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Triptans vs Other Drugs for Acute Migraine.
Are There Differences in Efficacy?
Peer Tfelt-Hansen, MD
Posted: June 2008  
Headache   2008;48:601-605

The introduction of triptans in migraine treatment was apparently a revolution. Comparative randomized clinical trials (RCTs) with triptan and other drugs do not give a clear-cut picture.

Oral triptans are superior to oral ergotamine and most likely because the bioavailability oral of ergotamine is extremely low.

Compared with NSAIDs, in most cases aspirin, triptans were not superior and in several RCTs triptans caused more adverse events that aspirin plus metoclopramide.

Guidelines for treatment of migraine should be evidence-based. It is suggested that based on current evidence, effervescent aspirin should be the first-line drug for the treatment of migraine. Aspirin is also much cheaper than the triptans.