Treatment of Acute Migraine Attack: Naproxen and Placebo Compared

Cephalalgia ◽  
1985 ◽  
Vol 5 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Knut Nestvold ◽  
Reidar Kloster ◽  
Markku Partinen ◽  
Raimo Sulkava
Keyword(s):  
Migraine Attack ◽  
Randomized Study ◽  
Treatment Preferences ◽  
Acute Migraine ◽  
Treatment Results ◽  
Double Blind ◽  
Head Pain ◽  
Main Complaint ◽  
Gastrointestinal Discomfort ◽  
Acute Migraine Attack

A double-blind, cross-over, randomized study of acute migraine attack compared treatment results of naproxen with that of placebo. Each treatment period continued for either three months or six migraine attacks, whichever occurred first. The initial dose of naproxen was 750 mg, with additional 250–500 mg doses taken if and when required, to a maximum of five 250 mg tablets within a period of 24 h in each migraine attack. Forty-one patients were enrolled in the study; they had all experienced at least two but not more than eight migraine attacks a month during the preceding year. Thirty-two patients completed the two treatment periods. Naproxen was statistically significantly superior to placebo in reducing the severity of head pain, nausea, and photophobia; in shortening the duration of head pain, nausea, vomiting, photophobia, and lightheadedness; in diminishing the frequency of vomiting; and in decreasing the need for escape medication. Both patient and physician treatment preferences significantly favoured naproxen. Nine side effects were experienced by seven patients while receiving placebo and seven by five patients during naproxen treatment. Mild gastrointestinal discomfort was the main complaint. Only one patient withdrew from treatment because of a side effect, which occurred while receiving placebo.

Treatment of Acute Migraine Attack With Diclofenac Sodium: A Double-Blind Study

1992 ◽  
Vol 32 (2) ◽  
pp. 98-100 ◽  
Author(s):  
George N. Karachalios ◽  
Adroniki Fotiadou ◽  
Nickolaos Chrisikos ◽  
Alexandros Karabetsos ◽  
Kyriakos Kehagioglou
Keyword(s):  
Migraine Attack ◽  
Diclofenac Sodium ◽  
Blind Study ◽  
Double Blind Study ◽  
Acute Migraine ◽  
Double Blind ◽  
Acute Migraine Attack

Differences of Anti-Nociceptive Mechanisms of Migraine Drugs on the Trigeminal Pain Processing during and Outside Acute Migraine Attacks

Cephalalgia ◽  
2004 ◽  
Vol 24 (8) ◽  
pp. 657-662 ◽  
Author(s):  
Z Katsarava ◽  
V Limmroth ◽  
O Baykal ◽  
D Akguen ◽  
H-C Diener ◽  
...  
Keyword(s):  
Migraine Attack ◽  
Healthy Subjects ◽  
Blink Reflex ◽  
Acute Attack ◽  
Pain Processing ◽  
Acute Migraine ◽  
Double Blind ◽  
Nociceptive Blink Reflex ◽  
Nociceptive Processing ◽  
Acute Migraine Attack

The aim of this study was to investigate central anti-nociceptive mechanisms of i.v. acetylsalicylic acid (ASA) and oral zolmitriptan (ZOL) in migraine patients and healthy subjects using the ‘nociceptive’ blink reflex (nBR). Twenty-eight migraine patients received ASA ( n = 14, 1000 mg i.v) or ZOL ( n = 14, 5 mg p.o) during the acute migraine attack and interictally. Thirty healthy subjects received either ASA or ZOL vs. placebo using a double blind cross over design. nBR was recorded in all patients and subjects before, 60 and 90 min after treatment. ASA and ZOL did not inhibit nBR responses in healthy subjects. Both ASA and ZOL suppressed nBR responses (ASA by 68%, ZOL by 78%) only during the acute attack but not interictally. The data suggest, that the anti-nociceptive effects of migraine drugs on the trigeminal nociceptive processing are different during and outside an acute migraine attack.

