Non‐migrainous headache for the evaluation of oral analgesics.

Abstract

1 Eight double-blind, randomized, placebo-controlled, single-dose, cross-over studies were carried out to evaluate the usefulness of testing the acute analgesic effect of drugs in out-patients with non-migrainous headache. 2 The reference compounds were either (1) aspirin, (2) a combination of aminopyrine, caffeine and butalbarbital (Optalidon®), and (3) a combination of (2) with dihydroergotamine (Tonopane).3 The test compounds were (1) proquazone, (2) fluproquazone and (3) and (4), new formulations of Optalidon® and Tonopan® in which the aminopyrine was replaced by propyphenazone. They were all found to be active. 4 A significant, dose-response relationship was established for aspirin (250, 500 and 1000 mg). 5 It is concluded that the non-migrainous headache model is a practical, reproducible and sensitive method for the investigation of the acute efficacy of analgesics.

Mild analgesics and the accident and emergency department--cost and safety more important than potency?

“…A quick assessment of the scientific value of this information is often impossible because of the variation in methodology between trials and the vagueness of the subjective end-point. Most evaluations have been conducted on in-patients with post-partum pain (Sunshine, 1980), chronic cancer pain (Wallenstein & Houde, 1975) or post-operative pain (Evans et al, 1982;Tammisto & Tigerstedt, 1980), or on out-patients attending dental (Lokken & Skjelbred, 1980;Cooper & Beaver, 1974) or general medical (Graffenreid & Nuesch, 1980) clinics. Analgesic trials on out-patients with post-traumatic pain are difficult to set up and are often restricted to small numbers of patients in unmatched groups.…”

Evidence for efficacy of acute treatment of episodic tension-type headache: Methodological critique of randomised trials for oral treatments

“…1): they were in chronic TTH [3,28]; 84% of patients had migraine [14]; rectal administration [26]; duplicate publication [38,80]; not randomised and double-blind [5,54,70]; without initial pain of at least moderate intensity, which can reduce sensitivity [12,13,15,16,33,65]; or not full publications [1]. Copies of 2 other publications (45 patients in total) could not be obtained [58,71].…”

Current and potential future drug therapies for tension-type headache

“…In an early double-blind, placebo-controlled, crossover trial, aspirin at doses of 1000 mg, 500 mg, and 250 mg was shown to be more effective than placebo in the treatment of nonmigraineous headache [4]. Moreover, a significant dose-response relationship was established for aspirin; 1000 mg of aspirin was superior to 500 mg and 500 mg was superior to 250 mg. Several comparative, randomized, placebo-controlled trials have shown that aspirin [5][6][7][8][9][10][11] and acetaminophen [11][12][13][14][15][16][17][18][19][20][21] are effective in the acute therapy of tension-type headache.…”