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Titolo:
MIGRAINE AND CLUSTER HEADACHE - THEIR MANAGEMENT WITH SUMATRIPTAN - ACRITICAL-REVIEW OF THE CURRENT CLINICAL-EXPERIENCE
Autore:
WILKINSON M; PFAFFENRATH V; SCHOENEN J; DIENER HC; STEINER TJ;
Indirizzi:
CITY LONDON MIGRAINE CLIN,22 CHARTERHOUSE SQ LONDON EC1M 6DX ENGLAND NEUROL PRACTICE MUNICH GERMANY UNIV LIEGE,DEPT NEUROL,CHR CITADELLE LIEGE BELGIUM UNIV ESSEN GESAMTHSCH ESSEN GERMANY CHARING CROSS & WESTMINSTER MED SCH,ACAD UNIT NEUROSCI LONDON ENGLAND
Titolo Testata:
Cephalalgia
fascicolo: 5, volume: 15, anno: 1995,
pagine: 337 - 357
SICI:
0333-1024(1995)15:5<337:MACH-T>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBRAL BLOOD-FLOW; TRIGEMINAL NUCLEUS CAUDALIS; SUBCUTANEOUS SUMATRIPTAN; 5-HT1-LIKE RECEPTOR; 5-HT RECEPTORS; CORONARY VASOSPASM; CLASSIC MIGRAINE; ORAL SUMATRIPTAN; ERGOTAMINE; ARTERIES;
Keywords:
EFFICACY; MIGRAINE AND CLUSTER HEADACHE; MODE OF ACTION; PHARMACOKINETICS; PHARMACOLOGY; PLACE IN THERAPY; SAFETY; SUMATRIPTAN; TOLERABILITY;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
166
Recensione:
Indirizzi per estratti:
Citazione:
M. Wilkinson et al., "MIGRAINE AND CLUSTER HEADACHE - THEIR MANAGEMENT WITH SUMATRIPTAN - ACRITICAL-REVIEW OF THE CURRENT CLINICAL-EXPERIENCE", Cephalalgia, 15(5), 1995, pp. 337-357

Abstract

Sumatriptan is a potent and selective agonist at the vascular 5HT(1) receptor which mediates constriction of certain large cranial blood vessels and/or inhibits the release of vasoactive neuropeptides from perivascular trigeminal axons in the dura mater following activation of the trigeminovascular system. The mode of action of this drug in migraine and cluster headache is discussed. On the basis of a detailed review of all published trials and available data from post-marketing studies, the efficacy, safety, tolerability and the place of oral and subcutaneous sumatriptan in the treatment of both conditions are assessed. A number of double-blind clinical trials have demonstrated that sumatriptan 100 mg administered orally is clearly superior to placebo in theacute treatment of migraine headache and achieves significantly greater response rates than ergotamine or aspirin. In other studies, 70 to 80% of patients receiving sumatriptan 6 mg sc experienced;relief of migraine headaches by I or 2 h after administration, and patients consistently required less rescue medication for unresolved symptoms. Sumatriptan was also effective in relieving associated migraine symptoms like nausea and vomiting. Sumatriptan was equally effective regardless ofmigraine type or duration of migraine symptoms. Overall, approximately 40% of patients who initially responded to oral or subcutaneous sumatriptan experienced recurrence of their headache usually within 24 h, effectively treated by a further dose of this drug. In 75% of patientswith cluster headache treated with sumatriptan 6 mg sc, relief was achieved within 15 min. Based on pooled study data, sumatriptan is generally well tolerated and most adverse events are transient. Adverse events following oral administration include nausea, vomiting, malaise, fatigue and dizziness. With the subcutaneous injection, injection site reactions occur in approximately 30%. Chest symptoms are reported in 3to 5% but have been associated with myocardial ischaemia only in rareisolated cases. The recommended dosage of sumatriptan at the onset ofmigraine symptoms is 100 mg orally or 6 mg subcutaneously. The recommended dosage for cluster headache is 6 mg sumatriptan sc. Sumatriptan must not be given together with vascoconstrictive substances, e.g. ergotamines, or with migraine prophylactics with similar properties, e.g.methysergide. Sumatriptan should not be given during the migraine aura. It is contraindicated in patients with ischaemic heart disease, previous myocardial infarction, Prinzmetal (variant) angina and uncontrolled hypertension.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 13:12:16