title: Triptan use after starting prophylactic migraine treatment: a retrospective cohort study in a primary care population.
abstract: BACKGROUND
  Clinical trials on the prophylactic effect of propranolol and metoprolol for migraine show that starting this medication leads to a decrease in the use of attack medication of 0.9-8.9 doses per month. However, studies in daily practice are lacking.
  
  
  METHODS
  We compared the number of triptans prescribed in the six months before and the six months after the start of propranolol/metoprolol in a Dutch national representative primary care cohort.
  
  
  RESULTS
  Of the 168 triptan-using patients who started with propranolol or metoprolol, the number of triptans prescribed before starting was 4.6 doses per month. The number of triptans prescribed six months before compared with six months after starting propranolol/metoprolol decreased with 1.0 dose per month (Wilcoxon rank test; p = 0.000).
  
  
  CONCLUSIONS
  In this primary care population, although the number of triptans prescribed decreased after starting propranolol or metoprolol, the decrease is relatively small compared to data from clinical trials.
authors: Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands a.f.h.smelt@lumc.nl.
authors: Antonia F H
authors: AF
authors: Smelt
authors: Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands Department of Primary and Community Care, Radboud University Medical Center, the Netherlands.
authors: Willem J J
authors: WJ
authors: Assendelft
authors: NIVEL Netherlands Institute for Health Services Research, the Netherlands.
authors: Christel E
authors: CE
authors: van Dijk
authors: Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.
authors: Jeanet W
authors: JW
authors: Blom
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D011320:Primary Health Care; D011433:Propranolol / Q000627:therapeutic use*; D012189:Retrospective Studies; D014363:Tryptamines / Q000627:therapeutic use*
chemical_list: D000700:Analgesics; D014363:Tryptamines; D011433:Propranolol; D008790:Metoprolol
keywords: Migraine; effectiveness; preventive medication; primary care; triptans