2024-09-26 15:49:30
Migraine is more than just a headache: it significantly affects the lives of many people. A comparative analysis shows which medication helps best.
Headaches, sensitivity to light, nausea – for many people these complaints are part of everyday life. Around 15 percent of women and six percent of men in Germany suffer from migraines. These pain attacks can significantly affect life. But which medications help best? A comprehensive comparative analysis of 137 studies with almost 90,000 participants provides new insights.
It was clear that triptans were the most effective medications for acute migraine pain. “Eletriptan, rizatriptan, sumatriptan and zolmitriptan had the best efficacy profiles and were more effective than the newly marketed drugs lasmaditan, rimegepant and ubrogepant,” the researchers from Copenhagen University Hospital reported in their study.
Not only did these drugs work quickly (within two hours), they also relieved accompanying symptoms such as nausea and sensitivity better than other preparations. However, triptans also constrict the blood vessels and are therefore less suitable for people with circulatory problems.
In addition to triptans, new active ingredients such as ditans and gepants were also investigated. These are said to have a more targeted effect and fewer side effects. Ditans only dock onto a specific serotonin receptor and do not cause vasoconstriction. Gepants inhibit the neurotransmitter CGRP, which plays a role in migraines. However, the researchers found that both drugs were less effective and less rapid.
Many migraine sufferers still resort to traditional painkillers such as ibuprofen or paracetamol. Here, too, there are clear differences in effectiveness. While ibuprofen proved to be effective – especially in terms of pain relief after 24 hours – paracetamol was the worst drug. It was barely more effective than a placebo.
“Ibuprofen scores particularly well in terms of its long-lasting effect,” say the researchers. Paracetamol showed few side effects, but the risk of liver damage in the event of an overdose remains. Read more about this here.
In addition to the effectiveness, the study also took into account the side effects of the medication. Lasmaditan caused dizziness, tiredness and sensory disturbances more frequently. The US Food and Drug Administration (FDA), for example, therefore advises against driving after taking it. Nausea was common with Ubrogepant. However, symptoms such as nausea, tiredness or dizziness are also common complaints of a migraine attack.
The conclusion of the study authors was: “The most effective triptans should be considered the preferred acute treatment for migraine and should also be included in the WHO list of essential medicines.” However, despite their proven effectiveness, triptans are still rarely used in Germany. Only around 7.3 percent of migraine patients take these medications – a small proportion considering their low cost and high effectiveness.
In order to improve the care of migraine patients, it is important that both doctors and those affected are informed about these new results, say the researchers. In the future, many people could receive better and faster help for their pain.