Original Article
Treatment of Migraine Attacks with Sumatriptan — The Subcutaneous Sumatriptan International Study Group*
N Engl J Med 1991; 325:316-321August 1, 1991
- Abstract
- Abstract
Background.
The headache in migraine attacks may be caused by dilatation of certain cranial arteries or arteriovenous anastomoses, by neurogenic dural plasma extravasation, or by both of these mechanisms. Sumatriptan, a novel selective agonist of 5-hydroxytryptamine—like receptors, blocks these phenomena. We investigated its efficacy in migraine.
Methods.
We studied 639 patients with migraine attacks in a randomized, double-blind, placebo-controlled, parallel-group clinical trial. We assessed the effect of subcutaneous injections of 6 or 8 mg of sumatriptan or placebo on the severity of headache and associated migraine symptoms 30, 60, and 120 minutes after treatment. Patients who were not free of pain after 60 minutes subsequently received placebo if they had initially received placebo or 8 mg of sumatriptan, and 6 mg of sumatriptan or placebo if they had initially received 6 mg of sumatriptan.
Results.
After 60 minutes, the severity of headache was decreased in 72 percent (95 percent confidence interval, 68 to 76 percent) of the 422 patients given 6 mg of sumatriptan, 79 percent (95 percent confidence interval, 71 to 87 percent) of the 109 patients given 8 mg of sumatriptan, and 25 percent (95 percent confidence interval, 17 to 33 percent) of the 105 patients given placebo (data on 3 patients could not be evaluated). As compared with the placebo group, 47 percent (95 percent confidence interval, 38 to 57 percent) more patients who had received 6 mg of sumatriptan and 54 percent (95 percent confidence interval, 43 to 65 percent) more patients who had received 8 mg of sumatriptan had a decrease in the severity of headache (P<0.001 for both comparisons). After 120 minutes, 86 to 92 percent of the 511 patients treated with sumatriptan (202 assigned to 6 mg plus placebo, 203 to 6 mg plus 6 mg, and 106 to 8 mg plus placebo) had improvement in the severity of headache, as compared with only 37 percent of the 104 patients who received placebo once or twice (P<0.001 for all comparisons). Twenty-one patients were excluded from the analysis because of missing data (19) or protocol violations (2). The response rates did not differ significantly among the sumatriptan regimens. Adverse events were minor and transient in all groups.
Conclusions.
We conclude that a single 6-mg dose of sumatriptan given subcutaneously is a highly effective, rapid-acting, and well-tolerated treatment for migraine attacks. The administration of a second dose 60 minutes later to patients not responding well to an initial dose affords little additional benefit. (N Engl J Med 1991; 325: 316–21.)
Media in This Article
Figure 1
Protocol for Treatment of Patients with Migraine Attacks with Sumatriptan (6 or 8 mg) or PlaceboFigure 2
Proportion of Patients Whose Headache Improved from Severe or Moderate Pain to Mild or No Pain (Open Bars) or to No Pain (Hatched Bars) 30 and 60 Minutes after Treatment with Placebo or 6 or 8 mg of Sumatriptan.Article Activity
- Article
MIGRAINE is a common disorder that can severely affect patients' quality of life and daily function. The patients typically have attacks of unilateral, pulsating, severe or moderately severe headache aggravated by routine physical activity and associated with anorexia, nausea, vomiting, photophobia, and phonophobia.1 The attacks may last from 4 to 72 hours and are sometimes preceded by transient focal neurologic symptoms (aura).1 Up to 15 percent of patients may have recurrent attacks.2 3 4 5 Current pharmacologic treatment is directed at acute symptomatic relief or involves prophylactic treatment to reduce the frequency of attacks. The efficacy of both types of treatment is poor, and they often produce unacceptable side effects.6 7 8 The remarkable variation in treatment strategies reflects the lack of clear superiority of any individual therapy.6 , 8
Serotonin (5-hydroxytryptamine) has a central role in the pathophysiology of migraine.9 Its metabolism is abnormal in patients with migraine,10 and intravenous administration of 5-hydroxytryptamine can alleviate migraine attacks.9 Antimigraine drugs share the ability to activate 5-hydroxytryptamine1 receptors.11 The headaches that are a prominent feature of migraine are believed to result from excessive dilatation of extracerebral cranial (dural or meningeal) arteries, arteriovenous shunts,11 or both; from neurogenic dural plasma extravasation12; or from a combination of these mechanisms.11 Sumatriptan (3-[2-(dimethylamino)ethyl]-N-methylindole-5-methanesulfonamide) is a novel selective agonist of 5–hydroxytryptamine1—like receptors that blocks these mechanisms.11 , 13 14 15 Preliminary clinical studies indicated that sumatriptan was an effective and well-tolerated treatment for migraine when given intravenously, subcutaneously, or orally.16 17 18 20 In migraine, the oral absorption of drugs is often limited by nausea and vomiting. Subcutaneous administration of sumatriptan, however, results in rapid attainment of peak plasma levels.17 A preliminary, dose-finding study indicated that doses of up to 8 mg were well tolerated and effective.19
Accordingly, we carried out a double-blind, placebo-controlled study to determine the efficacy and safety of sumatriptan in doses of 6 and 8 mg given subcutaneously. A comparison with placebo was chosen because there is no single, internationally accepted drug treatment for acute migraine. We also investigated whether a second 6-mg injection of sumatriptan after 60 minutes was of benefit to patients who did not respond adequately to the first 6-mg injection.
Methods
Selection of Patients
We recruited patients from our own patient populations or by referral from other clinicians. We included men and women 18 to 65 years of age who met the criteria of the International Headache Society's Headache Classification Committee for migraine either with aura (classic migraine) or without aura (common migraine)1 and who had at least a one-year history of migraine and a maximal frequency of six attacks per month. We excluded patients with a history of ischemic heart disease; peripheral vascular disease; renal, hepatic, or cardiac impairment; epilepsy; cerebral infarction; hypertension (blood pressure ≥160/95 mm Hg); or serious psychiatric illness, as well as women who were pregnant or not using adequate contraceptive measures. We also excluded patients who regularly required or abused opiate analgesic drugs, tranquilizers, ergot-containing drugs (≥10 mg per week), alcohol (>315 g per week), or other drugs. In addition, on the study day we excluded patients who had taken prophylaxis for migraine within 2 weeks, ergot-containing preparations within 24 hours, or simple analgesic or nonsteroidal antiinflammatory drugs within 6 hours.
Study Design and Treatments
The study was carried out between June and December 1989 in 58 hospital neurology departments, pain clinics, and physicians' offices in 10 countries. All patients underwent a prestudy evaluation to determine eligibility. They presented at the clinic at the time of a migraine attack; patients with moderate or severe headache (grade 2 or 3 on the rating scale described below) that had not begun to improve were assessed clinically and randomly assigned to receive a subcutaneous injection of placebo, 6 mg of sumatriptan, or 8 mg of sumatriptan (Fig. 1Figure 1
Protocol for Treatment of Patients with Migraine Attacks with Sumatriptan (6 or 8 mg) or Placebo). If after 60 minutes the patient was not completely free of pain, a second double-blind subcutaneous injection was given; patients treated initially with placebo or 8 mg of sumatriptan subsequently received placebo, whereas those treated initially with 6 mg of sumatriptan were randomly assigned to receive either 6 mg of sumatriptan or placebo. The patients remained at the clinic for at least 120 minutes after the first injection. If their symptoms had not improved by that time, they were then allowed to take their usual medication, which did not contain ergotamine or dihydroergotamine and which had been effective in the past (rescue medication). After two to five days, the patients returned to the clinic for a follow-up visit. The trial was conducted in accordance with the Declaration of Helsinki. Approval was obtained from the ethics committee in all facilities that had such a committee, and witnessed informed consent was obtained from each patient before the trial.Study Medication
Sumatriptan was supplied in ampules of isotonic saline solution containing 12 or 16 mg of sumatriptan base per milliliter as the succinate salt. Placebo was supplied in matching ampules containing isotonic saline solution.
