Is cardiothoracic ratio in healthy middle aged men an independent predictor of coronary heart disease mortality? Whitehall study 25 year follow up.

The relatively low response rate, particularly in high peak users, raises concern about the representativeness of this study. When the higher total consumption of sumatriptan among non-respondents in this group is taken into consideration, this bias could lead to underestimation of sumatriptan overuse. Appropriate heavy use of sumatriptan for cluster headache was rare. We conclude that heavy consumption of sumatriptan generally represents inappropriate use, mainly for tension and drug induced headaches. Inappropriate use may be related to the patient rather than the drug. Patients at greatest risk have generally been excluded from clinical trials conducted before the drug was marketed. Greater awareness of the problem among doctors could lead to more rational use of sumatriptan.