[Anti-migraine treatment: present and future].
This is a review of major new findings in migraine therapy during the last 2-3 years. As for acute treatment, large population studies have underscored both the advantages and the shortcomings of sumatriptan. Its subcutaneous form is by far superior to the other galenic forms, which may not be clearly better than adequately used NSAIDs. If one considers total headache relief at 1 hour (gain over placebo) for second generation oral triptans, elitriptan 80 mg seems superior to the others, but it is probably endowed with more CNS adverse effects; eletriptan 40 mg and rizatriptan 10 mg are slightly superior to sumatriptan 50 mg, zolmitriptan 2.5 mg or naratriptan 2.5 mg. It has been shown, including in humans, that the less hydrophilic triptans can act on central receptors. Efficacity in acute treatment was also demonstrated for an association of lysine acetylsalicylate-metoclopramide, for ibuprofen, for ketoprofen and for intranasal xylocaïne. In migraine prophylaxis a significant breakthrough came from riboflavin 400 mg, which has an outstanding efficacy-side effect profile.
Schoenen
J
J
Service universitaire de Neurologie, CHR Citadelle.
D000284:Administration, Oral; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005544:Forecasting; D006801:Humans; D007279:Injections, Subcutaneous; D008881:Migraine Disorders / Q000188:drug therapy* / Q000517:prevention & control; D010919:Placebos; D011985:Receptors, Serotonin / Q000187:drug effects; D012256:Riboflavin / Q000008:administration & dosage / Q000627:therapeutic use; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D018170:Sumatriptan / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D011985:Receptors, Serotonin; D017366:Serotonin Receptor Agonists; D018170:Sumatriptan; D012256:Riboflavin