The efficacy and side effects of intranasal sumatriptan (20 mg, 10 mg) or placebo in the treatment of a single migraine attack were evaluated in two randomized, double-blind, multicenter studies of 409 and 436 adult patients, funded by Glaxo Wellcome. Pain relief to mild or none occurred at 2-hours in two thirds of patients treated with 20 mg doses, in one half the group receiving 10 mg, and in one third of placebo-treated patients. A second dose was given within 24 hours to one-third of patients who had a recurrence of headache. Bitter or unpleasant taste in 25% was the most common side effect. [1]

COMMENT. Sumatriptan nasal spray (20 mg, 10 mg) is an effective treatment of acute migraine attacks, and should offer a more convenient and practical means of treatment in migraine-associated vomiting or in patients who object to injections.

Zolmitriptan (Zomig) for acute migraine was found effective in a multicenter, double-blind, placebo-controlled study of 1000 patients. The optimal initial dose was 2.5 mg orally [2]. In a further trial of 2.5 mg oral dose of zolmitriptan cf placebo in 327 patients, 12 to 65 years old, headache response at 2 hours was 62% cf to 36% for placebo. [3]

Autosomal dominant familial hemiplegic migraine, previously mapped to 19p chromosome locus, is linked to chromosome lq31 in a 39-member four-generation family from Wyoming. The majority reported minor head trauma as a trigger for attacks. [4]