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Oral sumatriptan for acute migraine.

D C McCrory¹, R N Gray

¹Center for Clinical Health Policy Research, Duke University, 2200 W. Main Street, Suite 220, Durham, NC 27705, USA.

The Cochrane Database of Systematic Reviews

|August 15, 2003

Summary

Oral sumatriptan effectively treats acute migraine attacks, providing significant pain relief and improved function. While generally well-tolerated, minor side effects can occur, with higher doses showing increased incidence.

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Area of Science:

Neurology
Pharmacology
Clinical Trials

Background:

Migraine is a common neurovascular disorder causing disabling headaches and autonomic dysfunction.
Sumatriptan, a selective serotonin 5-HT1B/1D agonist, is used to treat acute migraine attacks.
Its mechanism involves cranial vasoconstriction and neural inhibition.

Purpose of the Study:

To assess the efficacy and tolerability of oral sumatriptan for acute migraine attacks in adults.
Evidence was gathered from randomized controlled trials (RCTs).

Main Methods:

Searched Cochrane Central Register, MEDLINE, and reference lists.
Included double-blind RCTs comparing oral sumatriptan (25-100 mg) with placebo or other treatments.
Assessed pain-free response, headache relief, functional disability, recurrence, and adverse events.

Main Results:

Twenty-five RCTs with 16,200 participants were analyzed.
Sumatriptan (100 mg and 25 mg) significantly improved pain-free response, headache relief, and functional disability at 2 hours compared to placebo.
The 100-mg dose showed a higher incidence of adverse events (NNH=7.1) than placebo.

Conclusions:

Oral sumatriptan is an effective treatment for acute migraine attacks.
The drug is generally well-tolerated, with minor adverse events being common.
Other triptans show similar efficacy and side effect profiles; ergotamine + caffeine is less effective.

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