Journal of Basic and Clinical Pathophysiology

Journal of Basic and Clinical Pathophysiology

Comparison of ibuprofen and AAC (acetaminophen, Aspirin, Caffeine) for treating acute migraine episodes

Document Type : Research Paper

Authors
Saiedeh Jafari 1
Fereidon Khayyamfar 2
Iman Ansari 3
Razieh Jafari 4
Siamak Afshinmajd 5
1 School of Medicine, Shahed University, Tehran, Iran
2 Assistant Professor of Urology, Shahed University, Tehran, Iran
3 Medical Students Research Committee, Shahed University, Tehran, Iran
4 Mathematician, Iran
5 Associate Professor of Neurology - Neurophysiology Research Center, Shahed University, Tehran, Iran
10.22070/jbcp.2018.3469.1102
Abstract
Background and Objective: Migraines are the third most prevalent diseases and the seventh most debilitating diseases in the world. Medical treatment options for acute migraine episodes are various while none are infinitely effective for all patients. The aim of the present study was to compare fixed combination of acetaminophen, aspirin and caffeine with ibuprofen (AAC) with ibuprofen.
Materials and Methods: This double-blind clinical trial (Registration No. IRCT2017052930680N4) was performed upon patients attending the neurology clinic at Shahid Mostafa Khomeini General Hospital with complaint of headache. Treatment protocol for this study consisted of 2 medications prescribed for 4 consecutive episodes: Ibuprofen 400 mg and AAC tablets. Each patient received two sets of medication each for two episodes of headaches consisting of 2 of each drug. Pain perception was evaluated by 11-point Box Scale at three stages: prior to administration of the medication, and 2 and 6 hours after taking the medications and daily functions of the patient were assessed 6 hours after administering the medications by filling the Behavioral Rating Scale (BRS-6) which is a clinical assessment tool.
Results: Results of this study demonstrated that difference in severity of pain after taking 2 Ibuprofen tablets and AAC in the first and second episodes of migraine was statistically significant. Furthermore, AAC as compared to Ibuprofen, helped considerably more by allowing patients to regain enough focus to continue their daily life (P=0.001).
Conclusion: The results of this study showed that in patients with migraine, AAC is more effective than ibuprofen on improving patient's function and reducing pain.
Keywords
Migraine disorders
Acetaminophen
Aspirin
Caffeine
Ibuprofen
Treatment
  1. Peck KR, Johnson YL, Smitherman TA. Migraine. Handbook of Clinical Neurology 2016; 138:283-93.
  2. Kruit  M, Van bichem M, Hofman P, Bakkers JT, Terwindt GM, Ferrari MD,et all. Migraine as a risk factor for subclinical brain lesions. Journal of the American Medical Association 2004 ;291(4): 427-34.
  3. Steiner TJ, Stovner LJ, Birbeck GL. Migraine: the seventh disabler. Headache 2013; 53:227–229.
  4. Ornello R, pistoia F, Degan D. Migraine and hemorrhagic stroke: data from general practice. The Journal of Headache and Pain 2015; 16(8).
  5. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet (London, England). 2017;390(10100):1211-1259.
  6. Farhadi Z, Alidoost S, Behzadifar M, Mohammadibakhsh R, Khodadadi N, Sepehrian R, et al. The Prevalence of Migraine in Iran: A Systematic Review and Meta-Analysis. Iranian Red Crescent Medical Journal 2016;18(10):e40061.
  7. Becker WJ. Acute Migraine Treatment in Adults. Headache 2015;55(6):778-93.
  8. Wenzel RG, Sarvis CA, Krause ML. Over-the-counter drugs for acute migraine attacks: literature review and recommendations. Pharmacotherapy 2003;23(4):494-505.
  9. Baradaran M, M, Ahmadi Ahangar A, Teymourian F, Alinejad F, Moghadamnia A. Concomitant Administration of Alprazolam and Ibuprofen in Acute Migraine Headache. Journal of Babol University of Medical Sciences 2011; 13 (3) :15-21
