High-altitude
headache often fulfills the criteria of
migraine. Therefore, we hypothesized that
sumatriptan, a
5-HT1 receptor agonist specifically effective for treatment of
migraine, would also alleviate high altitude
headache. A randomized, placebo-controlled double-blind trial was performed on 29 mountaineers with at least moderate
headache on the day of arrival at 4559 m. Fourteen subjects received 100 mg
sumatriptan orally and 15 subjects received placebo. Before treatment there were no significant differences between groups regarding rate of ascent, duration and severity of
headache, and acute
mountain sickness score. All 6 female subjects were randomly assigned to placebo. Absolute values and the reduction of
headache scores 1, 3, and 12 h after the administration of
sumatriptan did not differ between treatment groups, but
headache scores tended to be lower with
sumatriptan after 1 or 3 h when compared with placebo. Considering only male mountaineers, there was a significant decrease of
headache scores after 1 and 3 h. Because there was only a minor transient amelioration of high altitude
headache with
sumatriptan, we conclude that
5-HT1 receptors do not play a major role in the pathophysiology of high altitude
headache.