsteroidal anti-inflammatory drugs (NSAIDs) Studies using 550 mg naproxen once or twice daily perimenstrually have shown limited efficacy [Nattero et al 1991;Sances et al 1990;Szekely et al 1989;Sargent et al 1985]. A recent open-label study of perimenstrual naproxen 550 mg daily has shown efficacy for prevention of menstrual migraine [Allais et al 2007].…”

Section: Perimenstrual Prophylaxismentioning

confidence: 99%

Review: Menstrual migraine: therapeutic approaches

MacGregor

2009

Ther Adv Neurol Disord

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The development of diagnostic criteria has enabled greater recognition of menstrual migraine as a highly prevalent and disabling condition meriting specific treatment. Although few therapeutic trials have yet been undertaken in accordance with the criteria, the results of those published to date confirm the efficacy of acute migraine drugs for symptomatic treatment. If this approach is insufficient, the predictability of attacks provides the opportunity for perimenstrual prophylaxis. Continuous contraceptive strategies provide an additional option for management, although clinical trial data are limited. Future approaches to treatment could explore the genomic and nongenomic actions of sex steroids.

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Naproxen Sodium in Menstrual Migraine Prophylaxis: A Double‐Blind Placebo Controlled Study

Cited by 138 publications

References 4 publications

Frovatriptan vs. transdermal oestrogens or naproxen sodium for the prophylaxis of menstrual migraine

Frovatriptan vs. transdermal oestrogens or naproxen sodium for the prophylaxis of menstrual migraine

Diagnosis and management of menstrual migraine

Review: Menstrual migraine: therapeutic approaches

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