“Our results show it could be a cost-effective, safe and easy to use treatment for people hospitalized for headache or migraine.” – Peter J Goadsby, MD, director UCSF Headache Center
A new report by an international team of headache specialists shows that aspirin, given intravenously (IV), may be a safe and effective option for people hospitalized for severe headache or migraine, and those undergoing acute pain of headache med withdrawal.
The study (“Intravenous aspirin (lysine acetylsalicylate) in the inpatient management of headache”) was published Sep 21 by Neurology®, the medical journal of the American Academy of Neurology.
According to co-author Peter J. Goadsby, MD, director of the University of California, San Francisco Headache Center:
• “Intravenous aspirin is not readily available in the United States and only on a ‘named patient’ basis in the United Kingdom, while it is more generally used in other parts of Europe.”
• “Our results show it could be a cost-effective, safe and easy to use treatment for people hospitalized for headache or migraine.”
• A “named patient” program is only available to people who have tried all other alternative treatments and do not qualify for a clinical trial.
For the study, researchers reviewed the medical records of 168 people between the ages of 18 and 75, hospitalized for headache and given aspirin through an IV. Of those, 117 were women.
• All but three people had chronic daily headache, a condition defined as having a headache 15 days or more per month for three months.
• Most had a diagnosis of migraine.
Participants received doses of one gram of aspirin, with an average of five doses. Overall, about 6% of people experienced side effects, none of which were considered severe. Side effects included nausea, pain from IV insertion and vomiting.
Before, during and after treatment, 86 participants wrote hourly in diaries about their pain. Pain was rated on a 10-point scale, with scores of 1-3 for mild headache, 4-7 for moderate headache, and 8-10 for severe headache. Participants’ comments, along with nurses’ notes, were also used to rate the effectiveness of IV aspirin.
The study found that:
• More than 25% of the time, people experienced a 3-point or greater reduction in pain scores, downgrading the headache from severe to moderate, moderate to mild or from mild to no headache.
• About 40% of the time, participants reported a moderate effect.
“It’s important to note that participants knew they were getting treatment and a placebo was not used, although placebo-controlled trials have shown intravenous aspirin is effective in acute migraine,” said Dr. Goadsby. “Our findings warrant more research into the use of IV aspirin for severe headache or migraine.”
Dr. Goadsby has also commented that the study confirms the migraine patients' motivation is not to seek sedation & addictive drugs but to find pain relief.
Potential side effects of aspirin include heartburn, nausea, vomiting, bleeding, worsening of asthma, kidney impairment and rash.
Source: American Academy of Neurology news release Sep 21, 2010; article abstract.