Page last updated: 2024-10-24

butalbital and Tension-Type Headache

butalbital has been researched along with Tension-Type Headache in 3 studies

butalbital: management of butalbital withdrawal can be simplified by using a phenobarbital-loading protocol; RN given refers to parent cpd
butalbital : A member of the class of barbiturates that is barbituric acid in which the hydrogens at position 5 are substituted by an allyl group and an isobutyl group. Frequently combined with other medicines, such as aspirin, paracetamol and codeine, it is used for treatment of pain and headache.

Tension-Type Headache: A common primary headache disorder, characterized by a dull, non-pulsatile, diffuse, band-like (or vice-like) PAIN of mild to moderate intensity in the HEAD; SCALP; or NECK. The subtypes are classified by frequency and severity of symptoms. There is no clear cause even though it has been associated with MUSCLE CONTRACTION and stress. (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1)

Research Excerpts

ExcerptRelevanceReference
"In the United States analgesic-overuse headache is often caused by butalbital-containing analgesics."4.81Should butalbital-containing analgesics be banned? Yes. ( Siow, HC; Young, WB, 2002)
"Over 28 million people suffer with migraine, yet this illness is less than optimally diagnosed and managed."2.41Do butalbital-containing products have a role in the management of migraine? ( Sarvis, CA; Wenzel, RG, 2002)

Research

Studies (3)

TimeframeStudies, this research(%)All Research%
pre-19900 (0.00)18.7374
1990's0 (0.00)18.2507
2000's3 (100.00)29.6817
2010's0 (0.00)24.3611
2020's0 (0.00)2.80

Authors

AuthorsStudies
Wenzel, RG1
Sarvis, CA1
Solomon, S1
Young, WB1
Siow, HC1

Clinical Trials (1)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
A Randomized, Double-blind, Double-dummy, Placebo-controlled, Crossover Study to Evaluate the Efficacy of TREXIMET® (Sumatriptan + Naproxen Sodium) vs. Butalbital-containing Combination Medications for the Acute Treatment of Migraine When Administered Dur[NCT00573170]Phase 3375 participants (Actual)Interventional2008-02-29Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

Bothersomeness-of-side Effect Subscore as Measured by the Revised Patient Perception of Migraine (PPMQ-R) Questionnaire 24 Hours After Taking Study Medication

The PPMQ-R questionnaire was used to assess participant satisfaction with migraine medication; the answers are used to generate a total score and 4 subscales scores for efficacy, functionality, ease-of-use and bothersomeness-of-side effects. The total score was calculated as the average of the efficacy, functionality and ease-of-use subscores. Subscores could range from 0 to 100; higher scores indicate greater satisfaction. (NCT00573170)
Timeframe: At 24 hours after dosing for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionscores on a scale (Mean)
Placebo88
Treximet86
Butalbital-containing Combination Medication89

Ease-of-Use Subscore as Measured by the Revised Patient Perception of Migraine (PPMQ-R) Questionnaire 24 Hours After Taking Study Medication

The PPMQ-R questionnaire was used to assess participant satisfaction with migraine medication; the answers are used to generate a total score and 4 subscales scores for efficacy, functionality, ease-of-use and bothersomeness-of-side effects. The total score was calculated as the average of the efficacy, functionality and ease-of-use subscores. Subscores could range from 0 to 100; higher scores indicate greater satisfaction. (NCT00573170)
Timeframe: At 24 hours after dosing for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionscores on a scale (Mean)
Placebo79
Treximet82
Butalbital-containing Combination Medication78

Efficacy Subscore as Measured by the Revised Patient Perception of Migraine (PPMQ-R) Questionnaire 24 Hours After Treating a Migraine

The PPMQ-R questionnaire was used to assess participant satisfaction with migraine medication; the answers are used to generate a total score and 4 subscales scores for efficacy, functionality, ease-of-use and bothersomeness-of-side effects. The total score was calculated as the average of the efficacy, functionality and ease-of-use subscores. Subscores could range from 0 to 100; higher scores indicate greater satisfaction. (NCT00573170)
Timeframe: At 24 hours after dosing for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionscores on a scale (Mean)
Placebo55
Treximet62
Butalbital-containing Combination Medication56

Functionality Subscore as Measured by the Revised Patient Perception of Migraine (PPMQ-R) Questionnaire 24 Hours After Taking Study Medication

