Switching 'Triptans' May Improve Migraine Response

NEW YORK (Reuters Health) - There are several so-called triptan drugs designed for treating migraines -- and if one doesn't work, another might, German researchers report.

Triptans are recommended as first-line agents for moderate-to-severe migraine that does not get better with regular painkillers. However, there are meaningful differences in efficacy and side effects among the triptans, note Dr. Hans-Christoph Diener, from University Essen, and colleagues, in their paper in the journal Headache.

Diener's group recruited some 200 patients who had experienced unsatisfactory migraine treatment with sumatriptan (brand name, Imitrex) on at least two occasions. The participants were randomly given either another triptan, almotriptan (Axert), to take for their next migraine, or an inactive placebo tablet.

The percentage of patients who experienced pain relief at 2 hours was significantly higher in the almotriptan group than the placebo group, 47 percent versus 24 percent. Almotriptan was also associated with greater sustained pain-free efficacy.

The number of adverse events did not differ significantly between groups, the researchers note.

These results aren't surprising, Diener and his colleagues point out, since "migraine patients are not all the same, migraine headaches are not all the same, and triptans are not all the same."

They conclude that "when migraine patients respond poorly to sumatriptan or other triptan treatment, another agent in this class should be attempted."

SOURCE: Headache, July/August 2005.