Evaluation of Efficacy, Safety, and Tolerability
Headache is usually the most prominent and most disturbing feature of a migraine attack. The severity of headache was therefore used to assess clinical efficacy. For this purpose, the patients rated the severity of their headaches on a four-point scale: 0 for no pain, 1 for mild pain, 2 for moderate pain, and 3 for severe pain. In addition, they rated their level of functional disability: 0 if they were able to work or function normally, 1 if their ability to work was mildly impaired, 2 if their ability to work was severely impaired, and 3 if they required bed rest. The presence or absence of other symptoms (nausea, vomiting, photophobia, or phonophobia) and the use of rescue medication were also noted. At the follow-up visit the patients were asked whether the headache or other symptoms of the migraine attack had recurred within the 24 hours after treatment and for their opinion of the efficacy of the treatment (ineffective, poor, reasonable, good, or excellent). The primary end points for clinical efficacy were the relief of headache (from grade 3 or 2 to grade 1 or 0) 60 and 120 minutes after the first injection.
Heart rate, blood pressure, and electrocardiograms were recorded before and at 30-minute intervals after treatment for 120 minutes. Urinalysis (measurement of glucose, protein, blood, bilirubin, and urobilinogen) was done before treatment and at the follow-up visit. Blood biochemical and hematologic tests (measurements of bilirubin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, urea, creatinine, total protein, albumin, sodium, potassium, calcium, hemoglobin, red-cell counts, platelet counts, mean corpuscular volume, and total and differential white-cell counts) were done before treatment, 120 minutes after the first injection, and at follow-up. Adverse events were recorded for 24 hours after the first injection. These were defined as any untoward clinical sign or symptom that occurred or worsened after treatment and was observed by the physician or reported by the patient in response to the question: Have you had any medical problems during the study?
Power Calculations and Randomization
Data on 280 patients were required to detect a 15 percent difference in the rate of relief of headache between the combination of 6 mg of sumatriptan and placebo and two 6-mg injections of sumatriptan with 80 percent power, at the two-sided 5 percent significance level. After allowances were made for comparisons with placebo and 8 mg of sumatriptan and for patients who did not require a second injection, data on a total of 630 patients were required.
A computer-generated randomization code was used to assign patients in blocks of six. In each block one patient was assigned to the group given placebo plus placebo, one to the group given 8 mg of sumatriptan plus placebo, and two each to the group given 6 mg of sumatriptan plus placebo and the group given 6 mg plus 6 mg of sumatriptan. Complete blocks were assigned to centers, and patients were entered in ascending sequential order at each center.
Statistical Analysis
Improvement in the severity of headache, other symptoms, and clinical disability and the time to the resolution of headache were analyzed initially with the MantelHaenszel chi-square test without correction for continuity, and these results are presented. A subsequent analysis with correction for continuity yielded identical results. The homogeneity of treatment differences across countries was assessed with the Breslow—Day test. All analyses adjusting for country effects yielded results similar to those of the unadjusted analyses; therefore, only the results from the latter are presented. The incidence of adverse events was compared with either the MantelHaenszel test or Fisher's exact test, as appropriate.
Results
Patient Population
Six hundred thirty-nine patients (96 percent of whom were white) each received treatment for one attack. The number of patients in each treatment group is shown in Figure 1. The demographic and clinical characteristics of the patients and the details of the attacks treated are summarized in Table 1Table 1
Demographic and Clinical Characteristics of the Study Population and Details of Migraine Attacks Treated, According to the First Study Injection Given.; there were no important differences among the treatment groups at entry into the study.Deviations from the Protocol
Minor deviations from the protocol, considered unlikely to affect the response to the medication, occurred in 141 patients. These included pretreatment diastolic blood pressure above 95 mm Hg (n = 18); migraine prophylaxis within 14 days of the study (n = 15), more than six headaches per month (n = 15), failure to follow the dose schedule (mainly involving a delayed second injection) (n = 24), and failure to return for follow-up (n = 18). Three patients were excluded from all efficacy analyses because they had a pretreatment headache of less than grade 2 or had taken other medications before or during the study. Two other patients were excluded from all analyses after 60 minutes because at 60 minutes open-label treatment with sumatriptan was given erroneously. Some data were missing for 27 patients, who were omitted from the relevant analyses; data on the severity of headache at 120 minutes were missing for 19 of these patients. Accordingly, of the 639 patients treated as shown in Figure 1, data on the severity of headache could be evaluated for 636 patients at 60 minutes (Fig. 2Figure 2
Proportion of Patients Whose Headache Improved from Severe or Moderate Pain to Mild or No Pain (Open Bars) or to No Pain (Hatched Bars) 30 and 60 Minutes after Treatment with Placebo or 6 or 8 mg of Sumatriptan.) and for 615 patients at 120 minutes (Fig. 3Figure 3
Proportion of Patients Whose Headache Improved from Severe or Moderate Pain to Mild or No Pain (Open Bars) or to No Pain (Hatched Bars) 120 Minutes after Treatment).Efficacy
Headache Relief
Figure 2 shows the proportions of patients in whom the severity of headache pain improved from severe or moderate to mild or none and the proportion who were free of pain 30 and 60 minutes after treatment. As compared with the placebo group at 60 minutes, 47 percent more patients (95 percent confidence interval, 38 to 57 percent) who had received 6 mg of sumatriptan and 54 percent more patients (95 percent confidence interval, 43 to 65 percent) who had received 8 mg of sumatriptan had improvement in the severity of headache (P<0.001 for both comparisons). The difference in values between the group given 6 mg of sumatriptan and that given 8 mg was not significant. A complete resolution of pain also occurred in a significantly higher proportion of patients treated with either dose of sumatriptan than of patients given placebo (P<0.001).
After 120 minutes, 357 patients who had received two injections could be evaluated. At this time, 75 percent of the patients (83 of 110) treated with 6 mg of sumatriptan plus placebo had improvement in the severity of headache, as had 81 percent of the patients (86 of 106) treated with two 6-mg injections of sumatriptan, 82 percent of the patients (40 of 49) given 8 mg of sumatriptan plus placebo, and 30 percent of the patients (28 of 92) given two injections of placebo. The response rates for all sumatriptan regimens were significantly better than for the regimen consisting of placebo alone (P<0.001 for all three comparisons), but the rates for the drug regimens did not differ significantly from each other. Notably, the response to two 6-mg injections of sumatriptan was not significantly different from that for 6 mg of sumatriptan plus placebo (95 percent confidence interval for the difference, —5 to +17 percent).
Figure 3 shows the response rates for all 615 patients who could be evaluated 120 minutes after the first injection (intention-to-treat analysis), according to the treatment regimen to which they were assigned, whether or not the second injection was given. The response rates for the sumatriptan regimens did not differ significantly from each other, but were clearly superior to the regimen consisting of placebo alone. As compared with the rate for placebo alone, the mean difference was 50 percent (95 percent confidence interval, 39 to 60 percent) for 6 mg of sumatriptan plus placebo, 54 percent (95 percent confidence interval, 43 to 64 percent) for two 6-mg injections of sumatriptan, and 55 percent (95 percent confidence interval, 44 to 66 percent) for 8 mg of sumatriptan plus placebo (P<0.001 for all three comparisons).
