title: Effectiveness of eletriptan in acute migraine: primary care for Excedrin nonresponders.
abstract: OBJECTIVE
  To evaluate the effectiveness of eletriptan as a treatment for acute migraine in patients who were poor responders to Excedrin and had not yet been exposed to a triptan.
  
  
  BACKGROUND
  Self-medication with over-the-counter drugs, such as Excedrin, is the most common treatment for migraine. Guidelines, however, recommend that triptans be used as first-line treatment of moderate to severe migraine--the severity affecting approximately 80% of migraineurs. Since over-the-counter medications, such as Excedrin, continue to be used in many patients, it is important that clinicians have information on the efficacy of triptans as first-line treatment and on treatment of migraineurs who have shown poor response to over-the-counter medications.
  
  
  METHODS
  One hundred ten patients meeting criteria for migraine who were poor responders to Excedrin received open-label treatment with a 40-mg dose of eletriptan for one migraine attack. Efficacy assessments were made at 1, 2, 4, and 24 hours postdose and consisted of headache and pain-free response rates, absence of associated symptoms, and functional response.
  
  
  RESULTS
  At 1 hour, the headache response rate was 44%; at 2 hours, 81%. The pain-free response rate at 1 hour was 14% and at 2 hours, 48%. At 2 hours, relief of baseline-associated symptoms ranged from 74% to 80%. Functional response was achieved by 82% of patients by 2 hours, and 68% of patients achieved relief of migraine that was sustained across 24 hours with no need for a second dose of eletriptan or for rescue medication. Eletriptan was well tolerated with adverse events being transient and mild to moderate in intensity.
  
  
  CONCLUSIONS
  Previous studies have established the efficacy of eletriptan as a first-line treatment for migraine. The results of this open-label trial demonstrate that the 40-mg dose of eletriptan had a high degree of efficacy and tolerability among patients who were poor responders to Excedrin.
authors.affiliation: Diamond Headache Clinic, Chicago, Ill 60614, USA.
authors.forename: Merle L
authors.initials: ML
authors.lastname: Diamond
authors.forename: Jayasena
authors.initials: J
authors.lastname: Hettiarachchi
authors.forename: Barbara
authors.initials: B
authors.lastname: Hilliard
authors.forename: George
authors.initials: G
authors.lastname: Sands
authors.forename: Robert
authors.initials: R
authors.lastname: Nett
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D004366:Nonprescription Drugs / Q000627:therapeutic use; D011759:Pyrrolidines / Q000627:therapeutic use*; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D017211:Treatment Failure; D014363:Tryptamines
chemical_list: D018712:Analgesics, Non-Narcotic; D007211:Indoles; D004366:Nonprescription Drugs; D011759:Pyrrolidines; D017366:Serotonin Receptor Agonists; D014363:Tryptamines; C115647:eletriptan