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Variation in almotriptan effectiveness according to different prophylactic treatments.

Author(s): Bermejo PE, Dorado R, Gomez-Arguelles JM

Affiliation(s): Puerta de Hierro University Hospital - Neurology, Madrid, Spain.

Publication date & source: 2009-10, Headache., 49(9):1277-82.

Publication type: Clinical Trial; Comparative Study

OBJECTIVE: To evaluate the effect of different migraine prophylaxis medications on subject responsiveness to almotriptan. BACKGROUND: There is evidence supporting an increase of responsiveness of symptomatic medications for migraine attacks by some prophylactic treatments although this has not been probed. METHODS: A total of 345 patients (230 women, mean age 37.3) with episodic or chronic migraine were classified according to the prophylaxis they were taking in the following groups: (1) no prophylactic medication; (2) propranolol; (3) topiramate; (4) flunarizine. Decrease in Analogical Visual Scale and pain-free at 2 hours after almotriptan intake was assessed at 2 months. Side effects and discontinuation or treatment were also assessed. RESULTS: Headache severity was reduced 4.2 in control group, 5.3 in propranolol group, 4.1 in topiramate group, and 4.0 in flunarizine group, whereas pain-free status was achieved in 37.3%, 48.7%, 36.1%, and 38.1% respectively. These two parameters were statistically significative between propranolol and control groups. Side effects were similar in all groups. CONCLUSIONS: Our results displayed a higher efficacy of almotriptan in propranolol group and we hypothesized it may be due to a common mechanism of action at serotoninergic receptors.

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