Effect of Type of Migraine and Duration of Attack before Treatment
The patients who had auras before their headache and those who did not responded similarly to sumatriptan. The respective response rates at 60 minutes were 69 percent and 73 percent for those given 6 mg of sumatriptan, 83 percent and 77 percent for those given 8 mg of sumatriptan, and 26 percent and 24 percent for those given placebo. Likewise, patients treated early (within the first four hours after the onset of symptoms) and those treated later responded equally well to sumatriptan. After 60 minutes, the respective response rates were 75 percent and 71 percent for 6 mg of sumatriptan, 73 percent and 81 percent for 8 mg of sumatriptan, and 25 percent and 25 percent for placebo.
Nausea, Vomiting, Photophobia, and Phonophobia
Sumatriptan was significantly more effective than placebo in relieving nausea, vomiting, photophobia, and phonophobia. Before treatment, 95 percent of all patients had at least one of these symptoms; 60 minutes after the first injection, 68 to 78 percent of the sumatriptan-treated patients, as compared with 31 percent of those given placebo, no longer had any of the symptoms. By 120 minutes, 81 to 92 percent of the sumatriptan-treated patients had none of these symptoms, as compared with 51 percent of the placebo group.
Functional Disability
Treatment with sumatriptan markedly improved the patients' ability to function normally. Among the sumatriptan-treated patients, 45 percent were able to function normally 60 minutes after the first injection, and 61 to 78 percent after 120 minutes, as compared with 9 percent and 22 percent, respectively, of the patients given placebo alone (P<0.001 for all comparisons).
Need for Rescue Medication at 120 Minutes
Rescue medication was taken by 44 percent of the patients randomly assigned to receive placebo alone, but by only 8 to 12 percent of those assigned to any of the sumatriptan regimens (P<0.001 for all comparisons).
Recurrence of Headache
Table 2Table 2
Number of Patients with a Recurrence of Migraine Attacks within 24 Hours, According to Treatment Group. shows the numbers of patients who had a complete resolution of headache within 24 hours and the proportion in whom headache of any grade subsequently recurred. Thirty-four to 38 percent of the sumatriptan-treated patients reported a recurrence of headache, as compared with 18 percent of the patients given placebo (P<0.02 for all comparisons). The interval to recurrence was extremely variable but tended to be longer in the patients treated with sumatriptan than in those given placebo (Table 2).Patients' Opinion of Treatment
The treatment received was rated as good or excellent by 64 percent of the patients randomly assigned to receive 6 mg of sumatriptan plus placebo, by 73 percent of those assigned to receive two 6-mg injections of sumatriptan, and by 78 percent of those assigned to receive 8 mg of sumatriptan plus placebo, as compared with 26 percent of the patients assigned to receive two injections of placebo (P<0.001 for all comparisons).
Safety and Tolerability
About half the sumatriptan-treated patients in each dose group had adverse events, as compared with about one third of those who received only placebo. The most frequently occurring adverse events are shown in Table 3Table 3
Most Frequently Reported Adverse Events among Patients with Migraine Attacks Treated with Sumatriptan or Placebo.. All resolved spontaneously and were generally short-lived (10 to 30 minutes) and mild in nature.There were no consistent changes in heart rate, blood pressure, or any of the blood or urine measurements. Minor electrocardiographic changes (prolongation of the PR interval, isolated ventricular extrasystoles, P-wave shift, and T-wave changes) occurred in six patients given sumatriptan (2 percent) and in two given placebo (2 percent).
Discussion
In this study, sumatriptan rapidly relieved the headache and other symptoms of migraine attacks, irrespective of the type of migraine and the duration of symptoms before treatment. Thirty minutes after the first injection, about 50 percent of the patients had improvement in the severity of symptoms; more than 70 percent had improvement after 60 minutes, and more than 90 percent had improvement after 120 minutes. As compared with a single subcutaneous injection of 6 mg of sumatriptan, neither a single 8-mg dose nor a second 6-mg dose provided significant additional benefit.
The primary end point in the assessment of efficacy was chosen as improvement in the severity of headache from moderate or severe pain to mild or no pain. Such improvement was considered to represent a clinically relevant response, and the use of this measure avoided the difficulty some patients may have had in distinguishing between mild residual headache and the complete absence of pain. Nevertheless, the majority of the sumatriptan-treated patients did report complete resolution of the headache and other symptoms within 120 minutes of treatment.
We believe that the results of this study are applicable to day-to-day general medical practice, since the clinical and demographic characteristics of the study population (Table 1) were similar to those of most patients with migraine.21 , 22 The only exceptions may be that the entry criteria, study design, and study setting (treatment in the clinic) would tend to select patients with more severe and more frequent attacks and that patients with serious concomitant diseases were excluded.
The efficacy of sumatriptan compared very favorably with that of other drugs used in the treatment of acute migraine attacks.6 7 8 , 23 Furthermore, unlike other antimigraine drugs, such as ergotamine, that are considered to be effective only if given early in an attack,7 , 8 sumatriptan was also effective when given late. In addition, sumatriptan was well tolerated. Adverse events were mostly minor and transient, and the incidence and severity were not dose-related. A few patients had minor electrocardiographic changes, but the incidence of these was the same in the groups given sumatriptan and that given only placebo. Furthermore, such electrocardiographic changes have been observed during migraine attacks.24 25 26 We therefore think that they are unlikely to have a causal relation to sumatriptan treatment.
In this single-dose study, most patients rated treatment with sumatriptan as good or excellent, even though headache recurred in a significant proportion of them. The mechanism of recurrence is obscure at present, but it may be related to the relatively short plasma half-life of sumatriptan (about two hours). We conclude that 6 mg of sumatriptan given subcutaneously is an effective, rapid, and well-tolerated treatment for migraine attacks.
Address reprint requests to Dr. Michel D. Ferrari at the Department of Neurology, University Hospital, P.O. Box 9600, 2300 R C Leiden, the Netherlands.
*A complete listing of investigators is given in the Appendix.
Appendix
The members of the Publication Committee are as follows: Michel D. Ferrari, M.D. (chairman), Department of Neurology, University Hospital, Leiden, the Netherlands; Eldad Melamed, M.D., Department of Neurology, Beilinson Medical Centre, Petah Tikva, Israel; Marek J. Gawel, M.R.C.P.(U.K.), Sunnybrook Medical Centre, Toronto; Giuseppe Nappi, M.D., Ph.D., Istituto Neurologico, "C Mondino," Università di Pavia, Pavia, Italy; Volker Luben, M.D., Medizinisches Zentrum für Chirurgie, Anaesthesiologie und urologic, Klinikum der Justus-Liebig, Universität Giessen, Giessen, Germany; Christine Tranchant, M.D., Service de neurologie II, Centre hospitalier urbain de Strasbourg—Hôpital Centre, Strasbourg, France; and Stephen Donoghue, Ph.D., Jean Durham, B.Sc, Alison Pilgrim, B.M., D.Phil., and Michael J.B. Tansey, M.D., Glaxo Group Research Ltd., Greenford, Middlesex, United Kingdom.
