Evaluation of the use of sumatriptan-naproxen sodium for menstrual migraine and dysmenorrhea

Evaluation of: Cady RK, Diamond ML, Diamond MP et al. Sumatriptan-naproxen sodium for menstrual migraine and dysmenorrhea: satisfaction, productivity, and functional disability outcomes. Headache 51(5), 664-673 (2011). Menstrual migraine (MM) is a form of headache that tends to occur with prolonged, intense and extremely disabling attacks in a short period around the menstrual cycle (usually 2 days before to 3 days after the onset of the menstrual flow). At least 50% of the female migraine population suffers from this subtype of migraine. The possible presence of other perimenstrual pain, such as dysmenorrhea, can make the attacks even more disabling. Since both of these conditions have a common pathological background consisting of a secretion of abnormally high levels of prostaglandins, it can be particularly useful to use a combination of sumatriptan, the progenitor of the triptans and the drug of choice in the treatment of migraine attack, and naproxen sodium, a potent inhibitor of prostaglandin biosynthesis. The combination of sumatriptan 85 mg and naproxen sodium 500 mg has been tested in women suffering from MM and dysmenorrhea, and this combination has been shown to achieve greater satisfaction when compared with placebo. Moreover, sumatriptan-naproxen was also better than placebo in reducing functional disability and improving productivity. The study is discussed in the context of the current state of knowledge about MM treatment.