The PPMQ-R questionnaire was used to assess participant satisfaction with migraine medication; the answers are used to generate a total score and 4 subscales scores for efficacy, functionality, ease-of-use and bothersomeness-of-side effects. The total score was calculated as the average of the efficacy, functionality and ease-of-use subscores. Subscores could range from 0 to 100; higher scores indicate greater satisfaction. (NCT00573170)
Timeframe: At 24 hours after dosing for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionscores on a scale (Mean)
Placebo55
Treximet61
Butalbital-containing Combination Medication56

Mean Time to First Use of Rescue Medication for the First Attack Treated With Study Medication (Attack 1)

Average time until participants took any medication to treat their migraine pain or symptoms within 48 hours after they took the first dose of study medication (placebo, Treximet, or butalbital-containing combination medication) for the first migraine attack treated. Participants were asked not to take rescue for at least 2 hours after they took the study medication (placebo, Treximet, or butalbital-containing combination medication) for that attack. Participants took rescue medication if they felt they needed it. (NCT00573170)
Timeframe: From dose time through 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionhours (Mean)
Placebo12.00
Treximet17.07
Butalbital-containing Combination Medication20.15

Mean Time to First Use of Rescue Medication for the Second Attack Treated With Study Medication (Attack 2)

Average time until participants took any medication to treat their migraine pain or symptoms within 48 hours after they took the first dose of study medication (placebo, Treximet, or butalbital-containing combination medication) for their second migraine attack treated in the study. Participants were asked not to take rescue for at least 2 hours after they took the study medication (placebo, Treximet, or butalbital-containing combination medication) for that attack. Participants took rescue medication if they felt they needed it. (NCT00573170)
Timeframe: From dose time through 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionhours (Mean)
Placebo8.29
Treximet20.90
Butalbital-containing Combination Medication16.70

Mean Time to First Use of Rescue Medication for the Third Attack Treated With Study Medication (Attack 3)

Average time until participants took any medication to treat their migraine pain or symptoms within 48 hours after they took the first dose of study medication (placebo, Treximet, or butalbital-containing combination medication) for their third migraine attack treated in the study. Participants were asked not to take rescue for at least 2 hours after they took the study medication (placebo, Treximet, or butalbital-containing combination medication) for that attack. Participants took rescue medication if they felt they needed it. (NCT00573170)
Timeframe: From dose time through 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionhours (Mean)
Placebo6.69
Treximet20.77
Butalbital-containing Combination Medication9.44

Number of Participants With a Sustained Pain-free (SPF) Response From 2 to 24 Hours Post-dose

SPF 2-24 hours is defined for all participants as having no pain at 2 hours post-dose and without the return of any pain or the use of any rescue medication (any medication taken after the first dose of study medication for any migraine pain or symptoms) from 2-24 hours. (NCT00573170)
Timeframe: From 2 to 24 hours post-dose. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionparticipants (Number)
Placebo10
Treximet26
Butalbital-containing Combination Medication18

Total PPMQ-R Score as Measured With the Revised Patient Perception of Migraine (PPMQ-R) Questionnaire 24 Hours After Taking Study Medication

The PPMQ-R questionnaire was used to assess participant satisfaction with migraine medication; the answers are used to generate a total score and 4 subscales scores for efficacy, functionality, ease-of-use and bothersomeness-of-side effects. The total score was calculated as the average of the efficacy, functionality and ease-of-use subscores. Subscores could range from 0 to 100; higher scores indicate greater satisfaction. (NCT00573170)
Timeframe: At 24 hours after dosing for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

Interventionscores on a scale (Mean)
Placebo63
Treximet68
Butalbital-containing Combination Medication63

"Numbers of Participants Able to Engage in Normal Activities Not Impaired at Time of Dosing and 2, 4, 6, and 8 Hours After Dosing as Assessed by the CDQ (Clinical Disability Questionnaire)"

"Clinical disability for each participant was assessed using the CDQ. This scale uses one question to assess ability to perform normal or usual activities. Responses are recorded on a 5-point scale, where 1 is normal/not impaired, 2 is mildly impaired, 3 is moderately impaired, 4 is severely impaired, and 5 is 'required bedrest." (NCT00573170)
Timeframe: At dosing and at 2, 4, 6 and 8 hours after dosing of each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
At dose time2 hours4 hours6 hours8 hours
Butalbital-containing Combination Medication1029506060
Placebo919597677
Treximet833627783

Mean Performance Index (PI) Scores at Time of Dosing and at 2, 4, 6, 8, 24 and 48 Hours After Dosing