The principal clinical investigators were as follows: Canada: M.J. Gawel, Toronto; R.F. Nelson, Ottawa, Ont.; F.G.H. Baillie, Hamilton, Ont.; D.C.N. Howse, Kingston, Ont.; A.F. Grunfeld, Montreal; J. Ducharme, Quebec; B.A. Anderson, Winnipeg, Man.; A.E. Goodridge, St. John's, Newf.; D.R. Montoya, Calgary, Alb.; and R.M. Sadler, Halifax, N.S.; Israel: A. Kuritzky, Petah Tikva; D. Harel, Haifa; Y. Goldhammer, Tel Hashomer; A. Reches, Jerusalem; and A.D. Korczyn, Tel Aviv; Finland: V.A. Laulumaa, Kuopio; and R.J. Salonen, Turku; France: P. Dano, Marseilles; C. Tranchant, Strasbourg; C. Ribot, Lyons; and N. Brion, Le Chesnay; United Kingdom: Y.M.A. Tai, Dudley; South Africa: D.V. Philcox, Cape Town; Italy: G.C. Manzoni, Parma; A. Agnoli and M. Giacovazzo, Rome; O. Albano, Bari; R. Di-Perri, Messina; F.F. Milone, Vicenza; M. Leandri, Genoa; G. Nappi, Pavia; F. Sicuteri, Florence; E. Sternieri, Modena; M. Del Zompo, Cagliari; Hungary: E. Csanda, Budapest; the Netherlands: M.D. Ferrari, Leiden; H.J.G. Kok, Den Helder; M.A.M. Bomhof, Breda; and J.W. Hartman and L.J.M.M. Mulder, Rotterdam; and Germany: J. Brand, Koenigsstein; A. Doenicke, V. Pfaffenrath, W. Paulus, and E. Siegel, Munich; M. Tryba, Bochum; V. Lueben, Giessen; H.D. Langohr, Fulda; R. Enkelmann, St. Goar am Rhein; J. Schimek, Giengen am Brenz; C. Riemasch-Becker, Wiesbaden; G. Sehhati-Chafai, Bremen; H.C. Niesel, Ludwigshafen; J. Eckart, Augsburg; H. Pistauer, Preetz; M. Moeckesch, Weinheim; H.U. Gerbershagen, Mainz; H.W. Scharafinski, Moers; and W. Faust, Schopfheim.
- References
References
1
Headache Classification Committee of the International Headache Society
CrossRef | Web of Science2
Ziegler DK. Epidemiology of migraine. In: Vinken PJ, Bruyn GW, Klawans HL, Rose FC, eds. Headache. Vol. 48 of Handbook of clinical neurology. Amsterdam: Elsevier Science, 1986:13–22.
3
Cook
Web of Science | Medline4
Linet
CrossRef | Web of Science | Medline5
Linet MS, Stewart WF. The epidemiology of migraine headache. In: Blau JN, ed. Migraine: clinical, therapeutic, conceptual and research aspects. London: Chapman & Hall, 1987:451–77.
6
Peatfield RC, Fozard JR, Rose FC. Drug treatment of migraine. In: Vinken PJ, Bruyn GW, Rose FC, eds. Headache. Vol. 48 of Handbook of clinical neurology. Amsterdam: Elsevier Science, 1986:173–216.
7
Perrin
CrossRef | Web of Science | Medline8
Thrush D. Does ergotamine work for migraine? In: Warlow C, Garfield J, eds. Dilemmas in the management of the neurological patient. Edinburgh, Scotland: Churchill Livingstone, 1984:106–14.
9
Lance
CrossRef | Web of Science | Medline10
Ferrari
Web of Science | Medline11
Saxena
CrossRef | Web of Science | Medline12
Moskowitz MA, Henrikson BM, Markowitz S, Saito K. Intra- and extracraniovascular nociceptive mechanisms and the pathogenesis of headpain. In: Olesen J, Edvinsson L, eds. Basic mechanism of headache. Amsterdam: Elsevier Science, 1988:429–37.
13
Humphrey
Web of Science | Medline14
Perren
Web of Science | Medline15
Buzzi
Web of Science | Medline16
Perrin
CrossRef | Web of Science | Medline17
Tfelt-Hansen
Web of Science | Medline18
Ferrari 19
Byer 20
Doenicke
CrossRef | Web of Science | Medline21
Lance
Web of Science | Medline22
Adult migraine: the patient observed. In: Blau JN, ed. Migraine: clinical, therapeutic, conceptual and research aspects. London: Chapman & Hall, 1987:3–30.
23
Callaham
CrossRef | Web of Science | Medline24
Leon-Sotomayor
CrossRef | Web of Science | Medline25
Perera
CrossRef | Web of Science | Medline26
Baborier
- Citing Articles (140)
Citing Articles
1
Christopher J Derry, Sheena Derry, R Andrew Moore, Maura Moore. 2012. Sumatriptan (subcutaneous route of administration) for acute migraine attacks in adults. .
CrossRef2
Andrew Blumenfeld, Chris Gennings, Roger Cady. (2012) Pharmacological Synergy: The Next Frontier on Therapeutic Advancement for Migraine. Headache: The Journal of Head and Face Painno-no
CrossRef3
Simon Akerman, Philip R. Holland, Peter J. Goadsby. (2011) Diencephalic and brainstem mechanisms in migraine. Nature Reviews Neuroscience 12:10, 570-584
CrossRef4
Peer Tfelt-Hansen. (2011) Optimal balance of efficacy and tolerability of oral triptans and telcagepant: a review and a clinical comment. The Journal of Headache and Pain 12:3, 275-280
CrossRef5
Peer C. Tfelt-Hansen, Peter J. Koehler. (2011) One Hundred Years of Migraine Research: Major Clinical and Scientific Observations From 1910 to 2010. Headache: The Journal of Head and Face Pain 51:5, 752-778
CrossRef6
Peer Tfelt-Hansen. (2011) Subcutaneous sumatriptan: results of a peculiar, unpublished, comparative, double-blind, randomised, and controlled trial. The Journal of Headache and Pain 12:2, 269-270
CrossRef7
Frederick G Freitag. (2011) Sumatriptan needle-free subcutaneous (Sumavel ® DosePro™) approved for the acute treatment of migraine, with or without aura, and cluster headaches. Expert Review of Neurotherapeutics 11:4, 481-490
CrossRef8
Anthony W. Fox. 2010. Publishing Clinical Studies. , 608-615.
CrossRef9
S. Evers, J. Áfra, A. Frese, P. J. Goadsby, M. Linde, A. May, P. S. S´ndor. 2010. Drug Treatment of Migraine. , 159-177.
CrossRef10
Gene M. Dubowchik, John E. Macor. 2010. Therapeutic Agents for the Treatment of Migraine. .
