Taking Triptans During Migraine Aura May Work Better

Taking Triptans During Migraine Aura May Work Better

by Teri Robert, Lead Expert

It's confusing. Some doctors tell us to take Migraine abortive medications such as the triptans early in a Migraine attack -- during the aura if you get auras. Others say triptans won't work taken that early, to wait for the headache phase to begin.

So, for those of us with Migraine with aura, when IS it best to take triptans? When the aura starts? When the pain starts? Does it even make a difference.

Aurora et. al. set out to take a look at those very question. The objective of their study was

"To reexamine the efficacy of terminating migraine headache by administration of sumatriptan during the visual-aura phase of the attack."

Previous studies have been conflicting and confusing. It has been shown that taking triptans early in the headache phase of a Migraine attack, while the pain is mild and allodynia has not fully developed, increases the success rate of triptans for giving pain-free relief. However, previous data had also shown that taking triptans during the aura phase did not abort the Migraine before the beginning of the headache phase. Given the length of time triptans remain active and effective in the body, it would seem that triptans taken during the aura phase should work better than reported. Because patients have been telling doctors how effective triptans are for them when taken during the aura phase, Aura et. al. decided to do a study comparing the effects of sumatriptan taken during aura phase, before the beginning of pain, and the effects when taken after the pain begins.

Study methods:

  • There were 32 patients with Migraine with aura (MWA) originally recruited for the study; 19 completed it.

  • Patients could be taking no more than one preventive medication.

  • Patients maintained a detailed Migraine diary electronically. It was updated and sent via the Internet or by paper copy.

  • Patients were asked to treat a total of eight consecutive Migraine attacks with 100 mg of sumatriptan.

    • For the first three attacks, patients treated at a time left to their judgment.

    • One attack was treated four hours after the aura began (late).

    • Two attacks were treated within one hour of one hour of the pain beginning (early).

    • Two attacks were treated during the aura phase, before the beginning of pain.

  • Patients recorded and reported pain levels and the presence of cutaneous allodynia (a condition in which an ordinarily painless stimulus is experienced as being painful) at four times:

    • When pain began.

    • When sumatriptan was taken.

    • Two hours after taking sumatriptan.

    • Four hours after taking sumatriptan.

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