These drugs might be best to relieve migraine pain

A number of medications can help relieve the agony of a migraine headache as it's occurring, including some that have come out in the past few years. Which drug is best? A large analysis of randomized controlled trials, published online Sept. 24, 2024, by The BMJ, found that older drugs called triptans are more effective than newer options. Scientists evaluated 137 studies involving almost 90,000 people who were randomly assigned to take either a placebo (an inactive pill) or one of 17 medications, including various types of triptans, nonsteroidal anti-inflammatory drugs (NSAIDs), antipyretics, and two classes of newer medications known as ditans and gepants. All of the drugs were better than a placebo at relieving pain within two hours. But the triptans eletriptan (Relpax), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig) were most effective. Eletriptan was the best at stopping pain quickly. Eletriptan and the NSAID ibuprofen (Advil) kept pain away longer than other medications. Triptans can cause temporary narrowing of blood vessels and are not advised for people with atherosclerosis of the heart arteries. Ditans and gepants don't have that risk, but do have other side effects and can be expensive. The study found they were no more effective for the average migraine sufferer than acetaminophen (Tylenol) and most NSAIDs. While the findings apply to the average patient, some individuals may respond better to the new drugs than to the older ones.

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