CrossRef11
Benjamin W. Friedman, Clemencia Solorzano, David Esses, Shujun Xia, Michael Hochberg, Niels Dua, Alan Heins, Paul Sasso, Polly E. Bijur, Richard B. Lipton, E. John Gallagher. (2010) Treating Headache Recurrence After Emergency Department Discharge: A Randomized Controlled Trial of Naproxen Versus Sumatriptan. Annals of Emergency Medicine 56:1, 7-17
CrossRef12
Peer Carsten Tfelt-Hansen. (2010) Does sumatriptan cross the blood–brain barrier in animals and man?. The Journal of Headache and Pain 11:1, 5-12
CrossRef13
Peer C. Tfelt-Hansen. (2009) Is there an inherent limit to the efficacy of calcitonin gene-related peptide receptor antagonists in the acute treatment of migraine? A comment. The Journal of Headache and Pain 10:6, 389-391
CrossRef14
Peer Tfelt-Hansen. (2009) What can be learned from the history of recurrence in migraine? A comment. The Journal of Headache and Pain 10:5, 311-315
CrossRef15
S. Evers, J. Áfra, A. Frese, P. J. Goadsby, M. Linde, A. May, P. S. Sándor. (2009) EFNS guideline on the drug treatment of migraine - revised report of an EFNS task force. European Journal of Neurology 16:9, 968-981
CrossRef16
Roger K. Cady, Morris Maizels, Dennis L. Reeves, Daniel M. Levinson, Judith K. Evans. (2009) Predictors of Adherence to Triptans: Factors of Sustained vs Lapsed Users. Headache: The Journal of Head and Face Pain 49:3, 386-394
CrossRef17
Benjamin Wolkin Friedman, Brian Mitchell Grosberg. (2009) Diagnosis and Management of the Primary Headache Disorders in the Emergency Department Setting. Emergency Medicine Clinics of North America 27:1, 71-87
CrossRef18
R. Corominas, M.J. Sobrido, M. Ribasés, E. Cuenca-León, P. Blanco-Arias, B. Narberhaus, M. Roig, R. Leira, J. López-González, A. Macaya, B. Cormand. (2009) Association study of the serotoninergic system in migraine in the spanish population. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 9999B, n/a-n/a
CrossRef19
L. C. Newman, R. K. Cady, S. Landy, P. O’Carroll, W. J. Kwong, S. P. Burch, A. C. Nelsen, S. A. McDonald. (2008) Treatment satisfaction and efficacy of the rapid release formulation of sumatriptan 100 mg tablets utilising an early intervention paradigm in patients previously unsatisfied with sumatriptan. International Journal of Clinical Practice 62:12, 1889-1899
CrossRef20
M. Gabriella Buzzi. (2007) Triptan efficacy in migraine attacks: from appropriate diagnosis to metabolic profiles and pharmacogenomics. Drug Development Research 68:6, 335-340
CrossRef21
Gary Hunter, José F. Téllez-Zenteno. (2007) Treatment of migraine in the emergency department. Drug Development Research 68:6, 360-368
CrossRef22
Patrick P.A. Humphrey. (2007) The Discovery of a New Drug Class for the Acute Treatment of Migraine. Headache: The Journal of Head and Face Pain 47:s1, S10-S19
CrossRef23
PJ Goadsby, DW Dodick, M Almas, H-C Diener, P Tfelt-Hansen, RB Lipton, B Parsons. (2007) Treatment-emergent CNS symptoms following triptan therapy are part of the attack. Cephalalgia 27:3, 254-262
CrossRef24
Paul Winner, James Adelman, Sheena Aurora, Michelle E. Lener, Michael Ames. (2006) Efficacy and tolerability of sumatriptan injection for the treatment of morning migraine: Two multicenter, prospective, randomized, double-blind, controlled studies in adults. Clinical Therapeutics 28:10, 1582-1591
CrossRef25
Malene Kirchmann. (2006) Migraine with aura: new understanding from clinical epidemiologic studies. Current Opinion in Neurology 19:3, 286-293
CrossRef26
, S. Evers, J. Afra, A. Frese, P. J. Goadsby, M. Linde, A. May, P. S. Sandor. (2006) EFNS guideline on the drug treatment of migraine - report of an EFNS task force. European Journal of Neurology 13:6, 560-572
CrossRef27
Natalie J. Wiendels, Michel D. Ferrari. (2006) Treating Migraine Attacks ASAP: Concept and Methodological Issues. Progress in Neurotherapeutics and Neuropsychopharmacology 1:01, 53
CrossRef28
Robert Kaniecki. (2006) Intercepting migraine: Results of early therapy with nonspecific and migraine-specific agents. Current Treatment Options in Neurology 8:1, 3-10
CrossRef29
Peter J. Goadsby, Roger Yates. (2006) Zolmitriptan Intranasal: A Review of the Pharmacokinetics and Clinical Efficacy. Headache: The Journal of Head and Face Pain 46:1, 138-149
CrossRef30
Timothy R. Smith, Abraham Sunshine, Stuart R. Stark, Diane E. Littlefield, Susan E. Spruill, W. James Alexander. (2005) Sumatriptan and Naproxen Sodium for the Acute Treatment of Migraine. Headache: The Journal of Head and Face Pain 45:8, 983-991
CrossRef31
Peter J. Goadsby. (2005) Can we Develop Neurally Acting Drugs for the Treatment of Migraine?. Nature Reviews Drug Discovery 4:9, 741-750
CrossRef32
Gretchen E. Tietjen, Kathy Athanas, Christine Utley, Nabeel A. Herial, Sadik A. Khuder. (2005) The Combination of Naratriptan and Prochlorperazine in Migraine Treatment. Headache: The Journal of Head and Face Pain 45:6, 751-753
CrossRef33
C Dahlof. (2005) Update on sumatriptan: new progress in migraine treatment. Therapy 2:3, 349-356
CrossRef34
Stephen H. Landy, Judy E. McGinnis, Susan A. McDonald. (2005) Pilot Study Evaluating Preference for 3-mg Versus 6-mg Subcutaneous Sumatriptan. Headache: The Journal of Head and Face Pain 45:4, 346-349
CrossRef35
Michel D. Ferrari. (2005) Should We Advise Patients to Treat Migraine Attacks Early: Methodologic Issues. European Neurology 53:1, 17-21
CrossRef36
MJ Levy, MS Matharu, R Bhola, K Meeran, PJ Goadsby. (2005) Octreotide is not effective in the acute treatment of migraine. Cephalalgia 25:1, 48-55
CrossRef37
MD Ferrari. (2004) Should we advise patients to treat migraine attacks early?. Cephalalgia 24:11, 915-917
CrossRef38
Astrid Nehlig. 2004. Caffeine and Headache. .
