New drugs, indications for migraine care
A family of 5-HT, 1B/1D agonist triptans should become the drugs of choice for the treatment of migraines over the use of narcotics once they are approved by the U.S. Food and Drug Administration, says Ninan Mathew, MD, a clinical professor at the University of Texas Medical School in Houston.
Mathew reports that zolmitriptan, rizatriptan, eletriptan, and naratriptan all have proven beneficial in studies, with similar activation periods of one to three hours and response rates ranging from 52% to 80%.
And while no large-scale comparative studies have been done, contraindications and side effects associated with the drugs should not impede their approval, Mathew reported to the American Neurological Society at its annual fall meeting in San Diego.
Mathew decried the use of narcotic treat-ment, saying they do not "activate the specific mechanisms" of migraine, they can be addictive and can cause what he called "rebound headaches."
In a related study, neurologist Robert Kaniecki at Allegheny University in Pittsburgh has shown that divalproex used for epilepsy control since 1978 proved as effective as propranolol in patients suffering from migraine without aura.
The study found that migraine frequency was reduced by 63% for patients on propranolol and 66% for patients given divalproex, while migraine days were reduced for 69% of propranolol patients and 66% of patients on divalproex. Kaniecki’s study was aimed to back up recent literature touting divalproex as a new choice for migraine prophylaxis. t
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