Treat migraines with specific drugs, study finds

CHICAGO, Illinois (Reuters) -- Migraine sufferers should receive the drugs they need to quickly relieve the pain rather than waiting for graduated treatment to see what works, U.S. researchers said Tuesday.

More patients participating in a study got relief from their debilitating headaches if they got migraine-specific drugs such as zolmitriptan, one of a relatively new class of drugs called triptans that alter absorption of the neurotransmitter serotonin to shrink the sufferers' swollen blood vessels.

Migraines are experienced by 28 million people in the United States -- 18 percent of women and 6 percent of men -- and cost an estimated $13 billion in absenteeism from work and reduced productivity. Only half of migraine sufferers are believed to seek out treatment, despite a growing array of effective drugs.

The study of 835 migraine patients from 13 countries by Richard Lipton of Albert Einstein College of Medicine in New York compared different methods of treating migraines, two of which involve step care where drug strength is increased based on effectiveness, and the third which provides stratified care based on pain level.

Lipton said the stepped-up care regime that offers common analgesics such as aspirin initially "delays the onset of pain relief and restoration of function for many patients."

"Utilization of clinically tested treatment strategies should improve the outcomes of care for patients," Lipton wrote in the report published in this week's Journal of the American Medical Association.

The study supported recommendations by the U.S. Headache Consortium (USHC), which rejected the step care strategy in its most restrictive form, David Matchar of Duke University wrote in an accompanying editorial.

"Instead, the USHC recommended the use of migraine-specific therapy for moderate to severe migraine once the physician had established that first-line medications were not effective for a given individual," he wrote.

Copyright 2000 Reuters. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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AMA Health Insight: Migraine
American Council for Headache Education
National Headache Foundation
U.S. Headache Consortium

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