CrossRef39
Olesen, Jes, Diener, Hans-Christoph, Husstedt, Ingo W., Goadsby, Peter J., Hall, David, Meier, Ulrich, Pollentier, Stephane, Lesko, Lynna M., . (2004) Calcitonin Gene–Related Peptide Receptor Antagonist BIBN 4096 BS for the Acute Treatment of Migraine. New England Journal of Medicine 350:11, 1104-1110
Full Text40
Jonathan P Gladstone, David W Dodick. (2003) Current and emerging treatment options for migraine and other primary headache disorders. Expert Review of Neurotherapeutics 3:6, 845-872
CrossRef41
JESSE WEINBERGER, WILLIAM H. FRISHMAN, DAWN TERASHITA. (2003) Drug Therapy of Neurovascular Disease. Cardiology in Review 11:3, 122-146
CrossRef42
Fred Sheftell, Robert Ryan, Verne Pitman, for the Eletriptan Steering Committ. (2003) Efficacy, Safety, and Tolerability of Oral Eletriptan for Treatment of Acute Migraine: A Multicenter, Double-Blind, Placebo-Controlled Study Conducted in the United States. Headache: The Journal of Head and Face Pain 43:3, 202-213
CrossRef43
Dominik Utiger, Urs Eichenberger, Dirke Bernasch, Ralf W. Baumgartner, Peter Bärtsch. (2002) Transient Minor Improvement of High Altitude Headache by Sumatriptan. High Altitude Medicine & Biology 3:4, 387-393
CrossRef44
Virgilio Gallai, Paola Sarchielli, Andrea Alberti, Mauro Pedini, Beatrice Gallai, Cristiana Rossi, Elisabetta Cittadini, the Collaborative Group for the App. (2002) Application of the 1988 International Headache Society Diagnostic Criteria in Nine Italian Headache Centers using a Computerized Structured Record. Headache: The Journal of Head and Face Pain 42:10, 1016-1024
CrossRef45
MD Ferrari, PJ Goadsby, KI Roon, RB Lipton. (2002) Triptans (serotonin, 5-HT1B/1D agonists) in migraine: detailed results and methods of a meta-analysis of 53 trials. Cephalalgia 22:8, 633-658
CrossRef46
Hans-Christoph Diener. (2002) Stellenwert der Triptane in der Migränetherapie: Welche Triptane gibt es?. Pharmazie in unserer Zeit 31:5, 462-468
CrossRef47
M Fukuda, N Suzuki, S Maruyama, K Dobashi, A Kitamura, F Sakai. (2002) Effects of sumatriptan on cerebral blood flow under normo- and hypercapnia in rats. Cephalalgia 22:6, 468-473
CrossRef48
Michael Bjorn Russell, Vibeke Ulrich, Morten Gervil, Jes Olesen. (2002) Migraine Without Aura and Migraine With Aura Are Distinct Disorders. A Population-Based Twin Survey. Headache: The Journal of Head and Face Pain 42:5, 332-336
CrossRef49
Reijo Salonen, Andrew Scott. (2002) Triptans: Do they differ?. Current Pain and Headache Reports 6:2, 133-139
CrossRef50
Paul L. Durham, Andrew F. Russo. (2002) New insights into the molecular actions of serotonergic antimigraine drugs. Pharmacology & Therapeutics 94:1-2, 77-92
CrossRef51
José A. Terrón. (2002) Is the 5-HT7 receptor involved in the pathogenesis and prophylactic treatment of migraine?. European Journal of Pharmacology 439:1-3, 1-11
CrossRef52
Wood, Alastair J.J., , Goadsby, Peter J., Lipton, Richard B., Ferrari, Michel D., . (2002) Migraine — Current Understanding and Treatment. New England Journal of Medicine 346:4, 257-270
Full Text53
David W. Dodick, Stephen Silberstein, Carl G. H. Dahlof. (2002) Is There a Preferred Triptan?. Headache: The Journal of Head and Face Pain 42:1, 1-7
CrossRef54
Fred D. Sheftell, Stewart J. Tepper. (2002) New Paradigms in the Recognition and Acute Treatment of Migraine. Headache: The Journal of Head and Face Pain 42:1, 58-69
CrossRef55
Michel D Ferrari, Krista I Roon, Richard B Lipton, Peter J Goadsby. (2001) Oral triptans (serotonin 5-HT1B/1D agonists) in acute migraine treatment: a meta-analysis of 53 trials. The Lancet 358:9294, 1668-1675
CrossRef56
P. Burke-Ramirez, M. Asgharnejad, C. Webster, R. Davis, A. Laurenza. (2001) Efficacy and Tolerability of Subcutaneous Sumatriptan for Acute Migraine: A Comparison Between Ethnic Groups. Headache: The Journal of Head and Face Pain 41:9, 873-882
CrossRef57
Robert G. Kaniecki. (2001) Mixing Sumatriptan: A Prospective Study of Stratified Care Using Multiple Formulations. Headache: The Journal of Head and Face Pain 41:9, 862-866
CrossRef58
Christopher R Lines, Kristel Vandormael, William Malbecq. (2001) A comparison of visual analog scale and categorical ratings of headache pain in a randomized controlled clinical trial with migraine patients. Pain 93:2, 185-190
CrossRef59
Stewart J. Tepper. (2001) SAFETY AND RATIONAL USE OF THE TRIPTANS. Medical Clinics of North America 85:4, 959-970
CrossRef60
HC Diener, P Tfelt-Hansen, F de Beukelaar, MD Ferrari, J Olesen, C Dahlof, N Mathew7, . (2001) The efficacy and safety of sc Alniditan vs. sc Sumatriptan in the acute treatment of migraine: a randomized, double-blind, placebo-controlled trial. Cephalalgia 21:6, 672-679
CrossRef61
B Tom, P De Vries, JPC Heiligers, EW Willems, E Scalbert, P Delagrange, PR Saxena. (2001) The lack of vasoconstrictor effect of the pineal hormone melatonin in an animal model predictive of antimigraine activity. Cephalalgia 21:6, 656-663
CrossRef62
Olaf Hoffmann, Ulrich Dirnagl, Joerg R. Weber. (2001) The trigeminovascular system in bacterial meningitis. Microscopy Research and Technique 53:3, 188-192
CrossRef63
José A. Terrón, Isabelle Bouchelet, Edith Hamel. (2001) 5-HT7 receptor mRNA expression in human trigeminal ganglia. Neuroscience Letters 302:1, 9-12
CrossRef64
Ajay Gupta, A. David Rothner. (2001) Treatment of childhood headaches. Current Neurology and Neuroscience Reports 1:2, 144-154
CrossRef65
L. Newman, L.K. Mannix, S. Landy, S. Silberstein, R.B. Lipton, D.G. Pait Putnam, C. Watson, M. Jobsis, A. Batenhorst, S. O'Quinn. (2001) 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
CrossRef66
Seref Demirkaya, Okay Vural, Babur Dora, Mehmet Akif Topcuoglu. (2001) Efficacy of Intravenous Magnesium Sulfate in the Treatment of Acute Migraine Attacks. Headache: The Journal of Head and Face Pain 41:2, 171-177
CrossRef67
Roel A Ophoff, Arn M.J.M van den Maagdenberg, Krista I Roon, Michel D Ferrari, Rune R Frants. (2001) The impact of pharmacogenetics for migraine. European Journal of Pharmacology 413:1, 1-10
CrossRef68
P. Burke-Ramirez, M. Asgharnejad, C. Webster, R. Davis, A. Laurenza. (2001) Efficacy and Tolerability of Subcutaneous Sumatriptan for Acute Migraine: A Comparison Between Ethnic Groups. Headache: The Journal of Head and Face Pain 41:9, 873
CrossRef69
Robert G. Kaniecki. (2001) Mixing Sumatriptan: A Prospective Study of Stratified Care Using Multiple Formulations. Headache: The Journal of Head and Face Pain 41:9, 862
CrossRef70
Carl G. H. Dahlöf. (2001) Sumatriptan: Pharmacological Basis and Clinical Results. Current Medical Research and Opinion 17:s1, s35-45
CrossRef71
José A. Terrón. (2000) 2-(2-aminoethyl)-quinoline (D-1997): A Novel Agonist at Craniovascular 5-HT1 Receptors Relevant to Migraine Therapy. CNS Drug Reviews 6:4, 267-277
