Behind the headlines: Is aspirin an effective treatment for migraine?

Aspirin can reduce the pain of a migraine headache in two hours for more than half of people, according to newspaper reports.

Aspirin is similar to sumatriptan in its effectiveness on migraines
Aspirin is similar to sumatriptan in its effectiveness on migraines

UK researchers examined 13 studies, involving 4,222 people, that had looked at the use of aspirin, sumatriptan or placebo for treating migraine.

Dr Varo Kirthi and colleagues from Oxford University's department of anaesthetics concluded that aspirin is an effective treatment for acute migraine headaches, similar to sumatriptan 50mg or 100mg.

'Aspirin 900mg or 1,000mg is an effective treatment for acute migraine headaches, with participants in these studies experiencing reduction in both pain and associated symptoms, such as nausea and photophobia,' they said.

For 52 per cent of people, this treatment would reduce moderate-to-severe migraine to no worse than mild pain within two hours, the researchers said.

'The addition of 10mg metoclopramide may provide additional pain relief and greater reduction in associated symptoms, particularly nausea,' they added.

Adverse events identified in the study were mainly mild and transient, but such events occurred less frequently in people treated with sumatriptan 100mg.

Was this not known before?
The researchers said that, although aspirin is frequently used to treat migraine headaches, they could find no systematic review of the efficacy of this intervention in adults.

'It is important to know where this widely available and inexpensive drug fits in the range of therapeutic options for migraine,' they said.

'For many migraineurs, non-prescription therapies offer convenience and may be the only therapies available or affordable.'

Dr Kirthi and colleagues pointed out that, although trials indicated that the treatments did not differ markedly, there were limited data comparing aspirin with other analgesics.

Exeter GP Dr David Kernick, RCGP headache champion, said that strands of evidence on the benefits of aspirin had been around for some time, but that the new research had pulled them together.

Wendy Thomas, chief executive of The Migraine Trust, said the charity welcomed the fact that findings 'confirm that aspirin can be an effective treatment of migraine symptoms for some sufferers'.

Why is this research significant?
Dr Kernick believes the new review is important because around 50 per cent of people with migraine self-medicate to treat the condition.

'If aspirin works, it generally works every time, but it needs to be taken with an antiemetic,' he said.

'In the study they looked at it with metoclopramide, which is not available OTC in the UK. I suggest using domperidone, which is available OTC.'

He added: 'Migraine is not just about pain, but also has an inflammatory component. My suggestion is that people take aspirin, which hits the inflammation, with paracetamol, which hits the pain, and domperidone.'

Mrs Thomas said The Migraine Trust would 'strongly encourage' people who think they have migraine to consult their GP to get a firm diagnosis of their headache, even if they find OTC medication to be effective.

'The Migraine Trust also recommends that if sufferers are considering taking aspirin they consult their GP for guidance about how, when and in what dosage to take it in order to ensure that it is effective and to avoid the risk of developing medication-overuse headache,' she said.

Informing patients
  • Aspirin 900mg or 1,000mg is an effective treatment for acute migraine headaches.
  • Treatment is effective in around 52 per cent of people.
  • Addition of an antiemetic may boost pain relief and reduce other symptoms such as nausea.

 

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