title: Relief of menstrual symptoms and migraine with a single-tablet formulation of sumatriptan and naproxen sodium.
abstract: BACKGROUND
  Dysmenorrhea and menstrual migraine may share a common pathogenic pathway. Both appear to be mediated, in part, by an excess of prostaglandin production that occurs during menstruation.
  
  
  METHODS
  Data were pooled from two replicate randomized controlled trials of 621 adult menstrual migraineurs with dysmenorrhea who treated migraine with sumatriptan-naproxen or placebo. Along with headache symptoms, nonpain menstrual symptoms (bloating, fatigue, and irritability) and menstrual pain symptoms (abdominal and back pain) were recorded at the time periods of 30 minutes and 1, 2, 4, and 4-24 hours. Relief of menstrual symptoms was compared using a Cochran-Mantel-Haenszel test. Logistic regression was used to determine the odds of a headache response with increasing numbers of moderate to severe dymenorrheic symptoms.
  
  
  RESULTS
  Sumatriptan-naproxen was superior to placebo for relief of tiredness, irritability, and abdominal pain at the time periods of 2, 4, and 4-24 hours (p≤0.023); back pain at the time periods of 4 and 4-24 hours (p≤0.023); and bloating at 4-24 hours endpoint (p=0.01). The odds ratios (ORs) of attaining migraine pain freedom for 2 hours and for sustained 2-24 hours decreased as moderate to severe dysmenorrhea symptoms increased with sumatriptan-naproxen versus placebo.
  
  
  CONCLUSIONS
  Treatment with sumatriptan-naproxen may provide relief of menstrual symptoms and migraine in female migraineurs with dysmenorrhea. The presence of moderate to severe dysmenorrhea symptoms is associated with decreased response rates for menstrual migraine, suggesting that the co-occurrence of these disorders may negatively impact the results of migraine-abortive therapy.
authors.affiliation: 1 Division of Internal Medicine, University of Cincinnati Medical Center , Cincinnati, Ohio.
authors.forename: Vincent T
authors.initials: VT
authors.lastname: Martin
authors.forename: Jeanne
authors.initials: J
authors.lastname: Ballard
authors.forename: Michael P
authors.initials: MP
authors.lastname: Diamond
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Mannix
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Derosier
authors.forename: Shelly E
authors.initials: SE
authors.lastname: Lener
authors.forename: Alok
authors.initials: A
authors.lastname: Krishen
authors.forename: Susan A
authors.initials: SA
authors.lastname: McDonald
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D004338:Drug Combinations; D004412:Dysmenorrhea / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008881:Migraine Disorders / Q000188:drug therapy* / Q000209:etiology; D009288:Naproxen / Q000008:administration & dosage*; D016017:Odds Ratio; D011293:Premenstrual Syndrome / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D018170:Sumatriptan / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics; D004338:Drug Combinations; D009288:Naproxen; D018170:Sumatriptan