Reactions 820 - 23 Sep 2000

Naratriptan

Exacerbation of migraine: 3 case reportsThree patients, 2 women and 1 man, experienced an

exacerbation of migraines during prophylactic treatment withnaratriptan for transformed migraine.

The 2 women, aged 36 and 41 years, and the man, aged 43years, had a clinical history of worsening episodic migraine.During the previous months, the patients had been usingeither zolmitriptan or SC sumatriptan for treatment of theirmigraines. They had experienced headaches for an average of4.5 days per week during the previous month. They all startedtreatment with naratriptan 2.5mg every 12 hours and, duringthe following 8- to 12-week period, experienced a relativedecrease of > 50% in both the intensity and frequency of theirheadache attacks. The 3 patients’ concomitant medicationswere propranolol and amitriptyline, nadolol, and valproic acid,respectively.

All 3 patients subsequently experienced a progressiveincrease in headache frequency and intensity, culminating inalmost continuous migrainous pain. Naratriptan treatment waswithdrawn and the patients’ headache frequency and intensitydecreased to a level experienced prior to naratriptan use.

Author comment: ‘These three cases show that long-termpreventive treatment with naratriptan can worsen TM[transformed migraine] . . . These clinical observations suggestthat there can be a real risk of severe, drug-induced headachewith the daily use of triptans. I would not recommend thiscontinuous approach in the treatment of patients with TM.’Pascual J. Worsening of transformed migraine with naratriptan as prophylactictreatment. Headache 40: 610-611, Jul-Aug 2000 - Spain 800835730

1

Reactions 23 Sep 2000 No. 8200114-9954/10/0820-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved