Migraine Treatment Getting Easier to Take
June 27, 2000 (Montreal) -- Some migraine sufferers are at the
end of their ropes. It's not so much that the medicine doesn't work, it's just
that they can't bear the taste of the tablets or can't swallow them, or just
can't keep them down. And then there are those who don't experience the relief
they'd hoped for from the drug.
So what's new in migraine therapies? Not much, at least in the
way of new medications. But newer, easier-to-take forms of existing treatments
may offer significant relief to migraine sufferers, reported several
researchers at the 42nd annual scientific meeting of the American Headache
Teen migraine sufferers in particular may benefit from the
nasal formulation of Imitrex, says A. David Rothner, MD, from the Cleveland
Clinic. In a long-term follow-up study, 70-80% of patients taking either a 10
milligram or 20 milligram dose of Imitrex nasal spray experienced significant
relief from migraine.
Additionally, teenagers don't seem to avoid taking the
medication, because "kids like to put things in their nose," says
Rothner in an interview with WebMD. "They like it better than pills and
they like it better than shots." He points out that one of the best things
about the drug is that it did not seem to lose its effectiveness over time, as
is seen with some migraine treatments.
Although the main side effect is the bad taste of the
medication -- it can be tasted at the back of the throat even when sprayed up
the nose -- "kids are pretty good at learning to mask it, probably better
than the drug companies. Lemon drops seem to work very nicely," Rothner
He emphasizes, however, that treatment for migraine is highly
personalized, and that it's important to match the drug, the dose, and the way
it is taken to the needs of the child and the family. Therapy with the stronger
migraine treatments may be appropriate for more severe and persistent
migraines, but mild migraines are often effectively managed with Advil or
Tylenol and rest, he notes.
For those who don't mind oral medications, two companies are
rolling out oral forms of the triptan group of migraine drugs. These drugs
promise to do for migraine therapy what M&Ms did for chocolate -- melt in
the mouth. Merck's fast-dissolving version of Maxalt MLT, now on the market, is
peppermint-flavored, and AstraZeneca's Zomig, awaiting FDA approval, will be
orange-flavored, representatives of the two companies tell WebMD.
Both pills are designed to dissolve on top of the tongue rather
than under it. The primary advantage of the new oral formulations, say
researchers, is that they can be taken without water, which may be helpful for
patients who have trouble swallowing pills without it, or for those whose
migraines are accompanied by nausea and can't keep anything down.
But when it comes to how well these drugs work, the melt
formulations are comparable to, but no better than, tablets.
"The benefit of the drug is in reducing pain. That does not
mean pain-free -- it's ... very similar to Zomig tablets," says Allan
Purdy, MD, professor of medicine at Dalhousie University and chief of neurology
at Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia.