What works best for migraine headaches?

Certain migraine medications like triptans, ergots and antiemetics might be two to five times more effective than ibuprofen for treating migraine attacks, according to a study published in the journal Neurology.

Even though there are many treatment options for migraine attacks, information on how medications compare with one another is lacking.

To find out, US researchers used data from nearly 3,00,000 people using a smartphone app over six years. The app allowed users to record the frequency of migraine attacks, triggers, symptoms, and effectiveness of medications used.

The participants suffered over 31 lakh migraine attacks for which they entered 47 lakh treatment attempts with various medications.

The researchers then evaluated the effectiveness of each drug, looking at a total of 25 medications among seven drug classes and compared them with ibuprofen.

The top three classes of medications more effective than ibuprofen were triptans (five times more effective), ergots (three times more effective), and antiemetics (two and a half times more effective).

The top three individual medications compared with ibuprofen were all triptans: eletriptan—six times more effective, with participants finding it helpful 78 per cent of the time; zolmitriptans—five and a half times more effective, helpful 74 per cent of the time; and sumatriptan—five times more effective, helpful 72 per cent of the time.

For comparison, ibuprofen was helpful 42 per cent of the time and acetaminophen 37 per cent of the time. Other non-steroidal anti-inflammatory drugs were 94 per cent more effective than ibuprofen.

A common combination of medications used to treat migraine—aspirin, acetaminophen and caffeine—were 69 per cent more effective than ibuprofen.

“These results confirm that triptans should be considered earlier for treating migraine, rather than reserving their use for severe attacks,” the study author noted.