Rapoport et al listed a number of criteria that can be used to evaluate the effectiveness of triptan therapy for a patient with migraine. This can help to identify a patient who may benefit from a change to a different triptan or to another medication. The authors are from Columbia University, New England Center for Headache, Yale University, Albert Einstein College of Medicien and New York Medical College.


Patient selection: migraine


May Need to Change If

time to onset of a beneficial effect

> 45 minutes

time to reach maximal effect

> 2 hours

percent of headache that remains once peak effect has been reached

> 20%

adverse effects

bothersome to patient

percent of headaches that recur or worsen within 24 hours

> 20%

time to recurrence of headache

rapid (< 10 hours)

percent of doses that result in a sustained, pain-free response, withut need for further medication

< 50% of the time

percent of doses that do not work well for the patient

> 33%


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