is the excessive and inadequately justified concern about potential risks of triptans. We evaluated causes and consequences of non-use of triptans in chronic migraine.
Observational study with case-control design. We included chronic migraine patients firstly referred to a headache unit. Patients were cases if they were triptan naïve and controls if they had used triptans. We analyzed if non-use of triptans was justified by formal contraindications or adverse events. We assessed if triptan naïve patients had higher frequency of vascular risk factors, contraceptive drugs or older age.
We included 941 patients. Triptan users were 247 (26.2%). Triptans had been discontinued due to adverse events in 116 patients (12.3%), so 578 patients (61.4%) were triptan naïve. Formal contraindications were found in 23 patients (2.4%). Frequency of vascular risk factors, contraceptive drugs or age did not differ between the groups (p>0.1). Triptan users used symptomatic medication fewer days/month (13.9 vs 17.1, p<0.001), more prior prophylactic treatment (79.4% vs 34.8%, p<0.001) and presented symptomatic medication overuse less frequently (55.1% vs. 63.0%, p=0.03).
Three-quarters of chronic migraine patients did not use triptans. Non-use of triptans was not justified by intolerability, frequency of contraindications or frequency of vascular risk factors.