Major study suggests best treatments for migraines

More than one billion people worldwide suffer with migraines

A major new study has suggested the group of drugs called triptans are the most effective medicine for adults experiencing acute migraines.

More than 89,000 people took part in the study led by the University of Oxford.

It compared the effectiveness of 17 different oral medications commonly used to treat migraines, with the results recently published in The British Medical Journal.

The study's lead author said four triptans - eletriptan, rizatriptan, sumatriptan and zolmitriptan - were found to be most effective.

Triptans are a group of drugs that are often given as an alternative when painkillers fail to provide relief.

They work by imitating the actions of the brain chemical serotonin, easing overactive pain nerves.

The study was led by the University of Oxford's Prof Andrea Cipriani

When comparing the drugs, researchers found eletriptan to be the most effective for pain relief at two hours, followed by rizatriptan, sumatriptan, and zolmitriptan.

The most effective for pain relief for up to 24 hours were eletriptan and ibuprofen.

Newer drugs, such as lasmiditan, rimegepant and ubrogepant were also included in the study, but were not as effective as triptans.

Lead author Andrea Cipriani, a professor of psychiatry at the University of Oxford, said: "We found that all the drugs licensed are better than placebo, but some are better than other active drugs for the acute treatment of migraine, which is something new."

He said triptans were currently "widely underused" and should be considered as a preferred treatment.

“Our findings pave the way to a precision medicine approach in clinical practice and should be used to help inform future guidelines about treatments for acute migraines to ensure that patients receive the best possible care,” he added.

The Migraine Trust estimates about 10 million people in the UK live with the neurological condition.

Among the symptoms are intense headaches, sensitivity to light, visual disturbances, nausea and vomiting.

Robert Music, chief executive of the Migraine Trust, said: "While triptans can be highly effective for some people with migraine, there are many who do not respond to them.

"Others experience intolerable side-effects or are unable to take them, including those with cardiovascular disease. Frequent use of triptans can also lead to medication overuse headache, which exacerbates the problem."

The study was funded by the National Institute for Health and Care Research Oxford Health Biomedical Research Centre and the Lundbeck Foundation.

Update 19 September 2024: This article was updated following feedback. Clarification was made about which drugs showed superior effectiveness.