Migraine

Abstract

In the discussion of preventive therapy for migraines, Charles (Aug. 10 issue)¹ did not include aspirin as an effective option. Several large, randomized, double-blind, placebo-controlled trials, including the Physicians’ Health Study,² have reported that the regular use of low-dose aspirin is effective in migraine prevention. A recent systematic review of studies on migraine prophylaxis with aspirin confirmed that regular use of low-dose aspirin can reduce the frequency of migraine.³ A comparison study of aspirin and metoprolol for migraine prevention reported reductions in migraine frequency in both groups, with the metoprolol group having a greater response (42.5%, vs. 29.6% in the aspirin group) but also having more medication-related side effects than the aspirin group.⁴ Another recent review of drugs for migraine also neglected to discuss the effectiveness of aspirin in prophylaxis.⁵ Given its documented effectiveness, low side-effect profile (especially in the young), and low cost, aspirin should not be overlooked as a useful means of migraine prevention.