title: A placebo-controlled crossover study of rizatriptan in the treatment of multiple migraine attacks. Rizatriptan Multiple Attack Study Group.
abstract: OBJECTIVE
  To examine the safety and efficacy of rizatriptan 10 mg PO in the treatment of multiple migraine attacks.
  
  
  BACKGROUND
  Rizatriptan is a potent and rapidly absorbed 5-HT1B/1D receptor agonist. Efficacy and general safety have been examined in controlled trials treating single migraine attacks. In the current placebo-controlled study, we report constancy of safety and efficacy of rizatriptan for patients treating four discrete migraine attacks.
  
  
  METHODS
  Patients with moderate or severe migraine (n = 473) were randomized to one of five sequence groups, in which each patient was to treat four migraine attacks. Patients in four groups received rizatriptan 10 mg for three of four attacks and placebo for the remaining attack. Patients in the fifth group received rizatriptan 10 mg for four attacks. Headache severity, functional disability, and migraine symptoms were measured immediately before dosing and at 0.5, 1, 1.5, 2, 3, and 4 hours postdose.
  
  
  RESULTS
  After the first attack, response rates were 77% for rizatriptan and 37% for placebo (p < 0.001). Similar efficacy of rizatriptan, ranging from a 75 to 80% response, was observed in each of the subsequent attacks with no evidence of tolerance to therapeutic effects. Most patients (93%) responded to rizatriptan 10 mg during the first or second attack. Adverse experiences were generally mild and transient, the most common being dizziness and somnolence. Incidence of adverse experiences per attack decreased after the first attack.
  
  
  CONCLUSIONS
  Rizatriptan 10 mg PO is efficacious and generally well tolerated in acute migraine. Its efficacy is maintained throughout the treatment of multiple, discrete migraine attacks.
authors.affiliation: Merck Research Laboratories, West Point, PA, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Kramer
authors.forename: D
authors.initials: D
authors.lastname: Matzura-Wolfe
authors.forename: A
authors.initials: A
authors.lastname: Polis
authors.forename: A
authors.initials: A
authors.lastname: Getson
authors.forename: P G
authors.initials: PG
authors.lastname: Amaraneni
authors.forename: M P
authors.initials: MP
authors.lastname: Solbach
authors.forename: W
authors.initials: W
authors.lastname: McHugh
authors.forename: J
authors.initials: J
authors.lastname: Feighner
authors.forename: S
authors.initials: S
authors.lastname: Silberstein
authors.forename: S A
authors.initials: SA
authors.lastname: Reines
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D017060:Patient Satisfaction; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014363:Tryptamines
chemical_list: D017366:Serotonin Receptor Agonists; D014230:Triazoles; D014363:Tryptamines; C093622:rizatriptan