Zolmitriptan in the treatment of migraine attacks - the ARES study

In an open-label Swiss multicentre trial to assess patient acceptance, effi cacy and safety of zolmitriptan 2.5 mg tablets in the acute treatment of mi graine, 112 patients were enrolled and 281 migraine attacks evaluated. Pati ents completed a specially designed protocol during and after each attack. Special attention was given to the patients' subjective comparison of the s tudy drug with previously used abortive treatments. On this matter, zolmitr iptan per formed clearly better than analgesics and NSAIDS (78% "better"). Compared with sumatriptan, zolmitriptan was narrowly preferred (45% "better ", 36% "worse"). Headache intensity was reduced from moderate or severe to mild or none after one hour in 51% and after 2 hours in 70%. Median time to efficacy was 50 minutes. Autonomic symp toms such as nausea and photo- and phonophobia were improved in 45 to 55%. A subjectively significant improve ment in general condition (functionality) was reported in 51% after one hou r and in 72% after 2 hours. Headache recurrence was reported by 25% of the responders after a median time lapse of 14 hours. Adverse effects were repo rted by 22%, and were all short lasting and spontaneously reversible. Rapid efficacy, high and persistent response rate, improvement of headache, auto nomic symptoms and general condition, and excellent tolerability are thus t he reasons for the patients' preference of zolmitriptan over traditional ab ortive drugs.