Evaluating the safety and tolerability profile of acute treatments for migraine

被引:30
作者
Martin, VT
Goldstein, JA
机构
[1] Univ Cincinnati, Div Gen Internal Med, Cincinnati, OH 45221 USA
[2] William Beaumont Hosp, Royal Oak, MI 48072 USA
关键词
ergots; migraine; NSAIDs; safety; tolerability; triptans;
D O I
10.1016/j.amjmed.2005.01.018
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Among the medications that have been used as acute treatments for migraine are nonspecific agents, including nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics (either single or combination), and narcotics, as well as migraine-specific medications, including ergot alkaloids and triptans (5-hydroxytryptamine 1B/1D agonists). All of these drugs have side effects that vary in type and, severity. Side effects of nonspecific medications, including gastrointestinal (GI) and renal effects with NSAIDs and cognitive effects and the potential for abuse with narcotics and butalbital-containing medications, have been documented over time, as these medications have been used for various indications. Side effects of the migraine-specific medications include GI and vascular symptoms with the ergots; for the triptans, they include chest and neurologic symptoms. Although adverse events are reported fairly frequently in patients receiving triptans, they are usually mild, and few patients discontinue therapy because of them. The most serious adverse events are cardiovascular. Because of potential vasoconstrictor effects-mild and transient increases in blood pressure and mild and transient effects on coronary artery tone-triptans as a class are contraindicated in patients with established or clinically suspected cardiovascular disease, specifically ischemic heart disease and uncontrolled hypertension. Other adverse events, including the potential for drug-drug interactions, are less common. Therefore, consideration should be given to the tolerability and safety of medications before their use as abortive medications for the treatment of migraine headache. (c) 2005 Elsevier Inc. All rights reserved.
引用
收藏
页码:36S / 44S
页数:9
相关论文
共 78 条
[1]  
Aukerman G, 2002, AM FAM PHYSICIAN, V66, P2123
[2]   The triptan formulations: A critical evaluation [J].
Bigal, ME ;
Bordini, CA ;
Antoniazzi, AL ;
Speciali, JG .
ARQUIVOS DE NEURO-PSIQUIATRIA, 2003, 61 (2A) :313-320
[3]   Efficacy and safety of rizatriptan versus standard care during long-term treatment for migraine [J].
Block, GA ;
Goldstein, J ;
Polis, A ;
Reines, SA ;
Smith, ME .
HEADACHE, 1998, 38 (10) :764-771
[4]   Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. [J].
Bombardier, C ;
Laine, L ;
Reicin, A ;
Shapiro, D ;
Burgos-Vargas, R ;
Davis, B ;
Day, R ;
Ferraz, MB ;
Hawkey, CJ ;
Hochberg, MC ;
Kvien, TK ;
Schnitzer, TJ ;
Weaver, A .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 343 (21) :1520-1528
[5]  
Bombardier C, 2002, AM J CARDIOL, V89, p3D
[6]   THE SAFETY AND TOLERABILITY OF SUMATRIPTAN - AN OVERVIEW [J].
BROWN, EG ;
ENDERSBY, CA ;
SMITH, RN ;
TALBOT, JCC .
EUROPEAN NEUROLOGY, 1991, 31 (05) :339-344
[7]   Frovatriptan: A review of drug-drug interactions [J].
Buchan, P ;
Wade, A ;
Ward, C ;
Oliver, SD ;
Stewart, AJ ;
Freestone, S .
HEADACHE, 2002, 42 :S63-S73
[8]   Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) [J].
Cleeman, JI ;
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, DR ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (19) :2486-2497
[9]   Safety trial with the 5HT1B/1D agonist avitriptan (BMS-180048) in patients with migraine who have experienced pressure, tightness, and/or pain in the chest, neck, and/or throat following sumatriptan [J].
Dahlof, CGH ;
Falk, L ;
Risenfors, M ;
Lewis, CP .
CEPHALALGIA, 1998, 18 (08) :546-551
[10]   Is there a preferred triptan? [J].
Dodick, DW ;
Silberstein, S ;
Dahlhöf, CGH .
HEADACHE, 2002, 42 (01) :1-7