Date of Award

2013

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Triptan drugs are safe and effective for use in the prevention of menstrually related migraines (MRMs).

STUDY DESIGN: Review of two English language randomized controlled trials and one pilot randomized control trial.

DATA SOURCES: Randomized controlled trials comparing Triptan drugs to a placebo group were found using Medline, PubMed, and OVID.

OUTCOMES MEASURED: Incidence of MRM based on patient self-report; number of relapses; patients’ subjective evaluations of effectiveness based on questionnaire; adverse effects of Triptan treatment.

RESULTS: Two randomized controlled trials and one pilot study were included in this review. Oral Triptan drugs were shown to be of benefit in the prevention of menstrually related migraines (MRMs).

CONCLUSIONS: The results of the randomized controlled trials reviewed demonstrate that oral Triptan drugs, given short-term, were safe and effective at preventing menstrually related migraines (MRMs). However, in one of the RCTs, some migraineurs experienced post-treatment attacks. There is not a clear explanation for these post-treatment attacks; further studies need to be conducted to allow for more flexible dosing in order to ensure that the migraineurs are being treated during their perimenstrual period (PMP).
Additionally, further studies should be conducted comparing Triptan dosing schedules, dosages, duration of treatment, routes of administration as well as the efficacy of the drugs within the Triptan class in preventing MRMs.

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