title: A long-term study to maximise migraine relief with zolmitriptan.
abstract: Part 1 of this international study was a randomised, double-blind, placebo-controlled study of 2.5 mg and 5 mg zolmitriptan (Zomig) in the treatment of persistent migraine headache, two hours after an initial dose of 2.5 mg zolmitriptan. Part 2 was a non-comparative evaluation of long-term, unrestricted zolmitriptan use for treatment of initial, persistent and recurrent migraine headaches. In Part 1, following the treatment of moderate or severe persistent headache, two-hour headache response rates with 5 mg zolmitriptan (51.6%, n = 322), 2.5 mg zolmitriptan (49.7%, n = 324) and placebo (51.6%, n = 343) were not significantly different. However, the pain-free response rate following the treatment of persistent migraine headache of any intensity was significantly higher with 5 mg zolmitriptan than with placebo (36.0% vs. 25.5%; p < 0.001). This was predominantly due to effects in the subgroup of patients with mild headache. Thus, migraine relief in patients whose initial headache shows a partial response to 2.5 mg zolmitriptan may be maximised by a second 5 mg dose. In Part 2 (involving 2499 evaluable patients), 65.8% of attacks were treated with a single dose of zolmitriptan (2.5 mg or 5 mg). Of those migraine attacks initially treated with 2.5 mg zolmitriptan, 70.3% required no further dose, similarly 62.7% of migraine attacks treated initially with 5 mg zolmitriptan only required a single dose. Over the whole attack (i.e. initial and any persistent headache), headache response rates to one or two zolmitriptan doses were greater than 88.8%. 'Level of pain' was the primary factor influencing the choice of dose. Zolmitriptan provided consistent migraine headache relief in the majority of patients and was well tolerated.
authors.affiliation: The Polyclinic, Seattle, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Tepper
authors.forename: G A
authors.initials: GA
authors.lastname: Donnan
authors.forename: A J
authors.initials: AJ
authors.lastname: Dowson
authors.forename: M A
authors.initials: MA
authors.lastname: Bomhof
authors.forename: A
authors.initials: A
authors.lastname: Elkind
authors.forename: J
authors.initials: J
authors.lastname: Meloche
authors.forename: P E
authors.initials: PE
authors.lastname: Fletcher
authors.forename: D S
authors.initials: DS
authors.lastname: Millson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D010080:Oxazoles / Q000009:adverse effects / Q000627:therapeutic use*; D023303:Oxazolidinones; D012008:Recurrence; D017366:Serotonin Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D013607:Tablets; D013997:Time Factors; D014363:Tryptamines
chemical_list: D010080:Oxazoles; D023303:Oxazolidinones; D017366:Serotonin Receptor Agonists; D013607:Tablets; D014363:Tryptamines; C089750:zolmitriptan