Effects of naratriptan versus naproxen on daily functioning in the acute treatment of migraine: a randomized, double-blind, double-dummy, crossover study.
OBJECTIVE
To evaluate the effect of acute treatment on ictal behavioral functioning of patients with migraine via ambulatory accelerometry.


BACKGROUND
The inability to carry out daily activities often complicates migraine attacks. Research into the effects of pharmacological drugs on this outcome parameter in the acute treatment of migraine has been based on subjective reports only.


METHODS
In a double-blind, double-dummy, crossover study, 12 patients with migraine treated 2 migraine attacks with the nonspecific antimigraine drug, naproxen (500-mg capsule) or the more specific antimigraine drug, naratriptan (2.5-mg tablet). The clinical symptoms of headache, nausea, vomiting, photophobia, and phonophobia, and the subjective symptoms reflecting mood, sleepiness, and level of functioning were measured by use of a daily log.


RESULTS
During the first 6 hours after intake of the study medication, the objective behavioral parameters showed no significant effect of time and no significant differences between naproxen and naratriptan, but naratriptan was significantly more efficacious than naproxen in relieving headache, nausea, and vomiting; the interval between treatment and relief was significantly shorter after intake of naratriptan.


CONCLUSIONS
Consciously perceived clinical and subjective symptoms do not necessarily run in parallel with their behavioral equivalents. It, thus, may be important to assess the effects of treatment on behavioral functioning in the evaluation of the general efficacy of antimigraine drugs in the acute treatment of a migraine attack.
Stronks
Dirk L
DL
Department of Medical Psychology, Erasmus MC, Rotterdam, The Netherlands.
Tulen
Joke H M
JH
Bussmann
Hans B J
HB
Mulder
Laus J M M
LJ
Passchier
Jan
J
D000203:Activities of Daily Living; D000208:Acute Disease; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000523:psychology; D009288:Naproxen / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use*; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D016896:Treatment Outcome; D014363:Tryptamines
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007211:Indoles; D010880:Piperidines; D017366:Serotonin Receptor Agonists; D014363:Tryptamines; D009288:Naproxen; C106783:naratriptan