Duloxetine May Be an Effective Prophylactic for Episodic Migraines
The study included 55 participants with episodic migraine who were randomly assigned to receive duloxetine or placebo over an 8-week period.
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The study included 55 participants with episodic migraine who were randomly assigned to receive duloxetine (30 mg /day for the first week, followed by 60 mg/d) or placebo over an 8-week period. Participants reported number of migraine episodes, migraine days, migraine pain level (reported on a 0 to 10 numeric pain scale [NPS]), migraine improvement, and treatment compliance via weekly phone calls. The researchers compared data from weeks 4 and 5 of treatment with baseline measures to determine the effects of treatment. A 50% improvement in any of the measures was considered clinically significant.
Participants who received duloxetine were found to have greater migraine improvement (52.3%±30.4%) compared with placebo (26.0%±27.3%; P =.001). Participants in both groups reported reductions in the number of migraine days (duloxetine: baseline, 6.8±2.5 days; follow-up, 3.9±3.7 days; difference, −48.8%±38.8%; P <.001). Participants in the placebo group had 6.1±2.3 migraine days per month at baseline, and this decreased to 4.4±3.5 days (difference, −23.4%±63.5%; P =.049). Neither group was found to have changes in intensity of migraine pain.
"Duloxetine seems to be an efficacious preventive agent for migraine at least by the parameter of self-estimated improvement. Larger cohorts are needed to establish this effect for the other parameters of migraine frequency and clinical pain," lead study investigator, Liella Kisler, of Technion Faculty of Medicine, Haifa, Israel, told Clinical Pain Advisor.
Kisler L, Weissman-Fogel I, Coghill R, et al. Duloxetine is effective in prevention of episodic migraine: a placebo controlled double blind exploratory study. Presented at: the World Congress on Pain 2018; September 12-16; Boston, MA. Poster 64161.
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