We thank Maizels for his letter. We agree that our results cannot be generalized to the most severely disabled segment of patients with migraine. We deliberately excluded those migraine sufferers whose attacks usually required bed rest or who vomited 20% or more of the time to define a migraine population for whom nonprescription medication would be most appropriate. We estimate that the most severely disabled segment of migraine sufferers who was excluded from our studies encompasses about 30% of the overall migraine population. These patient selection criteria were stressed in the abstract, "Patients and Methods" section, and in the "Comment" section to be sure that readers would understand our design and the reasons for it. We thank Maizels for reemphasizing this key point.
Lipton RB, Stewart WF, Ryan RE, Saper J, Silberstein S, Sheftell F. Limitations of Acetaminophen, Aspirin, and Caffeine in Alleviating Migraine—Reply. Arch Neurol. 1998;55(12):1590. doi: