aspirin--butalbital-and-caffeine-drug-combination and Migraine-Disorders

The aim of this study was to examine efficacy and tolerability of eletriptan in patients switched from barbiturate-containing combinations (Fiorinal), Fioricet. Migraineurs (n = 160) meeting IHS criteria, with unsatisfactory response in the past year to butalbital-containing combinations, treated up to 16 attacks over 3 months with eletriptan 40 mg. Assessments included headache response and pain-free rates and functional impairment at baseline and 2 h postdose, and global ratings of treatment satisfaction at 24 h. At 2 h postdose, average headache response and pain-free rates were 71% (95% CI, 69-74%) and 37% (95% CI, 35-40%), respectively; 68.5% of patients (95% CI, 65-72%) reported functional response. Within-patient analysis found no efficacy diminution over time (no tolerance). Average headache recurrence rate was 20% (95% CI, 18-23%). Eletriptan was well-tolerated; 6 (3.7%) patients discontinued due to adverse events. There were no serious treatment-related adverse events. We conclude that in poor responders to butalbital-caffeine combinations, switching to eletriptan 40 mg was well-tolerated and efficacious.

Topics: Acetaminophen; Adolescent; Adult; Analgesics; Aspirin; Barbiturates; Caffeine; Drug Combinations; Female; Humans; Indoles; Male; Middle Aged; Migraine Disorders; Patient Satisfaction; Pyrrolidines; Quality of Life; Serotonin Receptor Agonists; Treatment Outcome; Tryptamines

This report describes an acute organic brain syndrome with a fugue-like state in association with antimigraine pharmacotherapy. The differential diagnosis of: 1. possible psychotoxic effects of the combination of propranolol, imipramine, and butalbital; 2. confusional migraine with amnesia; and 3. psychogenic dissociation is considered. Although organically induced dissociative states are of clinical, neuropsychological and medico-legal significance, the DSM-III and DSM-III-R have specific categories only for dissociative conditions that are strictly psychogenic in origin.

Topics: Adolescent; Analgesics; Aspirin; Barbiturates; Caffeine; Dissociative Disorders; Drug Combinations; Drug Therapy, Combination; Female; Humans; Imipramine; Migraine Disorders; Phenacetin; Substance-Related Disorders

Topics: Analgesics; Aspirin; Barbiturates; Caffeine; Cluster Headache; Drug Combinations; Ergotamine; Headache; Humans; Methylamines; Migraine Disorders; Parasympatholytics; Phenacetin; Temporomandibular Joint Dysfunction Syndrome