Objective: This study sought to compare the efficacy of several doses of na
ratriptan tablets with that of sumatriptan tablets and placebo in the acute
treatment of a single migraine attack.
Methods: This was a randomized, double-blind, placebo-controlled, parallel-
group, dose-ranging study. Patients received either naratriptan tablets (1,
2.5, 5, 7.5, or 10 mg), sumatriptan tablets (100 mg), or placebo.
Results: A total of 643 patients took part in the study. Two hours after do
sing, headache relief was reported by significantly more patients treated w
ith any dose of naratriptan (52%-69%) or sumatriptan (60%) than with placeb
o (31%) (P < 0.05). Four hours after dosing, headache relief was reported b
y significantly more patients treated with any dose of naratriptan (63%-80%
) or sumatriptan (80%) than with placebo (39%) and by significantly more pa
tients treated with sumatriptan 100 mg (80%) than with naratriptan 1 mg (64
%), 2.5 mg (63%), or 5 mg (65%) (P < 0.05). Twenty-four-hour overall effica
cy (headache relief maintained through 24 hours postdose with no worsening,
no use of rescue medication, and no recurrence) was reported by more patie
nts treated with any dose of naratriptan (39%-58%) or sumatriptan (44%) tha
n with placebo (22%). Headache recurrence was reported in 17% to 32% of nar
atriptan-treated patients, 44% of sumatriptan-treated patients, and 36% of
placebo recipients. The overall incidence of adverse events was similar in
patients treated with naratriptan I mg (20%), naratriptan 2.5 mg (21%), and
placebo (23%). For naratriptan 5, 7.5, and 10 mg, the incidence of adverse
events was 32%, 37%, and 35%, respectively and for sumatriptan 100 mg it w
as 26%.
Conclusions: Our results suggest that the 2.5-mg dose of naratriptan tablet
s offers the optimal efficacy-to-tolerability ratio at the dose range betwe
en 1 and 10 mg. Although naratriptan 2.5 mg was less effective than sumatri
ptan 100 mg at 4 hours after dosing, the 2 medications showed similar effic
acy at 24 hours.