A Triptan And Nsaid May Curb Migraine

NEW YORK (Reuters Health) - Results of a study show that migraine sufferers may experience significantly greater pain relief with a combination of sumatriptan and the anti-inflammatory drug naproxen compared with either drug alone.

Triptans have proven to be very effective in relieving pain associated with migraine and also in aborting the attack, in part by preventing release of inflammatory substances from the nerve endings, Dr. Timothy R. Smith and colleagues explain in the journal Headache.

However, during a migraine attack triptans do not appear to have an effect on inflammatory substances already released or on the inflammatory process. That's where anti-inflammatory agents may help.

In their study, Smith, from Mercy Health Research/Ryan Headache Center, Chesterfield, Missouri, and colleagues randomly assigned 972 migraine patients to 50 milligrams sumatriptan, 500 milligrams naproxen, the combination of the two, or placebo.

Overall, 46 percent of migraine sufferers in the combined sumatriptan plus naproxen group saw their pain subside in 24 hours, the investigators report.

Combination therapy was significantly more effective than sumatriptan alone (29 percent), naproxen alone (25 percent) or placebo (17 percent).

Pain relief in just 2 hours was achieved in 65 percent of subjects in the combination group, 49 percent in the sumatriptan only group, 46 percent in the naproxen only group, and 27 percent in the placebo group.

Patients treated with sumatriptan plus naproxen were more likely than those in the other three groups to be free of nausea, and sensitivity to light and sound at 2 hours after taking the medications. The combination of sumatriptan and naproxen was well tolerated.

The current findings, Smith and colleagues note, support previous reports of improved outcomes in migraine sufferers treated with a triptan and anti-inflammatory agent.

SOURCE: Headache September 2005.