To the Editor.
— Cady et al1 presented a large and well-designed study of an exciting new drug, sumatriptan, for the treatment of migraine attacks. While the data concerning early relief were truly impressive, the authors largely neglected the problem of recurrences of migraine, and they reviewed the existing therapies for migraine in such a negative way as to suggest ignorance or bad judgment.In the sumatriptan group, 20% of patients received rescue medication in the clinic after 2 hours, and 61% received it within 24 hours. In the placebo-treated group, the percentages were 59% at 2 hours and 88% at 24 hours. It is therefore clear from the data presented that more than half of the sumatriptan-treated patients did not feel sufficient relief within 24 hours. Since initial relief was good, this later failure was most likely due to the recurrence of migraine. Initially, successful treatment of migraine
Tfelt-Hansen P, Iversen HK, Olesen J. Subcutaneous Sumatriptan in Acute Migraine. JAMA. 1991;266(19):2703. doi:10.1001/jama.1991.03470190051021