TREATMENT OF MENSTRUATION-ASSOCIATED MIGRAINE HEADACHE WITH SUBCUTANEOUS SUMATRIPTAN

Objective: To evaluate the efficacy and safety of sumatriptan, a 5-HT1 receptor agonist, in patients with menstruation-associated migraine. Methods: Two double-blind, placebo-controlled, single-attack parallel group studies of subcutaneous sumatriptan were conducted for the acute treatment of migraine. A retrospective analysis of 1104 patients prod uced 157 women who were treated for a menstruation-associated migraine (defined as a migraine beginning between 1 day before and 4 days afte r the onset of menstrual flow) and 512 women treated for nonmenstrual migraine. We excluded 435 other patients who were either male (123), w omen with hysterectomies (260), or women with missing data (52). Patie nts with moderate or severe pain were treated with 6 mg subcutaneous s umatriptan or placebo. One hour after treatment, response rates of hea dache severity and associated symptoms were measured. Menstruation-ass ociated migraine patients were compared to female patients with nonmen strual migraine. Migraine recurrence was analyzed retrospectively for 24 hours. Results: At 1 hour, 80% of the sumatriptan-treated menstrual -migraine patients had pain relief (reduction of severe or moderate pa in to mild or no pain), compared to 19% of the placebo patients (P < . 001). Sumatriptan also treated nausea and photophobia more effectively in menstrual-migraine patients than did placebo. Response rates for p ain and associated symptoms were similar between patients with menstru ation-associated and nonmenstrual migraines. Adverse effects were also similar between the groups. Conclusion: Sumatriptan was as effective and well tolerated for menstruation-associated migraine as it was for nonmenstrual migraine.