Aspirin; en sık kullanılan etkin ve ucuz bir analjeziktir. Ülkemizde şimdiye kadar oral yolla verilmekte olan aspirin, son yıllarda migren ataklarında intravenöz (IV) olarak verilmiş ve iyi sonuçlar bildirilmiştir. Bu çalışmada migren atağı nedeniyle acil servise başvuran 35 hastadan 23'üne 500 mg aspirin eş değerinde 900 mg Lysine-acetylsalicylate (LASA) I.V ve 12 hastaya 6 mg sumatriptan subkutan (S.C) olarak verildi. Aspirin alan 23 hastanın 15'inde (%62.5) 4-15 dakika içinde migren ağrısı belirgin şekilde kayboldu. 4 hastada (%17.4) İ.V LASA orta derecede etkili oldu. 3 hastada (%13.1) ağrıda hafif bir azalma oldu. Bir hastada (%4.3) ağrıda hiç bir değişiklik olmadı. Sumatriptan alan hastaların 10'unda (%83) ağrılar, 30-120 dakika içinde büyük ölçüde azaldı, İki hastada (% 17) ağrı, iki saat geçmesine rağmen kaybolmadı. Migren krizinde I.V LASA hızlı etkisi ve maliyetinin yeni antimigrenöz ilaçlara nazaran çok daha düşük olması nedeniyle, bu ilaca karsı kontrendikasyon yoksa, rahatça kullanılabilecek bir tedavi yöntemi olarak kabul edilebilir
Aspirin is an efficient and cheap analgesic drug, which is used frequently. It is given orally in our country up to date. Use of aspirin intravenously in migraine headache has recently been tried and satisfying results were reported. Thirty-five patients with migraine attacks were admitted to emergency service. Twenty-three patients were treated by 900 mg Lysine acetylsalicylate (LASA)-equivalent of 500 mg aspirin intravenously (I.V). Twelve patients were treated by subcutaneous (S.C) injection of 6 mg sumatriptan. In the patients treated with LASA, the headache relieved clearly in 15 (62.5%) within 4-15 minutes. A moderate pain relief was obtained in 4 patients (17.4%) and there was slight improvement headache in 3 patients (13.1%). There was no response in one patient (4.3%). The pain was disappeared within 30-120 minutes in ten patients (83%) who were treated by sumatriptan. Sumatriptan was not beneficial in two patients (17%)). Because of its rapid action and low cost, LASA I.V can be accepted as an effective therapy in migraine attacks treatment.
1. Ertekin C. Nörolojide Fizyopatoloji ve Tedavi, izmir: Bilgehan matbaası, 1987,187-188.
2. Eady MJ. Drug Therapy in Neurology. Edinburg: Churchill Livingstone, 1992, 316-317.
3. Noda S, Itoh H, Umezaki H, Fukuda Y. Successful treatment of migraine attacks with intravenous injection of aspirin. J Neurol Neurosurg Psychiatry 1985,48:1187.
4. Olesen J. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, neuralgias and facial pain. Cephalalgia 1988,8:(Suppl 7):l-96.
5. Lange R, Schwarz JA, Hohn M. Acetylsalicylic acid effervescent 1000 mg (Aspirin) in acute migraine attacks; a multicentre, randomized, double-blind, single dose, placebo-controlled parallel group study. Cephalalgia 2000,20:663-667.
6. Diener HC. Efficacy and safety of intravenous acetylsalicylic acid lysinate compared to subcutaneous sumatriptan and parenteral placebo in the acute treatment of migraine. A double-dummy, randomized, multicenter, parallel group study. The ASASUMAMIG Study Group. Cephalalgia 1999,19: 581-588.
7. Topçuoğlu M A, Selekler K, Keşfinin 100 Yılında Aspirin.Türk Nörol Derg 1996,3-4:96-101.
8. Limmroth V, Katsarava Z, Deiner HC. Acetylsalicylic acid in the treatment of headache. Cephalalgia 1999,19:545-551.
9. Ross-Lee L, Eadie MJ, Tyrer JH. Aspirin treatment of migraine attacks:clinical observation. Cephalalgial982,2:71-76.
10. Limmroth V, May A, Diener H. Lysine-acetylsalicylic acid in acute migraine attacks. Eur Neurol 1999,41:88-89.
11. Tfelt-Hansen P, Henry P, Mulder LJ, Scheldewaert RG, Schoenen J, Chazot G. The effectiveness of combined oral lysine acetylsalicylate and metoclopramide compared with oral sumatriptan for migraine. Lancet 1995,346:923-926.
12. Chabriat H, Joire JE, Danchot J, Grippon P, Bousser MG. Combined oral lysine acetylsalicylate and metoclopramide in the acute teatment of migraine: a multicentre double-blind, placebo controlled study. Cephalalgia 1999,14:297-300.
13. Tfelt-Hansen P. The effectiveness of combined oral lysine acetylsalicylate and metoclopramide (Migprive) in the treatment of migraine attacks. Comparison with placebo and oral sumatriptan. Funct Neurol 2000,15 (Suppl 3):196-201.