Treatment of severe, disabling migraine attacks in an over-the-counter population of migraine sufferers: results from three randomized, placebo-controlled studies of the combination of acetaminophen, aspirin, and caffeine

Cephalalgia. 1999 Sep;19(7):684-91. doi: 10.1046/j.1468-2982.1999.019007684.x.

Abstract

Objective: To examine the benefits of acetaminophen, aspirin, and caffeine (AAC) in the treatment of severe, disabling migraine attacks, in a population of migraine sufferers for whom over-the-counter (OTC) medications are appropriate.

Background: Subjects (n = 1220) who met the International Headache Society criteria for migraine with or without aura were included in three independent clinical studies.

Design/methods: Post-hoc analysis of 172 subjects who met the criteria for severe, disabling migraine reported a history of migraine attacks characterized by at least severe pain and severe disability, and treated attacks with severe pain and at least severe disability. Subjects who usually vomited with 20% or more of their migraine attacks, and those with incapacitating disability (subjects who required bed rest for more than 50% of their attacks) were not eligible for enrollment.

Results: From 1 h and continuing through 6 h postdose, the proportion of responders was significantly greater (p< or =0.01) for AAC than placebo. The pain intensity difference from baseline was significantly greater (p< or =0.05) for AAC than placebo from 0.5 h through 6 h. The proportion of subjects reporting improvement in functional disability, photophobia, and phonophobia was significantly greater for AAC than placebo from 2 h through 6 h postdose.

Conclusions: The nonprescription combination of AAC was well tolerated and effective.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetaminophen / administration & dosage
  • Acetaminophen / therapeutic use*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aspirin / administration & dosage
  • Aspirin / therapeutic use*
  • Caffeine / administration & dosage
  • Caffeine / therapeutic use*
  • Double-Blind Method
  • Drug Combinations
  • Drug Utilization
  • Female
  • Humans
  • Hyperacusis / drug therapy
  • Hyperacusis / etiology
  • Male
  • Middle Aged
  • Migraine Disorders / drug therapy*
  • Nausea / drug therapy
  • Nausea / etiology
  • Nonprescription Drugs / therapeutic use*
  • Photophobia / drug therapy
  • Photophobia / etiology
  • Severity of Illness Index

Substances

  • Drug Combinations
  • Nonprescription Drugs
  • Acetaminophen
  • Caffeine
  • Aspirin