CrossRef72
Peter J Goadsby. (2000) The pharmacology of headache. Progress in Neurobiology 62:5, 509-525
CrossRef73
Hannele Havanka, Carl Dahlöf, Paul H.M. Pop, Hans-Christoph Diener, Paul Winter, Helen Whitehouse, Habib Hassani. (2000) Efficacy of naratriptan tablets in the acute treatment of migraine: A dose-ranging study. Clinical Therapeutics 22:8, 970-980
CrossRef74
E A Schulman, R K Cady, D Henry, A S Batenhorst, D G Putnam, C B Watson, S O O'Quinn. (2000) Effectiveness of sumatriptan in reducing productivity loss due to migraine: results of a randomized, double-blind, placebo-controlled clinical trial.. Mayo Clinic Proceedings 75:8, 782-789
CrossRef75
R. G. Roberts. (2000) Management of a septic patient with postdural puncture headache. Anaesthesia 55:7, 720-721
CrossRef76
Paul Gupta, Paul Butler, Nick B Shepperson, Aileen McHarg. (2000) The in vivo pharmacological profile of eletriptan (UK-116,044): a potent and novel 5-HT1B/1D receptor agonist. European Journal of Pharmacology 398:1, 73-81
CrossRef77
Neil Roy Connelly, Robert K. Parker, Armin Rahimi, Charles S. Gibson. (2000) Sumatriptan in Patients With Postdural Puncture Headache. Headache: The Journal of Head and Face Pain 40:4, 316-319
CrossRef78
Peter De Vries, Carlos M Villalón, Pramod R Saxena. (1999) Pharmacological aspects of experimental headache models in relation to acute antimigraine therapy. European Journal of Pharmacology 375:1-3, 61-74
CrossRef79
B.U.K. Li, Robert D. Murray, Leo A. Heitlinger, Jennifer L. Robbins, John R. Hayes. (1999) Is cyclic vomiting syndrome related to migraine?. The Journal of Pediatrics 134:5, 567-572
CrossRef80
Leon J. Warshaw, Richard B. Lipton, Stephen D. Silberstein. (1999) Migraine: A “Woman's Disease?”. Women & Health 28:2, 79-99
CrossRef81
Jeffrey A. Cohen, Donna Beall, Arne Beck, Julia Rawlings, David W. Miller, Bill Clements, D. Gayla Pait, Alice Batenhorst. (1999) Sumatriptan treatment for migraine in a health maintenance organization: Economic, humanistic, and clinical outcomes. Clinical Therapeutics 21:1, 190-204
CrossRef82
Leon J. Warshaw, Wayne N. Burton. (1998) Cutting the Costs of Migraine: Role of the Employee Health Unit. Journal of Occupational & Environmental Medicine 40:11, 943-953
CrossRef83
(1998) Migraines. Academic Emergency Medicine 5:9, 900-905
CrossRef84
Peter J. Goadsby, Karen L. Hoskin. (1998) Serotonin inhibits trigeminal nucleus activity evoked by craniovascular stimulation through a 5ht1b/1D receptor: A central action in migraine?. Annals of Neurology 43:6, 711-718
CrossRef85
Pramod R Saxena, Peter De Vries, Jan P.C Heiligers, Willem A Bax, Antoinette MaassenVanDenBrink, Frank D Yocca. (1998) BMS-181885, a 5-HT1B/1D receptor ligand, in experimental models predictive of antimigraine activity and coronary side-effect potential. European Journal of Pharmacology 351:3, 329-339
CrossRef86
Peter De Vries, Edwin W Willems, Jan P.C Heiligers, Carlos M Villalón, Pramod R Saxena. (1998) The antimigraine agent alniditan selectively constricts porcine carotid arteriovenous anastomoses via 5-HT1B/1D receptors. European Journal of Pharmacology 351:2, 193-201
CrossRef87
Lawrence C. Newman, Richard B. Lipton. (1998) EMERGENCY DEPARTMENT EVALUATION OF HEADACHE. Neurologic Clinics 16:2, 285-303
CrossRef88
Peter J. Goadsby, Yolande Knight. (1997) Inhibition of trigeminal neurones after intravenous administration of naratriptan through an action at 5-hydroxy-tryptamine (5-HT 1B/1D ) receptors. British Journal of Pharmacology 122:5, 918-922
CrossRef89
Alexander Mauskop, Jerome Goldstein. (1997) The role of 5HT1D-receptor agonists and magnesium in the treatment of migraine headache. Current Pain and Headache Reports 1:3, 246-250
CrossRef90
Ninan T. Mathew. (1997) SEROTONIN 1D (5-HT1D) AGONISTS AND OTHER AGENTS IN ACUTE MIGRAINE. Neurologic Clinics 15:1, 61-83
CrossRef91
David G. Sciberras, William J. Polvino, Barry J. Gertz, Haiyung Cheng, Michael Stepanavage, Johanna Wittreich, Timothy Olah, Mark Edwards, Timothy Mant. (1997) Initial human experience with MK-462 (rizatriptan): a novel 5=HTID agonist. British Journal of Clinical Pharmacology 43:1, 49-54
CrossRef92
David G. Sciberras, William J. Polvino, Barry J. Gertz, Haiyung Cheng, Michael Stepanavage, Johanna Wittreich, Timothy Olah, Mark Edwards, Timothy Mant. (1997) Initial human experience with MK-462 (rizatriptan): a novel 5=HT ID agonist. British Journal of Clinical Pharmacology 43:1, 49-54
CrossRef93
Burton L. Scott, Randolph W. Evans, Joseph Jankovic. (1996) Treatment of palatal myoclonus with sumatriptan. Movement Disorders 11:6, 748-751
CrossRef94
A. May, H.J. Gijsman, A. Wallno¨fer, R. Jones, H.C. Diener, M.D. Ferrari. (1996) Endothelin antagonist bosentan blocks neurogenic inflammation, but is not effective in aborting migraine attacks. Pain 67:2-3, 375-378
CrossRef95
Peter J. Goadsby, Karen L. Hoskin. (1996) Inhibition of trigeminal neurons by intravenous administration of the serotonin (5HT)1B/D receptor agonist zolmitriptan (311C90): are brain stem sites therapeutic target in migraine ?. Pain 67:2-3, 355-359
CrossRef96
W. Hester Visser, Jacobus Burggraaf, Linda M. Muller, Rik C. Schoemaker, Patricia A. Fowler, Adam F. Cohen, Michel D. Ferrari. (1996) Pharmacokinetic and pharmacodynamic profiles of sumatriptan in migraine patients with headache recurrence or no response*. Clinical Pharmacology & Therapeutics 60:4, 452-460
CrossRef97
Pramod R. Saxena, Peter De Vries, Jan P.C. Heiligers, Antoinette Maassen VanDenBrink, Willem A. Bax, Tjeerd Barf, Håkan Wikström. (1996) Investigations with GMC2021 in experimental models predictive of antimigraine activity and coronary side-effect potential. European Journal of Pharmacology 312:1, 53-62
CrossRef98
Leopold Schmetterer, Michael Wolzt, Kurt Krejcy, Ursula Graselli, Oliver Findl, Hans-Georg Eichler, Ernst A. Singer. (1996) Cerebral and ocular hemodynamic effects of sumatriptan in the nitroglycerin headache model. Clinical Pharmacology & Therapeutics 60:2, 199-205
CrossRef99
George R. Mushet, Roger K. Cady, C. Camak Baker, Bill Clements, Donna L. Gutterman, Randy Davis. (1996) Efficacy and tolerability of subcutaneous sumatriptan administered using the IMITREX® STATdose™ System. Clinical Therapeutics 18:4, 687-699
CrossRef100
V. Limmroth, A. May, P. Auerbach, G. Wosnitza, T. Eppe, H.C. Diener. (1996) Changes in cerebral blood flow velocity after treatment with sumatriptan or placebo and implications for the pathophysiology of migraine. Journal of the Neurological Sciences 138:1-2, 60-65
CrossRef101
Ena T. Lavelle, P. Williams, Timothy G. Dinan. (1996) Sumatriptan mediated growth hormone responses do not alter throughout the menstrual cycle. Human Psychopharmacology: Clinical and Experimental 11:2, 139-143