Double-Blind Comparison of An Acetaminophen 400 mg-Codeine 25 mg Combination Versus Aspirin 1000 mg and Placebo in Acute Migraine Attack

Cephalalgia ◽  
1994 ◽  
Vol 14 (2) ◽  
pp. 156-161 ◽  
Author(s):  
F Boureau ◽  
JM Joubert ◽  
V Lasserre ◽  
B Prum ◽  
G Delecoeuillerie
Keyword(s):  
Clinical Trials ◽  
Migraine Attack ◽  
Evaluation Criteria ◽  
Complete Disappearance ◽  
Acute Migraine ◽  
Double Blind ◽  
Significant Difference ◽  
The Difference ◽  
Blind Comparison ◽  
Acute Migraine Attack

The purpose of this study was to compare the efficacy and tolerance of a single dose of the acetaminophen 400 mg-codeine 25 mg combination (ACC) aspirin 1000 mg (A) and a placebo (P) for the treatment of acute migraine attack. The study design was randomized, multicentre, double-blind and double dummy with cross-over on three periods. Of the 198 patients who had three attacks 29.8%, 52.3% and 49.7% had recorded the complete or almost complete disappearance of the pain at 2 h after P, A and ACC respectively. When compared with the placebo, the difference was significant for the A and ACC. When complete disappearance of pain at 2 h was used as a criterion, no significant difference was observed. These results enabled the sensitivity of the evaluation criteria suggested for clinical trials of migraine attack to be discussed.

The Postdrome of the Acute Migraine Attack

Cephalalgia ◽  
2006 ◽  
Vol 26 (2) ◽  
pp. 214-220 ◽  
Author(s):  
L Kelman
Keyword(s):  
Migraine Attack ◽  
Average Duration ◽  
Gastrointestinal Symptoms ◽  
Low Grade ◽  
Acute Migraine ◽  
Mood Change ◽  
Head Pain ◽  
Cognitive Difficulties ◽  
Headache Clinic ◽  
Acute Migraine Attack

This study was performed to document the frequency, duration and types of symptoms of postdrome in migraine patients. Eight hundred and twenty-seven consecutive headache clinic patients (IHS 1.1, 1.2 and 1.5.1) were evaluated at first visit. Postdrome frequency, duration and characteristics were analysed. Sixty-eight per cent of 827 patients reported postdrome (69.1% females; 56.8% males, P < 0.007). The average duration of the postdrome was 25.2 h. Fifty-six per cent had postdrome for ≤ 12 h, 32% for 12–24 h, 88% for ≤ 24 h, and 12% for > 24 h. The commonest symptoms were tiredness (71.8%), head pain (33.1%), cognitive difficulties (11.7%), ‘hangover’ (10.7%), gastrointestinal symptoms (8.4%), mood change (6.8%), and weakness (6.2%). Patients with postdrome compared with patients without postdrome have more characteristic and more frequent migraine features. This study demonstrated postdrome in 68% of patients, duration ≤ 24 h in most patients, more often associated with a full-blown migraine attack, more common in females, and with commonest symptoms being tiredness and low-grade headache.

Chlormezanone in the Treatment of Migraine Attacks: A Double Blind Comparison with Diazepam and Placebo

Cephalalgia ◽  
1982 ◽  
Vol 2 (4) ◽  
pp. 205-210 ◽  
Author(s):  
Peer Tfelt-Hansen ◽  
Kai Jensen ◽  
Per Vendsborg ◽  
Martin Lauritzen ◽  
Jes Olesen
Keyword(s):  
Severe Pain ◽  
Treatment Result ◽  
Acute Migraine ◽  
Treatment Results ◽  
Standard Regimen ◽  
Double Blind ◽  
Treatment Groups ◽  
Significant Difference ◽  
Blind Comparison ◽  
Acute Migraine Attack

