Sumatriptan is a selective 5-HT1-like agonist, which is effective in the treatment of
migraine and
cluster headache. It has been rigorously assessed in clinical trials involving over 7000 patients who have treated over 35,000
migraine attacks. Both subcutaneous and oral
sumatriptan provide a high level of efficacy with 86% of patients obtaining relief after a single 6 mg injection (at 2 h) and 75% after 100 mg oral
sumatriptan (4 h), compared with up to 37% in the placebo-treated group (P < 0.001). The onset of effect is rapid, occurring 10 min after injection and 30 min after the
tablet. Oral
sumatriptan (100 mg) has been evaluated against
ergotamine, 2 mg, plus
caffeine, 200 mg (as
Cafergot); and against
aspirin, 900 mg, plus
metoclopramide, 10 mg.
Headache relief was superior in
sumatriptan-treated patients; 66% obtaining relief at 2 h, compared with 48% on
Cafergot (P < 0.001). The percentage of patients obtaining complete relief of
headache (Grade 0, no
pain) was significantly higher with
sumatriptan (40%) than with
Cafergot (14%) at 2 h. Associated symptoms such as
nausea,
vomiting and
photophobia are effectively relieved by
sumatriptan, whereas
Cafergot provoked
nausea and
vomiting in a proportion of patients.
Headache relief with
sumatriptan was also superior to that seen with
aspirin plus
metoclopramide.
Sumatriptan was as effective in the relief of accompanying
nausea and
vomiting as
aspirin plus
metoclopramide. The efficacy of
sumatriptan is maintained after repeated long-term use; over a six-month period efficacy was comparable in the first and last attacks, regardless of how many attacks were treated.(ABSTRACT TRUNCATED AT 250 WORDS)