Consultant. Vol. 43 No. 2

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When Are OTC Analgesics Appropriate for Acute Migraine?

By SEYMOUR DIAMOND, MD and RICHARD WENZEL, PharmD | February 1, 2003

Diamond Headache Clinic, Chicago

Dr Diamond is founder and director of the Diamond Headache Clinic and director of the Diamond Inpatient Headache Unit at St Joseph Hospital, both in Chicago. He is also adjunct professor of cellular and molecular pharmacology and clinical professor of family medicine at Finch University of Health Sciences/The Chicago Medical School in North Chicago. Dr Wenzel is a pharmacist at the Diamond Inpatient Headache Unit and adjunct professor at the University of Illinois--Chicago College of Pharmacy.

THE CASE:
A 34-year-old woman complains of headaches that interfere with work. Her first headache episode, approximately 6 years earlier, was relatively mild. Initially, she experienced attacks only once every 3 to 4 months and managed them effectively with over-the-counter (OTC) agents. However, in the last 6 months the attacks have become more frequent—they occur at least twice a month—and are so severe that she misses work. The patient takes acetaminophen, ibuprofen(Drug information on ibuprofen), or the combination of acetaminophen, aspirin(Drug information on aspirin), and caffeine(Drug information on caffeine) for her headaches. She has increased her use of OTC agents to at least 2 or 3 days a week in anticipation of attacks. Results of physical and other examinations are otherwise normal. A diagnosis of migraine without aura, according to International Headache Society criteria, is made.

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When Are OTC Analgesics Appropriate for Acute Migraine?

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