Overall cognition was assessed with a composite score (range 0-9) called the Performance Index, as derived from the number of correct responses per minute on subtests of the Mental Efficiency Workload Test (MEWT) cognitive battery. For a particular participant, lower scores indicate a negative impact, or worsened, general cognition; higher scores indicate improved cognition. (NCT00573170)
Timeframe: At time of dosing, and at 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionscores on a scale (Mean)
Dose time2 hours4 hours6 hours8 hours24 hours48 hours
Butalbital-containing Combination Medication7.307.277.387.347.337.617.69
Placebo7.367.337.447.387.457.667.78
Treximet7.297.377.507.437.337.827.88

Mean Stanford Sleepiness (SS) Scale Scores at Time of Dosing and at 2, 4, 6, 8, 24 and 48 Hours After Dosing

"Participant alertness was evaluated with the 7-point modified SS scale, where 1 is feeling active, vital, alert, wide awake, 2 is still functioning at high levels, but not peak; able to concentrate, 3 is awake, but relaxed; responsive but not fully alert, 4 is somewhat foggy, let down, 5 is foggy, losing interest in remaining awake, 6 is sleepy, woozy, fighting sleep, prefer to lie down, and 7 is no longer fighting sleep, sleep onset soon, having dream like thoughts." (NCT00573170)
Timeframe: Dose time, 2, 4, 6, 8, 24 and 48 hours post-dose. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionunits on a scale (Mean)
Dose time, n=318, 316, 3042 hours, n=275, 268, 2514 hours, n=249, 240, 2346 hours, n=215, 219, 2108 hours, n=195, 195, 18624 hours, n=252, 258, 24148 hours, n=215, 240, 218
Butalbital-containing Combination Medication4.003.883.913.823.912.782.60
Placebo3.943.883.753.783.852.732.56
Treximet3.973.873.673.753.812.802.72

Number of Participants Using Rescue Medication Within 48 Hours Post Dose

Number of participants who took any medication to treat their migraine pain or symptoms within 48 hours after they took the first dose of study medication (placebo, Treximet, or butalbital-containing combination medication) for that attack. Participants were asked not to take rescue for at least 2 hours after they took the study medication (placebo, Treximet, or butalbital-containing combination medication) for that attack. Participants took rescue medication if they felt they needed it. (NCT00573170)
Timeframe: From dose time through 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
Use of 1st rescue < 2 hours post-doseUse of 1st rescue (investigational medication)Use of 2nd rescue (investigational medication)Use of other rescue (not investigational med.)
Butalbital-containing Combination Medication252031218
Placebo252341146
Treximet19158795

Number of Participants Who Reported a Complete Symptom-Free Response at 2, 4, 6, 8, 24 and 48 Hours After Dosing

Complete symptom-free is defined as migraine-free, neck pain-free, and sinus pain-free without the use of any rescue medication prior to the defined time point. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hours4 hours6 hours8 hours24 hours48 hours
Butalbital-containing Combination Medication213638387462
Placebo131927294347
Treximet296867689586

Number of Participants With a Migraine-free Response 2-48 Hours After Dosing

Migraine-free is defined as pain-free with no migraine-associated symptoms (nausea, vomiting, photophobia [sensitivity to light], and phonophobia [sensitivity to sound]) with use of any rescue medication before the defined time point. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hours4 hours6 hours8 hours24 hours48 hours
Butalbital-containing Combination Medication223739407565
Placebo142028294648
Treximet3374707310190

Number of Participants With a Pain-free Response From 2 to 48 Hours Post-dose

Pain-Free is defined as having no pain and without the use of any rescue medication from the time of the initial dose of study medication for a particular migraine attack until the defined time point at 2, 4, 6, 8, 24 or 48 hours post-dose. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hours post-dose4 hours post-dose6 hours post-dose8 hours post-dose24 hours post-dose48 hours post-dose
Butalbital-containing Combination Medication263940427866
Placebo162129304851
Treximet4586787910493

Number of Participants With Pain Relief at 2, 4, 6, 8, 24 and 48 Hours After Dosing Moderate or Severe Baseline Pain

Pain relief is defined as having no or mild pain and no use of rescue medication after dosing in those participants who had moderate or severe pain at dosing. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hours post-dose4 hours post-dose6 hours post-dose8 hours post-dose24 hours post-dose48 hours post-dose
Butalbital-containing Combination Medication1149066618871
Placebo765148466254
Treximet1481241079712799

Number of Participants With Pain-freedom and Relief of Nausea at 2, 4, 6, 8, 24 and 48 Post-dose Time Points

