Clinical Presentation
The suboptimal response to current treatments in some patients might be linked to persistent trigeminal vascular activation, highlighting the need for innovative treatment approaches [PMID:20430313].
Management
Novel formulations such as needle-free injectable sumatriptan, effervescent diclofenac, and orally inhaled dihydroergotamine have demonstrated faster and more complete relief, potentially addressing patient dissatisfaction with current treatments [PMID:20430313].
Patients often seek faster and more complete symptom relief, and novel treatment modalities like needle-free injectable sumatriptan and inhaled dihydroergotamine may improve patient satisfaction and treatment adherence [PMID:20430313].
In a study using MEMS to objectively measure compliance, once-daily (od) treatment was associated with a used-on-schedule rate more than double those of multiple daily dosing regimens (bd or tds), though overall compliance remained suboptimal at 66% [PMID:9601625].
Objective compliance assessment via MEMS revealed an average compliance rate of 66% among patients prescribed migraine prophylaxis, highlighting the critical issue of noncompliance [PMID:9601625].
Key Recommendations
The study suggests that multiple daily dosing (bd or tds) is associated with lower compliance rates compared to once-daily dosing, potentially undermining the efficacy of migraine prophylaxis [PMID:9601625]. (Evidence: Moderate)
References
1 Silberstein SD. Meeting acute migraine treatment needs through novel treatment formulations. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 2010. link 2 Mulleners WM, Whitmarsh TE, Steiner TJ. Noncompliance may render migraine prophylaxis useless, but once-daily regimens are better. Cephalalgia : an international journal of headache 1998. link
2 papers cited of 3 indexed.