title: Comparative study of a combination of isometheptene mucate, dichloralphenazone with acetaminophen and sumatriptan succinate in the treatment of migraine.
abstract: OBJECTIVE
  To compare the safety and efficacy of isometheptene mucate, dichloralphenazone with acetaminophen to sumatriptan succinate for the treatment of mild-to-moderate migraine, with or without aura, when taken at the first sign of an attack.
  
  
  BACKGROUND
  The Food and Drug Administration approved sumatriptan succinate and the combination of isometheptene mucate, dichloralphenazone with acetaminophen for the treatment of migraine. As part of the stratified treatment of migraine, those patients whose headaches are mild or moderate may benefit from nontriptan medications. Additionally, early treatment of acute migraine before the headache has become moderate or severe may improve response to treatment.
  
  
  METHODS
  This was a multicenter, double-blind, randomized, parallel-group study to assess the safety and efficacy of the combination of isometheptene mucate, dichloralphenazone with acetaminophen and sumatriptan succinate in the early stages of a single migraine attack. Patients diagnosed with migraine, with or without aura, as defined by the International Headache Society diagnostic criteria were enrolled.
  
  
  RESULTS
  One hundred thirty-seven patients were enrolled in the study. Data for efficacy were available for 126 patients; safety data were available for 128 patients. No statistically significant difference between the two active agents in the patient's response to treatment was demonstrated. Headache recurrence was not significantly different over the 24-hour evaluation period for those patients responding in the first 4 hours. In those with headache recurrence, it was statistically significantly more severe in those patients treated with sumatriptan succinate. Improvement in functional disability was, in general, better among those treated with isometheptene mucate, dichloralphenazone with acetaminophen. Global analysis of efficacy was similar in the two active groups. Patients treated with sumatriptan succinate were somewhat more likely to have adverse effects than the isometheptene mucate, dichloralphenazone with acetaminophen group.
  
  
  CONCLUSIONS
  Both isometheptene mucate, dichloralphenazone with acetaminophen and sumatriptan succinate are safe and effective when used early in the treatment of an acute migraine. Several parameters suggest that isometheptene mucate, dichloralphenazone with acetaminophen may have a slight advantage compared with sumatriptan succinate in the early treatment of mild-to-moderate migraine.
authors.affiliation: Diamond Headache Clinic, Chicago, Ill 60614-1726, USA.
authors.forename: F G
authors.initials: FG
authors.lastname: Freitag
authors.forename: R
authors.initials: R
authors.lastname: Cady
authors.forename: F
authors.initials: F
authors.lastname: DiSerio
authors.forename: A
authors.initials: A
authors.lastname: Elkind
authors.forename: R M
authors.initials: RM
authors.lastname: Gallagher
authors.forename: J
authors.initials: J
authors.lastname: Goldstein
authors.forename: J A
authors.initials: JA
authors.lastname: Klapper
authors.forename: A M
authors.initials: AM
authors.lastname: Rapoport
authors.forename: C
authors.initials: C
authors.lastname: Sadowsky
authors.forename: J R
authors.initials: JR
authors.lastname: Saper
authors.forename: T R
authors.initials: TR
authors.lastname: Smith
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000983:Antipyrine / Q000627:therapeutic use*; D002214:Capsules; D002697:Chloral Hydrate / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008744:Methylamines / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy*; D012008:Recurrence; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D018170:Sumatriptan / Q000627:therapeutic use*
chemical_list: D000700:Analgesics; D002214:Capsules; D004338:Drug Combinations; D006993:Hypnotics and Sedatives; D008744:Methylamines; D017366:Serotonin Receptor Agonists; D000082:Acetaminophen; D002697:Chloral Hydrate; D018170:Sumatriptan; D000983:Antipyrine; C008192:isometheptene; C007333:dichloralantipyrine