Rizatriptan versus usual care in long-term treatment of migraine

Because of the recurrent nature of migraine, a major concern with pharmacologic therapy is whether it will remain effective, safe, and tolerable over the long term. The development of sumatriptan offered an improvement in migraine therapy, although concerns remain about chest symptoms associated with this class of drugs. In early clinical trials, rizatriptan was shown to have good bioavailability and favorable effects on quality of life. Long-term extension trials ran for up to 12 months and compared rizatriptan with "usual care" (i.e., medications used for acute therapy). These studies showed that the 10-mg rizatriptan dose was consistently superior to usual care with regard to pain relief and complete pain relief (pain-free). Side effects were generally mild and transient in all treatment groups. Nausea, dizziness, and somnolence were the most commonly reported adverse effects.