Triptan’ may safely prevent menstrual migraine
A drug used to treat acute migraine can be safely taken long term to prevent some of the migraines women may experience around the time of their period, research shows.
Results of the study indicate that naratriptan twice daily is well tolerated when taken for 6 continuous days per month for up to 1 year for the prevention of menstruation-related migraine.
"For many of the approximately 18 percent of US women with migraine, menstruation is a predictable trigger of migraine attacks,” note Dr. Jan Lewis Brandes, from Vanderbilt University School of Medicine in Nashville, and colleagues in the journal Headache.
While naratriptan is not approved for the prevention of migraine, it has been shown to be significantly more effective than placebo for short-term prevention of menstrual migraine, they point out. Moreover, this triptan has been shown to be well tolerated for short-term use, although how well women tolerate it over the long term has not been studied, until now.
Brandes and colleagues studied the tolerability of naratriptan 1 milligram twice daily starting 3 days before the expected onset of menstrually related migraine and continuing for a total of 6 days. Women in the study had the option to use an additional 2.5-milligram dose for breakthrough migraines.
A total of 457 women took at least one dose of naratriptan on study; 318 and 131 completed 6 and 12 months of treatment, respectively.
According to the investigators, the women tolerated naratriptan well over the course of the study. The only adverse event occurring at an incidence of more than 2 percent during the 6-day treatment periods when naratriptan 1 milligram twice daily was taken was ear, nose, and throat infection (3 percent)—even when an additional 2.5-milligram dose was taken.
There were no serious drug-related adverse events recorded and no patients experienced noteworthy drug-related changes in heart function, vital signs, or laboratory tests.
Furthermore, women reported that they did not have a migraine around the time of their period in roughly 50 percent of the “perimenstrual” periods during which naratriptan was used. The efficacy of naratriptan for the prevention of menstrual migraine did not wane over time in the 131 women who remained in the study for the full 12 months.
Results also showed that naratriptan reduced “headache impact” and depressive feelings when used for up to 12 months for the short-term prevention of menstruation related migraine.
SOURCE: Headache June, 2007.
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