Conflict of Interest: Dr. Tfelt-Hansen has consulted for and conducted studies for AlmirallProdesfarma, Johnson & Johnson, Pfizer, Pozen, Inc., and Vanguard.
Triptans vs Other Drugs for Acute Migraine. Are There Differences in Efficacy? A Comment
Article first published online: 28 MAR 2008
© 2008 the Author
Headache: The Journal of Head and Face Pain
Volume 48, Issue 4, pages 601–605, April 2008
How to Cite
Tfelt-Hansen, P. (2008), Triptans vs Other Drugs for Acute Migraine. Are There Differences in Efficacy? A Comment. Headache: The Journal of Head and Face Pain, 48: 601–605. doi: 10.1111/j.1526-4610.2008.01064.x
- Issue published online: 28 MAR 2008
- Article first published online: 28 MAR 2008
- Accepted for publication December 17, 2007.
The introduction of triptans in migraine treatment was apparently a revolution. Comparative randomized clinical trials (RCTs) with triptan and other drugs do not give a clear-cut picture.
Oral triptans are superior to oral ergotamine most likely because the bioavailability oral of ergotamine is extremely low (<1%).
Compared with NSAIDs, in most cases aspirin, triptans were not superior and in several RCTs triptans caused more adverse events than aspirin plus metoclopramide.
Guidelines for treatment of migraine should be evidence-based. It is suggested that based on current evidence, effervescent aspirin should be the first-line drug for the treatment of migraine. Aspirin is also much cheaper than the triptans.