The number of participants with no pain and relief of nausea in those participants for whom nausea was present at dose time. Participants using rescue medication were removed from the participants with relief group for all subsequent timed assessments, regardless of pain and associated symptom evaluations at the specified time point. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hrs post-dose4 hrs post-dose6 hrs post-dose8 hrs post-dose24 hrs post-dose48 hrs post-dose
Butalbital-containing Combination Medication88893028
Placebo56891520
Treximet132832293941

Number of Participants With Pain-freedom and Relief of Phonophobia at 2, 4, 6, 8, 24 and 48 Post-dose Time Points

The number of participants with no pain and relief of phonophobia in those participants for whom phonophobia was present at dose time. Participants using rescue medication were removed from the participants with relief group for all subsequent timed assessments, regardless of pain and associated symptom evaluations at the specified time point. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hrs post-dose4 hrs post-dose6 hrs post-dose8 hrs post-dose24 hrs post-dose48 hrs post-dose
Butalbital-containing Combination Medication152430306152
Placebo111521213334
Treximet255749577971

Number of Participants With Pain-freedom and Relief of Photophobia at 2, 4, 6, 8, 24 and 48 Post-dose Time Points

The number of participants with no pain and relief of photophobia in those participants for whom photophobia was present at dose time. Participants using rescue medication were removed from the participants with relief group for all subsequent timed assessments, regardless of pain and associated symptom evaluations at the specified time point. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hrs post-dose4 hrs post-dose6 hrs post-dose8 hrs post-dose24 hrs post-dose48 hrs post-dose
Butalbital-containing Combination Medication162327322420
Placebo111622213538
Treximet306454618481

Number of Participants With Pain-freedom and Relief of Vomiting at 2, 4, 6, 8, 24 and 48 Hours Post-dose

The number of participants with no pain and relief of vomiting in those participants for whom vomiting was present at dose time. Participants using rescue medication were removed from the participants with relief group for all subsequent timed assessments, regardless of pain and associated symptom evaluations at the specified time point. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hrs post-dose4 hrs post-dose6 hrs post-dose8 hrs post-dose24 hrs post-dose48 hrs post-dose
Butalbital-containing Combination Medication001132
Placebo111033
Treximet012132

Number of Participants With Relief From Neck Pain at 2, 4, 6, 8, 24 and 48 Hours After Dosing Who Also Had the Symptom at Baseline

The number of participants with no pain and relief of neck pain in those participants for whom neck pain was present at dose time. Participants using rescue medication were removed from the participants with relief group for all subsequent timed assessments, regardless of pain and associated symptom evaluations at the specified time point. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hrs post-dose4 hrs post-dose6 hrs post-dose8 hrs post-dose24 hrs post-dose48 hrs post-dose
Butalbital-containing Combination Medication142219294437
Placebo4712162026
Treximet194339385146

Number of Participants With Relief From Sinus/Facial Pain at 2, 4, 6, 8, 24 and 48 Hours After Dosing in Those Who Also Had the Symptom at Dosing

The number of participants with no pain and relief of sinus/facial pain in those participants for whom sinus/facial pain was present at dose time. Participants using rescue medication were removed from the participants with relief group for all subsequent timed assessments, regardless of pain and associated symptom evaluations at the specified time point. (NCT00573170)
Timeframe: At 2, 4, 6, 8, 24, and 48 hours post-dose for each attack treated with study medication. All 3 migraine attacks were to have been treated within 19 weeks of randomization (when study medication was dispensed).

,,
Interventionparticipants (Number)
2 hrs post-dose4 hrs post-dose6 hrs post-dose8 hrs post-dose24 hrs post-dose48 hrs post-dose
Butalbital-containing Combination Medication91715163024
Placebo541081315
Treximet143529283840

Reviews

3 reviews available for butalbital and Tension-Type Headache

ArticleYear
Do butalbital-containing products have a role in the management of migraine?
    Pharmacotherapy, 2002, Volume: 22, Issue:8

    Topics: Analgesics; Barbiturates; Drug Combinations; Drug Utilization; Humans; Migraine Disorders; Practice

2002
Butalbital-containing agents: should they be banned? No.
    Current pain and headache reports, 2002, Volume: 6, Issue:2

    Topics: Barbiturates; Controlled Clinical Trials as Topic; Drug Therapy, Combination; Humans; Legislation, D

2002
Should butalbital-containing analgesics be banned? Yes.
    Current pain and headache reports, 2002, Volume: 6, Issue:2

    Topics: Barbiturates; Headache; Humans; Legislation, Drug; Tension-Type Headache

2002