Single Dose of Aspirin Effective Treating Migraine

A single 1,000-mg dose of aspirin is a positive treatment against acute migraine headaches for more than half of the people who take it, according to a new literature review.

Researchers at the John Radcliffe Hospital (Oxford, United Kingdom) searched through the Cochrane Central, Medline, Embase, and the Oxford Pain Relief databases for studies through March 10, 2010, that compared aspirin (alone or in combination) and metoclopramide or other active comparators in treating acute migraine. The 13 selected studies, which included 4,222 participants, were randomized, double blind, placebo-controlled, or active-controlled; evaluated the use of aspirin to treat a single migraine headache episode; and included at least 10 participants per treatment group.

The researchers found that a single 1,000-mg dose of aspirin reduced pain from moderate or severe to no pain by two hours in 24% of people, compared to only 11% in those taking placebo. Severe or moderate pain was reduced to no worse than mild pain by two hours in 52% taking aspirin, compared to 32% with placebo; and the headache relief at two hours was sustained for 24 hours more often with aspirin. The researchers also found that aspirin reduced associated symptoms of nausea, vomiting, photophobia, and phonophobia when compared with placebo; and metoclopramide, when combined with the aspirin, significantly reduced nausea and vomiting compared to aspirin alone, although it had minimal effect on pain. Fewer participants taking aspirin needed rescue medication, but adverse events were reported more often with aspirin than placebo, although mostly mild and transient. The findings were published online on April 14, 2010, in the Cochrane Database of Systematic Reviews.

"Aspirin plus metoclopramide will be a reasonable therapy for acute migraine attacks, but for many it will be insufficiently effective,” said review coauthor R. Andrew Moore, D.Sc. "We are presently working on reviews of other OTC [over-the-counter] medicines for migraines, to provide consumers with the best available evidence on treatments that don't need a prescription.”

Migraine headache occurs in approximately 12% of individuals living in Western countries, according to the researchers. Women may be three times more likely to have migraine compared to men, and it is most common between the ages of 30 and 50 years. Nearly all patients with migraine headaches use medications to treat acute pain and although there are many options for abortive therapy for migraine, simple OTC analgesics could have a significant role in treatment.

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