CrossRef102
J. Brennum, T. Brinck, L. Schriver, B. Wanscher, P. Soelberg Sørensen, P. Tfelt-Hansen, J. Olesen. (1996) Sumatriptan has no clinically relevant effect in the treatment of episodic tension-type headache. European Journal of Neurology 3:1, 23-28
CrossRef103
M. Leone, L. Grazzi, D. D'Amico, F. Moschiano, G. Bussone. (1995) A review of the treatment of primary headaches. Part I: Migraine. The Italian Journal of Neurological Sciences 16:8, 577-586
CrossRef104
Anne-Maree Kelly, Michael G Bryant, Steven Zebic. (1995) The emergency department management of migraine. Emergency Medicine 7:3, 162-169
CrossRef105
Thuan T.T. Dao, James P. Lund, Guy Rémillard, Gilles J. Lavigne. (1995) Is myofascial pain of the temporal muscles relieved by oral sumatriptan? A cross-over pilot study. Pain 62:2, 241-244
CrossRef106
Alan Currie, Ann Ryman, R. Hamish McAllister-Williams. (1995) Exacerbation of migraine with paroxetine: Case report. Human Psychopharmacology: Clinical and Experimental 10:4, 349-350
CrossRef107
Marcello Fanciullacci, Riccardo Sicuteri, Massimo Alessandri, Pierangelo Geppetti. (1995) Buspirone, but not sumatriptan, induces miosis in humans: Relevance for a serotoninergic pupil control*. Clinical Pharmacology & Therapeutics 57:3, 349-355
CrossRef108
M.D. Ferrari, P.R. Saxena. (1995) 5-HT1 receptors in migraine pathophysiology and treatment. European Journal of Neurology 2:1, 5-21
CrossRef109
Stefan Evers, Ingo-Wilhelm Husstedt, Annette Enbergs. (1995) Coronary angiography in migraine patient after subcutaneous sumatriptan. The Lancet 345:8943, 198
CrossRef110
Judith M. Hall, Pierangelo Geppetti. (1995) Kinins and kinin receptors in the nervous system. Neurochemistry International 26:1, 17-26
CrossRef111
J Olesen, B.K. Rasmussen. (1995) Classification of primary headaches. Biomedicine & Pharmacotherapy 49:10, 446-451
CrossRef112
Kusum L Kumar. (1994) Recent advances in the acute management of migraine and cluster headaches. Journal of General Internal Medicine 9:6, 339-348
CrossRef113
Donald M. Yealy. (1994) Acute Pain Management. Academic Emergency Medicine 1:2, 186-189
CrossRef114
Fabio Facchinetti, Rossella E. Nappi, Grazia Sances, Loredana Fioroni, Giuseppe Nappi, Andrea R. Genazzani. (1994) The neuroendocrine effects of sumatriptan, a specific ligand for 5-HT 1 -like receptors. Clinical Endocrinology 40:2, 211-214
CrossRef115
R. Salonen, E. Ashford, C. Dahl
f, R. Dawson, N. E. Gilhus, V. L
CrossRef116
Joanne Shay, Judit Futo, Nancy Badrov, Jonathan Moss. (1994) Estrogen withdrawal selectively increases serotonin reactivity in rabbit basilar artery. Life Sciences 55:13, 1071-1081
CrossRef117
J DEKEYSER, G VAUQUELIN, J DEBACKER, H DEVOS, N WILCZAK. (1993) What intracranial tissues in humans contain sumatriptan-sensitive serotonin 5-HT1-type receptors?. Neuroscience Letters 164:1-2, 63-66
CrossRef118
Wood, Alastair J.J., , Welch, K.M.A.. (1993) Drug Therapy of Migraine. New England Journal of Medicine 329:20, 1476-1483
Full Text119
Won Suk Lee, Michael A. Moskowitz. (1993) Conformationally restricted sumatriptan analogues, CP-122,288 and CP-122,638 exhibit enhanced potency against neurogenic inflammation in dura mater. Brain Research 626:1-2, 303-305
CrossRef120
Edith Hamel, Lyne Grégoire, Benjamin Lau. (1993) 5-HT1 receptors mediating contraction in bovine cerebral arteries: a model for human cerebrovascular ‘5-HT1Dβ‘ receptors. European Journal of Pharmacology 242:1, 75-82
CrossRef121
M. G. BOUSSER, H. D'ALLENS, A. RICHARD, . (1993) Efficacy of subcutaneous sumatriptan in the acute treatment of early-morning migraine: a placebo-controlled trial. Journal of Internal Medicine 234:2, 211-216
CrossRef122
A.H. Chester, G.S. O'Neil, M.H. Yacoub, WillemA. Bax, PramodR. Saxena. (1993) Sumatriptan and ischaemic heart disease. The Lancet 341:8857, 1419-1420
CrossRef123
Jack Klapper. (1993) The pharmacologic treatment of acute migraine headaches. Journal of Pain and Symptom Management 8:3, 140-147
CrossRef124
Michel D. Ferrari, Pramod R. Saxena. (1993) Clinical and experimental effects of sumatriptan in humans. Trends in Pharmacological Sciences 14:4, 129-133
CrossRef125
I. JANSEN, J. OLESEN, L. EDVINSSON. (1993) 5-Hydroxytryptamine receptor characterizations of human cerebral, middle meningeal and temporal arteries: regional differences. Acta Physiologica Scandinavica 147:2, 141-150
CrossRef126
M.J.B. Tansey, A.J. Pilgrim, K. Lloyd. (1993) Sumatriptan in the acute treatment of migraine. Journal of the Neurological Sciences 114:1, 109-116
CrossRef127
George M. Anderson. (1993) Reviewing the Role of Serotonin in Disruptive Behavior. Journal of Child and Adolescent Psychopharmacology 3:1, vii-ix
CrossRef128
Peter J. Goadsby, Lars Edvinsson. (1993) The trigeminovascular system and migraine: Studies characterizing cerebrovascular and neuropeptide changes seen in humans and cats. Annals of Neurology 33:1, 48-56
CrossRef129
D.N. Bateman. (1993) Sumatriptan. The Lancet 341:8839, 221-224
CrossRef130
Pramod R. Saxena, Jan P.C. Heiligers, Carlos M. Villalón, Michel D. Ferrari. (1992) Effects of tertatolol, a β-adrenoceptor antagonist with agonist affinity at 5-HT1A receptors, in an animal model of migraine: comparison with propranolol and pindolol. European Journal of Pharmacology 220:1, 79-86
CrossRef131
Gilman, Sid, . (1992) Advances in Neurology. New England Journal of Medicine 326:24, 1608-1616
Full Text132
J.N Blau. (1992) Migraine: theories of pathogenesis. The Lancet 339:8803, 1202-1207
CrossRef133
Carl Dahlöf. (1992) Headache recurrence after subcutaneous sumatriptan. The Lancet 339:8790, 425-426
CrossRef134
Judit Futo, Joanne Shay, Spencer Block, John Holt, Michael Beach, Jonathan Moss. (1992) Estrogen and progesterone withdrawal increases cerebral vasoreactivity to serotonin in rabbit basilar artery. Life Sciences 50:16, 1165-1172
CrossRef135
Michael A. Moskowitz. (1992) Neurogenic versus vascular mechanisms of sumatriptan and ergot alkaloids in migraine. Trends in Pharmacological Sciences 13, 307-311
CrossRef136
(1992) Sumatriptan, serotonin, migraine, and money. The Lancet 339:8786, 151-152
CrossRef137
Constantin Ionescu-Tirgovisti, Simion Pruna. (1991) Peripheral sympathetic activity during a migraine attack. The Lancet 338:8774, 1084-1085
CrossRef138
Raskin, Neil H., . (1991) Serotonin Receptors and Headache. New England Journal of Medicine 325:5, 353-354
Full Text139
(1991) Treatment of Acute Cluster Headache with Sumatriptan. New England Journal of Medicine 325:5, 322-326
Full Text140
Patrick P.A. Humphrey, Wasyl Feniuk. (1991) Mode of action of the anti-migraine drug sumatriptan. Trends in Pharmacological Sciences 12, 444-446
CrossRef
