The acute treatment of migraine requires matching patient need to drug and formulation. In particular, nausea and vomiting, quick time to peak intensity, and the common gastroparesis of migraineurs, all call for a variety of non-oral formulations for treatment of attacks. A novel breath-powered powder sumatriptan intranasal treatment offers an improvement, at least in pharmacokinetics, over con...

AIMS AND METHODS In this double-blind, double-dummy, randomised, parallel group, multicentre study, the efficacy of dosing and re-dosing of a fixed combination of indomethacin, prochlorperazine and caffeine (Indoprocaf) was compared with encapsulated sumatriptan in the acute treatment of two migraine attacks. Additionally, in the group taking Indoprocaf, two different oral formulations were tes...

A 54-year-old man with an active 1 pack per day smoking history, a history of coronary artery disease (status-post stenting), and chronic cluster previously refractory to a wide variety of therapeutic interventions (including gamma knife radiosurgery) presents complaining of cluster attacks that recently had worsened in their frequency and pain intensity. His prophylactic regimen included verap...

INTRODUCTION Treatment-resistant trigeminal neuralgia is a distressing condition, for both the patient and the treating doctor. To our knowledge, there are no reported cases of trigeminal neuralgia successfully treated with oral sumatriptan in the literature. CASE PRESENTATION A 51-year-old Caucasian woman was prescribed opiate analgesia for management of her treatment-resistant trigeminal ne...

CLINICAL HISTORY This 47-year-old woman has a history of migraine since aged 4 years. Until 1 year ago, the headaches occurred one to two times per week, lasted all day, resulted in functional incapacity, and were not relieved by over-the-counter medications or nonsteroidal antiinflammatory drugs. About 10 years ago, she was taking Fiorinal #3 but stopped when she developed rebound headaches. S...

BACKGROUND The gastric stasis that commonly accompanies migraine headache may impair absorption of conventional oral tablets in the stomach. A fast-disintegrating/rapid-release formulation of sumatriptan has been developed to enhance tablet disintegration and drug dispersion and potentially improve absorption. OBJECTIVE Two studies were conducted comparing the time to onset of relief from mod...

1. The mechanism of action of sumatriptan on coronary flow was examined before and after two different forms of endothelial ablation in guinea-pig isolated hearts. The mechanism was assessed in terms of the influence of the integrity of the coronary endothelium, the role of release of nitric oxide (NO) from the endothelium, and the receptor subtypes mediating the effects. 2. Continuous perfusio...

CLINICAL HISTORY This 60-year-old woman has had a history of severe migraines without aura since she was 25 years old. The attacks now occur once every 3 weeks or less, lasting up to a week without treatment. Sumatriptan, 6 mg, administered subcutaneously (SQ) completely relieves the headache and zolmitriptan, 5 mg, decreases the headaches to a dull level. Sumatriptan, 50 mg, administered orall...