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Controversies in Neurology
September 2001

What Matters Is Not the Differences Between Triptans, but the Differences Between Patients

Author Affiliations

From the Michigan Head Pain and Neurological Institute, Ann Arbor.

 

JOHN N.WHITAKERMD

Arch Neurol. 2001;58(9):1481-1482. doi:10.1001/archneur.58.9.1481

DON'T CONFUSE me with the facts, scientific or otherwise. Not all that matters always matters. This is particularly true with headache, where what seems to matter most are variables that we do not understand, are not easily identified, and have not been studied. Headache is a condition in which over 30% of the afflicted respond to placebo; patients with nearly identical symptoms respond to entirely different treatments; and pill color and patient confidence may be more important than such factors as the area under the curve, recurrence rates, time-to-peak value, and others.1,2 It is an illness in which a magical treatment for one patient serves to worsen the identical condition in another.

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