One hundred and fifty patients treated for an acute migraine attack all received a standard regimen consisting of metoclopramide 10 mg i.m. and—20 min later—paracetamol 1 g orally. Simultaneous trial medication was given. This consisted of placebo, diazepam 5 mg as tablets, or chlormezanone 400 mg as capsules given in a double dummy fashion. A successful treatment result was defined as a decrease of two or three steps on a four-point verbal pain report scale, and no need for further treatment. Patients with severe pain (all three treatment groups together) showed significantly better treatment results ( p < 0.001) than patients with pain of medium severity. In the group with severe pain there was no significant difference between diazepam, chlormezanone or placebo. In the group with pain of medium severity there was a significant ( p < 0.01) effect of chlormezanone, but no significant effect of diazepam. Chlormezanone may possibly be a valuable addition to antiemetic and analgesic therapy of migraine attacks.

Efficacy of Phenazone in the Treatment of Acute Migraine Attacks: A Double-Blind, Placebo-Controlled, Randomized Study

Cephalalgia ◽  
2004 ◽  
Vol 24 (10) ◽  
pp. 888-893 ◽  
Author(s):  
H Göbel ◽  
A Heinze ◽  
U Niederberger ◽  
T Witt ◽  
V Zumbroich
Keyword(s):  
Adverse Events ◽  
Randomized Study ◽  
Controlled Study ◽  
Acute Migraine ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Number Of Patients ◽  
Significant Difference ◽  
Main Target

In this study we compared the efficacy of 1000 mg phenazone with that of placebo in the treatment of acute migraine attacks in a randomized double-blind, placebo-controlled study of 208 patients. The main target criterion was the number of patients with a pain reduction from severe or moderate to slight or no pain 2 h after taking the pain medication. The percentage of patients satisfying the main target criterion was 48.6% for phenazone and 27.2% ( P < 0.05) for placebo. Freedom from pain after 2 h was reported by 27.6% with phenazone treatment and 13.6% ( P < 0.05) with placebo. Compared with placebo, the phenazone treatment also resulted in a significant improvement in the associated migraine symptoms of nausea, phonophobia and photophobia. Of patients treated with phenazone 11.4%, and 5.8% of those treated with placebo reported adverse events. There was no significant difference between the groups with regard to numbers of patients with adverse events. No serious adverse events occurred. The results show that phenazone at a dosage of 1000 mg is effective and well tolerated in the treatment of acute migraine attacks.

Treatment of the Acute Migraine Attack Current Status

Cephalalgia ◽  
1983 ◽  
Vol 3 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Marcia Wilkinson
Keyword(s):  
Migraine Attack ◽  
Temporal Artery ◽  
Acute Attack ◽  
Current Status ◽  
Acute Migraine ◽  
Similar Action ◽  
Drug Treatments ◽  
Ergotamine Tartrate ◽  
Acute Migraine Attack ◽  
Gastrointestinal Activity

The main treatment of the acute migraine attack remains sleep, sedation, an anti-nauseant and analgesics, and in some patients 1 or 2 mg of ergotamine tartrate. Drugs containing large amounts of caffeine should not be used. Absorption of drugs may be impaired in a migraine attack. Metoclopramide is probably the anti-emetic of choice because it is an effective anti-nauseant and promotes normal gastrointestinal activity. Domperidone has a similar action but is said not to go through the blood-brain harrier, so is less likely to cause extrapyramidal reactions. All drugs, including analgesics such as aspirin and paracetamol, are best given in a soluble or effervescent form. Where vomiting occurs early in the attack, suppositories may be indicated. Ergotamine tartrate is necessary in about one third of attacks and is best given by suppository or by inhalation. Doses higher than 2 mg per attack or 6 mg in one week may cause toxic symptoms, the early signs of which are headache, nausea, vomiting and a feeling of not being very well. The non-drug treatments of an acute attack include pressing on the temporal artery, hot and cold compresses and relaxation.

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