ZOMIG & IMITREX FOR MIGRAINES Introduction Th

This research paper presents a discussion of migraines that includes classification and clinical presentation, epidemiology, general treatment approaches, and the drugs Zomig and Imitrex used for treatment. Discussion also offers treatment comparisons regarding cost, effectiveness, safety, and alternatives.

Migraines are found in all civilizations. A reliable description of migraine without aura (MO) dates back to the first century AD and descriptions of migraine with aura (MA) date from the seventeenth century. MO is characterized by a headache attack that lasts between four and 72 hours; it is usually severe, unilateral, pulsating, aggravated by physical activity, and accompanied by nausea, vomiting, photo- and phonophobia. MA is initiated by aura, for example reversible visual, sensory, motor, and/or aphasic symptoms; the headache is similar to that of MO (12:683).

Migraine etiology is largely unknown, however a gene was mapped for familial hemiplegic migraine to chromosome 19. Information regarding inheritance of more common types of migraine is less clear. The diagnosis of migraine currently relies on the headache history; measurements of urine excretion of 5-hydroxyindololacetic acid and cerebral blood flow are not used for diagnostic purposes. A lack of precision leaves individual interpretation which leads to false conclusions regarding genetic factors. The diagnostic criteria of the International Headache So

presence of preceding aura or nausea at baseline. For example, zolmitriptan doses of 2.5 and 5 mg produce 2 hour headache responses of 61 percent and 68 percent, respectively. Studies show that there are no clinically significant interactions between zolmitriptan and commonly co-prescribed migraine medications. This drug is well tolerated. Most adverse effects are mild to moderate and of short duration; cardiovascular effects are reassuring (7:53-58). Sumatriptan is a selective agonist at the vascular 5-hydroxytryptamine receptor subtype, it mediates vasoconstriction of cranial blood vessels. It is effective and well-tolerated as a treatment for migraine when given by the subcutaneous or oral route. Headache relief rates of over 80 percent have been shown with subcutaneous sumatriptan at two hours and over 70 percent with oral sumatriptan at four hours. It is also associated with relief of symptoms of heaviness, pressure, pain, tingling, and tightness. Adverse symptoms are mild or moderate with common symptoms of palpitations, chest tightness, and throat tightness (4:32-35). One study concluded that the 50-mg oral dose is generally effective for migraine without aura of moderate and severe intensity (10:421). Other st

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