We evaluated naratriptan, a long half-life "triptan", to prevent recurrence of migraine headaches in known patients who obtained initial relief with sumatriptan. Adult migraineurs with a documented high frequency of recurrent migraine headache (more than 50% recurrence within 2 to 12 hours of initial relief) were entered in this study. Following initial relief with sumatriptan (50 mg. oral, 20 mg. nasal spray or 6 mg. subcutaneous), patients took naratriptan, 2.5 mg. for up to three migraines. Patients completed headache diaries to record any recurrent headache for up to 24 hours after naratriptan.
If recurrence occurred, patients rescued with a non-triptan medication. 17 migraineurs in this study treated 40 migraine headaches. In 30 out of 40 headaches (75%), there was no recurrence of migraine within 24 hours of sumatriptan administration. The remaining 10 migraines treated with naratriptan showed recurrence of migraine in 13 hours, as compared to recurrence at 5 hours with sumatriptan alone. No adverse events were reported and no patients
were dropped from the study for any side effects. We believe that naratriptan can be used safely and effectively to prevent recurrent headaches in migraineurs with a high frequency of recurrence. This property may be very useful in preventing recurrent migraines in the setting of menstrual or other cyclic migraines, post-traumatic migraines and flare-ups of migraine headache patterns.
Double-blind placebo-controlled studies are warranted to replicate the findings in this study.