Rizatriptan in the treatment of menstrual migraine

Objective: To determine the efficacy of oral rizatriptan 10 mg and 5 mg for treating menstrually associated migraine attacks. Methods: Data from two large clinical trials with identical designs were in cluded in a retrospective analysis. The studies were randomized, double-mas ked, placebo-controlled, incomplete block, two-period, crossover designs. W omen with migraines were randomly assigned to one of five treatment sequenc es for the treatment of two migraine attacks. Only data from the first atta ck in women with migraines who were treated with rizatriptan or placebo wer e included in the analysis. A menstrually associated attack was defined as one that occurred within 3 days before or after the onset of the last menst rual period. Results: In the subgroup of 335 women with menstrually associated migraine, rizatriptan was effective compared with placebo. At 2 hours after dosing, 68% of 139 women taking rizatriptan 10 mg and 70% of 115 women taking rizat riptan 5 mg with a menstrually associated migraine had pain relief compared with 44% of 81 patients taking placebo (P < .05). In all women, rizatripta n was as effective in treating menstrual as well as nonmenstrual migraine: 68% of 139 patients taking rizatriptan 10 mg with a menstrually associated migraine had pain relief at 2 hours after dosing compared with 69% of 393 p atients with nonmenstrually associated attacks (test of menstrual associati on = nonsignificant; the analysis had 80% power to detect a difference of s ix percentage points between groups). Similar results were found for rizatr iptan 5 mg (menstrual = 70%, nonmenstrual = 66%; not statistically signific ant). Conclusion: Rizatriptan is effective in the treatment of menstrually associ ated migraine attacks. (C) 2000 by The American College of Obstetricians an d Gynecologists.