Menstrually associated migraines (MAM)! I've know them to make more than one woman wish for menopause. Approximately 60% of female migraineurs report MAMs.
An article in the March, 2001, issue of Headache: The Journal of Head and Face Pain is an encouraging report of the study, "Naratriptan (Amerge) as Short-Term Prophylaxis of Menstrually Associated Migraine: A Randomized, Double-Blind, Placebo-Controlled Study."
MAM is not defined by the International Headache Society criteria as a specific migraine subtype, but for this study, was defined as a migraine occurring during the perimenstrual period (PMP). The PMP was defined as beginning two days before menses began and ending with the fourth day of menstrual flow.
Study Objective: "To determine the efficacy of naratriptan 1-mg and 2.5-mg tablets twice daily compared with placebo as short-term prophylaxis of menstrually associated migraine."
Study Methods: "A randomized, double-blind, three-arm, parallel-group, placebo-controlled study was conducted in women aged 18 years or older with a history of migraine with or without aura, as defined by the International Headache Society, of at least 6 months. Two dose strengths of naratriptan (1 mg, 2.5 mg) or identical-appearing placebo tablets (1:1:1) were administered twice daily for 5 days starting 2 days prior to the expected onset of menses across four perimenstrual periods."
In this study:
- 171 women completed the study.
- the treatment groups were similar in age, migraine history, ethnic group, use of contraceptives, employment status, and other relevant characteristics.
- the participants were in three treatment
groups:
- Amerge 1 mg twice daily,
- Amerge 2.5 mg twice daily,
- or placebo
- In the group treated with Amerge 1 mg, 61% reported a reduction in MAMs of 50% or more while only 38% of the placebo group reported like results
- three times as many of those treated with Amerge 1 mg were migraine-free over a four-cycle time period than in the placebo group.
- The duration of break through MAM's was significantly shorter for those treated with Amerge - 13.8 hours as compared to 20.4 hours for participants receiving placebo.
- Amerge 1 mg was tolerated by nearly 90% of the patients with none to moderate adverse effects not requiring discontinuing of Amerge.
- Treatment with Amerge, 2.5 mg did not statistically improve the results over Amerge, 1 mg.
The authors close the article:
"In summary, naratriptan (Amerge), 1 mg, is an effective, well-tolerated, short-term prophylactic treatment for MAM. The twice-daily treatment limited to the PMP offers a novel treatment strategy for patients with predictable migraine."
_________________________
Reference:
Newman, L., Mannix, L.K., Landy, S.,
Silberstein, S., Lipton, R.B., Putnam, D.G. Pait, Watson, C., Jöbsis, M.,
Batenhorst, A. & O'Quinn, S. "Naratriptan as Short-Term Prophylaxis of Menstrually Associated Migraine: A
Randomized, Double-Blind, Placebo-Controlled Study."
Headache: The Journal of Head and Face Pain 41 (3), 248-256.
