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Ibuprofen is Effective for Half of Migraine Patients


If you suffer with migraine, what medication do you take and find to be effective? Chances are about 50-50 that you use over-the-counter (OTC) ibuprofen to treat your migraine pain, according to a new Cochrane review.

Ibuprofen is an inexpensive, effective migraine treatment

The National Migraine Association reports that 36 million Americans suffer from migraine, and the condition affects women three times more often than men. The National Headache Foundation notes that less than half of people with migraine get a diagnosis from their healthcare provider, and in some cases it is misdiagnosed as tension-type headache or sinus headache.

A new review published by The Cochrane Collaboration reveals that 49 percent of people with migraine take OTC drugs as the only treatment for their pain and experience pain relief within two hours of dosing. A typical migraine attack can last between four and 72 hours, and less than 10 percent of sufferers can work or function normally during an attack. Migraines are also often accompanied by nausea, vomiting, and an increased sensitivity to light and sound.

The Cochrane review also noted that only 20 percent of migraine sufferers use prescription medications and that 29 percent of patients use both OTC and prescription drugs.

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According to review co-author Sheena Derry of the Pain Research and Nuffield Department of Anaesthetics at the University of Oxford, the study of was undertaken to determine whether ibuprofen is an effective treatment for migraine, and whether taking an antiemetic for nausea was an improvement over taking ibuprofen alone.

Prescription drugs for treatment of migraine pain, which include narcotic analgesics such as codeine, Fiorinal® with codeine, and Demerol®, affect the central nervous system and alter a patient’s perception of pain. Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit blood vessel inflammation. NSAIDs are associated with gastrointestinal problems, while prescription pain killers have side effects that include drowsiness, dizziness, dry mouth, nausea, and vomiting.

The review evaluated nine studies that included 4,373 adults who had a diagnosis of migraine. Overall, 414 individuals took 200 mg of ibuprofen, 1,615 took 400 mg, 208 took 600 mg, and 1,127 received a placebo. Twenty-six percent of patients who took 400 mg achieved a pain-free state within two hours, compared with 20 percent who took only 200 mg and 11 percent who took placebo. During the same period, 57 percent who took 400 mg of ibuprofen said their pain had decreased from moderate or severe to “no worse than mild” compared with 25 percent taking placebo.

The researchers also found that nausea and other symptoms that often accompany migraines decreased within two hours and that fewer patients who took ibuprofen needed to take other medications for these symptoms compared with patients who took placebo.

Although ibuprofen may not be effective for everyone, “for those who experience these outcomes, ibuprofen is a useful, inexpensive and readily available treatment,” noted Derry. Migraine sufferers who do not get relief from ibuprofen can try alternative treatments, including the narcotics mentioned, and possibly even natural complementary approaches such as feverfew, butterbur, magnesium, or magnetic stimulation.

National Headache Foundation
National Migraine Association
Rabbie R et al. The Cochrane Database of Systematic Reviews 2010 (10)