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DOES ORAL SUMATRIPTAN RELIEVE RECURRENT MIGRAINES?

Subcutaneous sumatriptan effectively relieves acute migraine in about 50 percent of patients, but as many as 30 percent of patients have recurrences within 24 hours. This multicenter randomized study evaluated the effectiveness of oral sumatriptan for treating recurrences.

Among 424 patients with migraine, there were 1904 attacks treated with subcutaneous sumatriptan, and 1221 initial responses. But in 725 of these 1221 episodes, headache recurred within 24 hours. These recurrences were treated with either oral sumatriptan (100 mg) or placebo. Within four hours, about 81 percent of patients given oral sumatriptan had headache relief, versus only about 27 percent of placebo-treated patients. However, at 24 hours, headaches had returned in over half of the oral sumatriptan group.

Oral sumatriptan had little value as a "rescue" medication for patients whose headache failed to respond to initial subcutaneous sumatriptan.

Comment: This study, funded by the maker of oral sumatriptan, provides evidence that the drug can confer short-term relief of recurrent migraines after an initial response to subcutaneous sumatriptan. Oral sumatriptan is currently under consideration by the FDA, but not yet approved.

— TL Schwenk

Published in Journal Watch General Medicine October 4, 1994

Citation(s):

Cady RK et al. Oral sumatriptan in the treatment of recurrent headache. Arch Fam Med 1994 Sep 3 766-772.

• Medline abstract (Free)