Acute Migraine Treatment With Intranasal Sumatriptan Linked to Taste Disturbance

bad taste
bad taste
Intranasal administration of sumatriptan allows for dual absorption in the nasal cavity and the intestines.

Although intranasal sumatriptan demonstrates superior headache relief over placebo in acute migraine attacks, administration of the agent is also associated with a 6-fold increased risk for taste disturbance, according to results of a recent systematic review and meta-analysis published in Neurological Sciences.

Researchers included data from 16 randomized controlled trials (n=5925). The overall effect-estimate demonstrated that intranasal sumatriptan was significantly superior to placebo for pain relief (risk ratio [RR] 1.70; 95% CI, 1.31-2.21; P <.0001) and headache relief (RR 1.58; 95% CI, 1.35-1.84; P <.00001) at 2 hours. Although sumatriptan was significantly more effective for headache relief at 30 minutes compared with placebo (RR 1.31; 95% CI, 1.08-1.59; P =.005), no statistically significant difference was observed between the 2 groups with respect to the overall RR of pain-free participants 30 minutes after treatment (RR 1.18; 95% CI, 0.49-2.88; P =.71).

Further analysis showed that although higher doses of sumatriptan resulted in shorter time to headache relief compared with placebo, they also correlated with a greater incidence of adverse events, notably taste disturbance (RR 6.87; 95% CI, 3.76-12.54; P <.00001).  

Overall, the researchers concluded that the use of intranasal sumatriptan is an effective treatment for patients with acute migraine attacks; however, future investigations are needed to better understand differences in routes of administration and other therapies for migraine.

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Menshawy A, Ahmed H, Ismail A, et al. Intranasal sumatriptan for acute migraine attacks: a systematic review and meta-analysis [published online September 23, 2017]. Neurol Sci. doi:10.1007/s10072-017-3119-y