Chapter

WHO essential medicines list: A comment on the migraine part of it

Peer Tfelt-Hansen

in Headache care, research and education worldwide

Published on behalf of Oxford University Press

Published in print May 2010 | ISBN: 9780199584680
Published online November 2012 | e-ISBN: 9780191753435 | DOI: http://dx.doi.org/10.1093/med/9780199584680.003.018

Series: Frontiers in Headache Research Series

WHO essential medicines list: A comment on the migraine part of it

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The introduction of sumatriptan—the first triptan (5-HT1B/1D receptor agonist—in the early 1990s, after an extensive trial programme in the acute treatment of migraine, was considered a revolution. Each of the subsequent triptans also underwent an extensive trial programme to find the right dose and comparison with sumatriptan, the standard drug of this new class of medicines. Sumatriptan has been used to treat in excess of 700 million migraine attacks and based on this large use, the evidence from the triptan trial programmes and the fact that sumatriptan became generic in Europe from May 2006, the Global Campaign, Lifting the Burden of Headache, suggested in 2006 that sumatriptan 50 mg should be included on the List of Essential Medicines of the World Health Organization (WHO).

It was argued by WHO that 50 to 100 mg of sumatriptan is no better than aspirin in randomized clinical trials, and WHO is correct. However, the clinical impression by headache experts is that triptans are more effective than the Over-The-Counter (OTC) drugs.

What is the current use of triptans? In Denmark and United Kingdom only 10% to 15% of migraine patients use a triptan. Only 27% of the migraine patients in Denmark have contact with a physician concerning their migraine and can thus get prescription drugs for migraine therapy. The rest of the migraine patients have to manage with OTC drugs.

Chapter.  2405 words. 

Subjects: Neurology ; Public Health and Epidemiology

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