Oral therapy for migraine: Comparisons between rizatriptan and sumatriptan. A review of four randomized, double-blind clinical trials

The introduction in 1991 of sumatriptan succinate, the first approved 5-HT1 B/1D receptor agonist, represented a significant advance in the treatment o f acute migraine. The approval of three additional 5-HT receptor agonists, including rizatriptan, has further expanded the options for migraine treatm ent. Four randomized clinical trials have compared the effects of oral suma triptan with those of oral rizatriptan. Forty mg rizatriptan was more effec tive than 100 mg sumatriptan but was associated with a high incidence of ad verse events. Five mg rizatriptan was comparable to 50 mg sumatriptan. In t wo trials, rizatriptan 10 mg, the recommended dose in most countries, had a more rapid onset of action than 50 mg (p<0.05) and 100 mg sumatriptan (p=0 .075). In addition, 10 mg rizatriptan resulted in more patients being pain- free after 2 hours than 100 mg sumatriptan (p<0.05), and resulted in fewer drug-related adverse events than sumatriptan.