4/15/2010 Aspirin a good option for treating mig…

Aspirin A Good Option For Treating Migraines | Life And

Style | BMJ Group

The humble aspirin is often underestimated, but it can be a potent pain reliever for migraine
sufferers, working as well as a low-dose prescription drug for migraine. When taken at a high
dose (up to 1000 milligrams), aspirin reduces migraine pain within two hours for more than
half of the people who take it, according to new review of studies.

What do we know already?

Some 6 million people in the UK get migraines. The pain of these headaches can last for
several days, often accompanied by nausea and unpleasant sensitivity to light or sound. More
than half of the people who get migraines can't work or study, and need to lie down in a dark
room, during an attack. The World Health Organization rates migraines as one of the most
disabling long-term conditions you can have.

But many people don't see a doctor about their migraines, so don't have access to
prescription medicines. One of the most popular over-the-counter remedies is aspirin, which
can be taken as tablets or dissolved in water (effervescent aspirin). Aspirin is also sometimes
combined with other medicines for migraines, such as paracetamol, caffeine, and anti-nausea
drugs.

Many studies have found that aspirin can relieve migraine symptoms, but detailed reviews of
these studies have been lacking. Researchers have now taken a close look at the best of this
research to see what conclusions they can draw. They also pooled the studies' results to get a
clearer idea of just how well aspirin works.

What does the new study say?

Aspirin alone or with an anti-nausea drug called metoclopramide worked just as well for
migraines as 50 milligrams of a prescription drug for migraine called sumatriptan. However, a
100 mg dose of sumatriptan was slightly more likely to completely relieve pain after two
hours than aspirin plus metoclopramide.

Roughly 1 in 2 people (52 percent) who took a single dose of aspirin rated their pain as
having improved to mild or better within two hours. And 1 in 4 people (24 percent) said that
their pain had completely gone.

In comparison, only 1 in 3 people (32 percent) who took a dummy treatment (a placebo) said
their pain had improved to mild or better, and 1 in 10 (11 percent) reported that their pain
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had gone.

People who took aspirin were also more likely to see improvements in other migraine
symptoms, such as nausea and sensitivity to light or sound. And those who took an anti-
nausea drug called metoclopramide along with aspirin had greater relief from feeling sick than
those who just took aspirin.

All the people in the studies had moderate to severe migraine pain before treatment, and
neither the participants nor the researchers knew whether each person had been give an
active treatment or a placebo. The doses of aspirin used in the studies ranged from 900 mg to
1000 mg.

How reliable are the findings?

These findings should be quite reliable, as they are based on the best type of studies, called
randomised controlled trials (RCTs). In total, the researchers looked at 13 RCTs with 4,222
people who had moderate to severe migraines.

However, these findings don't entirely reflect how aspirin is used for migraines in real life.
For example, many people take aspirin (or another treatment) when they first get migraine
symptoms, well before their pain becomes moderate or severe. Some research suggests that
taking painkillers early works better than waiting until the pain gets worse.

Also, these studies didn't look at what happens when people frequently take aspirin for
migraines. It's well-known that aspirin can irritate the stomach, so it's possible that frequent
use might lead to stomach problems. We also need more research into how aspirin compares
with other migraine treatments, both prescription and over-the-counter.

Where does the study come from?

This review of studies was done by researchers at the University of Oxford. It was published
in the Cochrane Library by the Cochrane Collaboration, an international organisation that
evaluates medical research.

What does this mean for me?

If you get migraines, the low cost and easy availability of aspirin may make it an appealing
treatment option. And this research shows that aspirin works well for many people and may
completely relieve your symptoms. If you get nausea along with migraine pain, taking aspirin
plus metoclopramide may be a better option than taking aspirin on its own. However, this
combination is only available on prescription.
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But bear in mind that aspirin doesn't work for everyone. Also, children under 16 shouldn't
take aspirin for migraines or any other condition, as it can cause a dangerous problem called
Reye's syndrome.

What should I do now?

It's best to see your GP if you get migraines. By taking a close look at your symptoms,
including your headache frequency and severity, your doctor can help you decide on your
best treatment options, both prescription and over the counter. Your doctor can also help you
identify things that might be triggering your migraines, and possibly prescribe treatments to
help prevent these headaches.

From:
Kirthi V, Derry S, Moore RA, et al. Aspirin with or without an antiemetic for acute migraine
headaches in adults (Cochrane review). In: The Cochrane Library. Wiley, Chichester, UK.

To learn more, see our information on migraines in adults.

© BMJ Publishing Group Limited ("BMJ Group") 2010

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