Treating migraine: The case for aspirin
High-dose aspirin is an effective treatment for acute migraine. So why aren’t more physicians recommending it?
WHAT'S NEW?: A reminder of aspirin's efficacy in treating migraine
The update of this meta-analysis confirms that high-dose aspirin (900-1000 mg) is an effective treatment for migraine headache in adults between the ages of 18 and 65 years. The addition of metoclopramide reduces nausea and vomiting, but offers little if any benefit for headache/pain relief.
CAVEATS: Lack of comparison with other treatments
Data were insufficient to compare the efficacy of aspirin with zolmitriptan, other nonsteroidal anti-inflammatory drugs alone, or acetaminophen plus codeine. Aspirin should be used with caution in patients with chronic renal disease and/or a history of peptic ulcer disease.
CHALLENGES TO IMPLEMENTATION: Patients want a prescription
Patients often expect a prescription when they visit a physician with complaints of migraine headache and may feel shortchanged if they’re told to take an aspirin. Providing a prescription for the antiemetic metoclopramide, as well as a brief explanation of the evidence indicating that aspirin is effective for migraine, may adequately address such expectations.
Acknowledgement
The PURLs Surveillance System was supported in part by Grant Number UL1RR024999 from the National Center for Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.
