Migraine is a
chronic disease that significantly reduces quality of life between, as well as during, attacks. Treatments that provide consistent relief may reduce the burden of the disease. In the open-label phase of a two-part study, patients could choose to treat initial, persistent or recurrent
migraine headache of any intensity with 2.5 mg or 5 mg
zolmitriptan. This novel study design allowed patients to manage and maximise their
migraine relief.
Headache response rates and
pain-free response rates were assessed within two hours of dosing with
zolmitriptan, and response rates were compared across
migraines with and without a history of
aura, and associated or not with menses. Consistency of response was also assessed in those patients treating at least 20 attacks. Of 49,784 attacks treated, 66% (32,737 attacks) were treated with a single dose of
zolmitriptan. Two-hour
headache response rates to an initial dose of 2.5 mg or 5 mg
zolmitriptan were 85% (median 95%) and 79% (median 88%), respectively, across all attacks. Corresponding
pain-free response rates were 69% and 59%. Responses were independent of gender and age and were similar in patients with and without
aura and in attacks associated or not associated with menses. Consistent response rates were achieved within individual patients; during months 1 to 3, 64% of patients reported a
headache response in > 75% of their
migraine attacks. In patients treating at least 20 attacks, 2.5 mg and 5 mg
zolmitriptan produced consistently high
headache response rates (range 84-91% and 76-84%, respectively) and
pain-free response rates (range 70-76% and 58-65%, respectively) across attacks. In the minority of attacks requiring a second dose of
zolmitriptan for persistent or recurrent
headache, response rates to a second dose were also consistent across attacks. In conclusion,
zolmitriptan 2.5 mg and 5 mg show consistent effectiveness in the treatment of multiple
migraine attacks in individual patients and are unaffected by gender, age and the presence of
aura or the relationship to menses.