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Study finds wide range of effective migraine treatments, but not opioids

Several available treatments produce pain relief for people with migraine, according to a new analysis. Photo by pheee/Pixabay
Several available treatments produce pain relief for people with migraine, according to a new analysis. Photo by pheee/Pixabay

June 15 (UPI) -- Several available treatments for migraine improve pain and function among people with the debilitating headaches, but opioids are not among them, an analysis of previous research published Tuesday by JAMA found.

Effective medications included triptan drugs such as Axert, non-steroidal anti-inflammatory drugs such as ibuprofen, acetaminophen. Some nerve stimulation therapies are effective, too, the study said.

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Evidence that supports using opioid-based pain relievers to treat migraine is, however, weak. Their lack of efficacy, combined with potential side effects and risk for addiction, makes usefulness questionable, researchers said.

Still, many sufferers are not taking advantage of treatments that work, one of the researchers said.

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"Migraine is a very common condition, and unfortunately many people with migraine go without appropriate treatment for a number of reasons," study co-author Dr. Juliana VanderPluym told UPI in an email.

However, "there numerous potential options for acute treatment of migraine, including medication and non-medication interventions," said VanderPluym, an assistant professor of neurology at the Mayo Clinic in Scottsdale, Ariz.

More than one in 10 people in the United States experience migraine, which causes severe pain, typically on one side of the head, along with nausea, vomiting and extreme sensitivity to light and sound, according to the Migraine Research Foundation.

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Migraine attacks can last for hours or even days, and the pain can be debilitating.

For this analysis, the researchers compiled data for more than 100 reviews and clinical trials that collectively included nearly 30,000 participants with migraine.

The included trials compared several treatments -- almotriptan, marketed as Axert; frovatriptan, marketed as Frova; sumatriptan; and zolmitriptan, marketed as Zomig -- against a placebo, or "sham" therapy that offers no clinical benefit.

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People with migraine who used these drugs at the onset of an attack were up to three times as likely to be pain free within two hours and achieve sustained pain relief within one day compared to those who took a placebo, the data showed.

Those who used non-steroidal anti-inflammatory drugs, or NSAIDs, aspirin, diclofenac or ibuprofen, including Advil and Motrin, were up to twice as likely to be pain free within two hours and achieve sustained pain relief within one day compared to those who took a placebo.

People on combined treatment with sumatriptan and the NSAID naproxen, which is marketed as Aleve, were up to four times as likely to be pain free within two hours and achieve sustained pain relief within one day compared to those who took a placebo.

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Those who took rimegepant, which is marketed as Nurtec, or ubrogepant, which is marketed as Ubrelvy, also experienced pain relief within two hours, as well as sustained pain relief, as did those on lasmiditan, which is marketed as Reyvow.

Nerve stimulation devices, which are designed to deliver small electrical pulses to the affected area of the brain at the start of an attack, also were more than twice as likely as placebos to produce sustained pain relief.

"These new acute treatments are ... exciting because they have been specifically designed for migraine," VanderPluym said.

"The fact that there is such growth in the field of migraine research is a real source of hope for patients with migraine and the clinicians who care for them," she said.

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