Analgesics (including combined in combination with caffeine) and NSAIDs (ibuprofen) are used to treat a migraine attack. Drugs should be quick (prolonged forms of analgesics and NSAIDs do not apply). Concomitant therapy is antiemetic medications that significantly reduce the severity of symptoms of nausea and vomiting. Analgesics are effective in the treatment of patients with a mild headache, which does not significantly interfere with the patient’s ability to work.
With moderate and severe pain, disrupting the patient’s ability to work, specific antimigraine medicines (triptans) are connected. If previous attacks did not lend themselves to cupping with other drugs, oral tryptans are recommended for the treatment of migraine attacks of all types of severity.
Triptans are specific anti-migraine drugs. Serotonin receptor agonists, which cause the narrowing of the excessively dilated vessel and reduce its permeability affects the mechanisms of developing a migraine headache. Unlike analgesics and NSAIDs, tryptans should not be taken beforehand, before an attack. The highest efficiency of triptans is noted when they are taken in the phase of pain increase. Triptans also block the pain at the level of the spinal cord of the trigeminal nerve, which helps to reduce the number of headache relapses and ensures the effectiveness of drugs with regard to concomitant nausea, vomiting and photophobia.
Risatriptan (Risamigren) meets all the requirements for the drug for migraine treatment:
- It is effective for arresting migraine attacks with both aura and without aura;
- It has a high bioavailability, quickly stops the attack of a headache and accompanying symptoms;
- It has a favorable safety profile.
In the latest recommendations in the treatment of acute migraine, emphasis is placed on the effectiveness of rizatriptan. A meta-analysis involving 53 randomized placebo-controlled trials involving more than 24,000 patients with migraine showed that 5 mg and 10 mg rizatriptan was more effective than sumatriptan 50 and 100 mg and other tryptans, both in the onset of action and in duration. Also, rizatriptan was better tolerated by patients.