  10. Moore RA, Derry S, Wiffen PJ, Straube S, Aldington DJ. Overview review: Comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions. European Journal of Pain 2015;19(9):1213-23.
  11. Goldstein J, Silberstein S, Saper JR, Ryan RE Jr, Lipton RB. Acetaminophen, aspirin, and caffeine in combination versus ibuprofen for acute migraine: results from a multicenter, double-blind, randomized, parallel-group, single-dose, placebo-controlled study. Headache 2006;46(3): 444-53.
  12. Reuter U, Israel H, Neeb L. The pharmacological profile and clinical prospects of the oral 5-HT1F receptor agonist lasmiditan in the acute treatment of migraine. Therapeutic Advances in Neurological Disorders 2015;8(1): 46-54.
  13. Landy S, derossett S,rapoport A. Two Double-Blind, Multicenter, Randomized, Placebo-Controlled, Single-Dose Studies of Sumatriptan/Naproxen Sodium in the Acute Treatment of Migraine: Function, Productivity, and Satisfaction Outcomes. Medscape General Medicine 2007;9(2): 53
  14. Abbasi M, Nabavi SM, Fereshtehnejad SM, Jou NZ, Ansari I, Shayegannejad V, et al. Multiple sclerosis and environmental risk factors: a case-control study in Iran. Neurological Sciences 2017;38(11):1941-1951.
  15. Zhang Y, Parikh A, Qian S. Migraine and stroke. Stroke and Vascular Neurology 2017;2(3):160-167.
  16. Abbasi M, Nabavi SM, Fereshtehnejad SM, Ansari I, Zerafatjou N, Shayegannejad V, et al. Risk factors of Multiple sclerosis and their Relation with Disease Severity: A Cross-sectional Study from Iran. Archives of Iranian Medicine 2016;19(12):852-860.
  17. Ertas M, Baykan B, Orhan EK, Zarifoglu M, Karli N, Saip S, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. The Journal of Headache and Pain 2012;13(2):147–57
  18. Cascio Rizzo A, Paolucci M, Altavilla R, Brunelli N, Assenza F, Altamura C, et al. Daith Piercing in a Case of Chronic Migraine: A Possible Vagal Modulation. Frontiers in Neurology 2017; 8:624.
  19. Afshinmajd S, Davati A, Akbari F. The effects of body mass index on the treatment of the patients with migraine headaches. Iranian Journal of Neurology 2011; 10(3-4):35-38.
  20. Lipton R, Stewart W, Ryan R. Efficacy and safety of acetaminophen, aspirin, and caffeine in alleviating migraine headache pain: three double-blind, randomized, placebo-controlled trials. Archives of Neurology 1998 ;55(2): 210-7.
  21. Goldstein J, Hagen M, Gold M. Results of a multicenter,double-blind, randomized, parallel-group, placebo-controlled, single-dose study comparing the fixed combination of acetaminophen, acetylsalicylic acid, and caffeine with ibuprofen for acute treatment of patients with severe migraine. Cephalalgia 2014 ;34(13): 1070-1078.
  22. Goldstein J, Silberstein S, Saper J. Acetaminophen, Aspirin, and Caffeine Versus Sumatriptan Succinate in the Early Treatment of Migraine: Results from the ASSET trial. Headache 2005 ;45(8): 973-82.
  23. Goldstein J, Hoffman H, Armellino J. Treatment of severe, disabling migraine attacks in an over-the-counter population of migraine sufferers: results from three randomized, placebo-controlled studies of the combination of acetaminophen, aspirin, and caffeine. Cephalalgia 1999 ;19(7): 684-91.
  24. Diener H, Pfaffenrath V, Pageler L. The fixed combination of acetylsalicylic acid, paracetamol and caffeine is more effective than single -controlled substances and dual combination for the treatment of headache: a multicentre, randomized, double-blind, single-dose, placebo parallel group study. Cephalalgia 2005;25(10): 776-87.
  25. Diener H, Peil H, Aicher B, et all. The efficacy and tolerability of a fixed combination of acetylsalicylic acid, paracetamol, and caffeine in patients with severe headache: a post-hoc subgroup analysis from a multicentre, randomized, double-blind, single-dose, placebo-controlled parallel group study. Cephalalgia 2011;31(14): 1466-76.

 

 

Journal of Basic and Clinical Pathophysiology
Volume 6, Issue 2
September 2018
Pages 1-6