VANCOUVER, B.C. – At least half of migraine patients who are given a prescription for a medication to abort their attacks wait too long to take their medication, making it less likely to be effective, Roger K. Cady, M.D., reported at the annual meeting of the American Headache Society.
In a pharmacy-based study of migraineurs, 49% of patients with severe migraines and 51% of patients with moderate migraines said they waited more than 2 hours after the onset of the most recent headache before taking the medication, which was either rizatriptan or another oral nontriptan, said Dr. Cady, director of the Headache Care Center, Springfield, Mo.
“You tell patients to treat early, but you really have no idea what that means to them,” Dr. Cady commented.
Rizatriptan is considered to provide effective relief only 35% of the time if a patient waits 2 hours, he said in an interview. “They set themselves up for failure.”
The most common reason that patients gave for delaying their treatment was to see if their headache really was a migraine. Overall, 86% of the study patients had other headaches as well as migraine.
This is probably unrealistic thinking on the patient's part, Dr. Cady commented. Most migraineurs are familiar with their migraines and the signs of an impending migraine.
Patients who had migraines for less than 3 years were one and a half times more likely to delay using the medication than those who had a longer history of migraine, he said.
Other reasons given for delay were wanting to rely on medication only for a severe attack (reported by 46% of those who delayed), having concerns about side effects (37%), having concerns that the drug would become less effective if taken too often (34%), having concerns about becoming dependent (29%), facing limits on supply from the provider (15%), and being worried about cost (9%). Also, 3% of the patients said they had been instructed by their physicians not to take the medication too early.