Reactions 737 - 6 Feb 1999

★Naratriptan/zolmitriptan

First report of headache: 11 case reportsDrug-induced headache occurred in 11 women aged 25–83

years following treatment with naratriptan or zolmitriptan formigraine.

Six of the women had previously received treatment withergot derivatives and/or triptans and the remaining 5 womenhad not received these agents previously. All of the womenhad used naratriptan (2 women) or zolmitriptan (9) for at least6 months. Four women developed a chronic daily headache, 3women developed a daily migraine-type headache and 4experienced an increase in their migraine headaches.

Naratriptan and zolmitriptan were discontinued in all 11patients. This occurred in a hospital setting for most patients.At the time of hospitalisation, 4 patients were receivingzolmitriptan 7.5–10mg weekly or naratriptan 10–12mgweekly. At follow-up, 9 of the women had benefited from thewithdrawal of naratriptan or zolmitriptan.

Author comment: ‘In contrast to initial expectations, there isevidence now that all members of the triptan family are able tocause drug-induced headache.’ The new 5-HT agonists mayincrease treatment options for migraine, but the improvedpharmacological properties of these agents may lead to aquicker onset of drug-induced headache, at lower dosages.Limmroth V, et al. Headache after frequent use of serotonin agonists zolmitriptanand naratriptan. Lancet 353: 378, 30 Jan 1999 - Germany 800738345

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of migraine or headacheinduced by naratriptan or zolmitriptan.

1

Reactions 6 Feb 1999 No. 7370114-9954/10/0737-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved