The essential migraine medication actually does nothing to relieve the symptoms of dizziness
Rizatriptan medication is often recommended for different types of migraines
Aeksandr Zubkov / Getty Images
A commonly prescribed drug for migraines seems to be done little to relieve those vestibular, which causes vertigo, as well as more typical symptoms such as headaches and light sensitivity. This despite the drug, called Rizatriptan, sometimes recommended for this type of migraines.
Research on the vestibular treatment of migraine has been largely incoherent, showing mixed results for a range of drugs, explains Jeffrey Staab at Mayo Clinic de Rochester, Minnesota. Some more recent drugs such as Galcanezumab could reduce the frequency in which such attacks occur, but, so far, no randomized trial had tested if migraine drugs relieve vestibular symptoms during an episode itself.
To fill this gap, Staab and his colleagues recruited 134 adults with vestibular migraine which was invited to take 10 milligrams of rizatriptan or a placebo at the start of vestibular symptoms, such as balance problems or the feeling of rotation, during a total of 307 moderate to severe episodes. They then evaluated their symptoms on a scale of 0 to 3 at several points until the episode was resolved.
An hour after taking the medication – when rizatriptan reaches its maximum concentration in the bloodstream – it was no more efficient than a placebo to relieve symptoms, despite the credited medication for its rapid action. People of the two groups were also equally likely to turn to a backup drug after waiting for an hour required.
After 24 hours, Rizatriptan seemed to provide slightly better relief to sensitivity to movement, light and sound, but not for dizziness. Participants also reported slightly higher scores for physical well -being – such as their energy level and their ability to perform daily tasks – compared to placebo, but without difference in mental well -being or acceptance of side effects.
Rizatriptan belongs to a class of drugs called triptans, which are generally effective in treating migraine headaches, but which may not work for vestibular symptoms, says Staab.
The results suggest that the brains involved in vestibular migraines – vestibular systems, which are “quite primitive” from an evolutionary point of view – lack sensitivity to triptans, for reasons still to explore, explains Peter GoaDsby to King’s College in London. But vestibular migraines should not be classified as a distinct condition of other migraines, he said rather that their symptoms represent “small twists and turns” in the pathology of migraines which justify their own targeted treatment strategy.
“He tells colleagues clinician that you need to ask questions about these symptoms,” said GoaDsby. “And if you treat someone with a vestibular migraine – for example, with a triptan – you need to be ready not to work, and to understand that this does not mean that the patient is difficult or unreasonable.”
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