Dr. Cynthia Collawn, chief resident at Sinai Hospital, was ready to begin her 36 hours on call recently when she was struck by one of the disabling migraine headaches she has suffered since she was a teen-ager.
The pain had started, as usual, above her right eye and traveled to the back of her head. She curled up in a ball of pain in a dark corner of the hospital's emergency room, a bandanna pulled tightly around her forehead, hoping for a partial recovery from an injection of a strong prescription drug.
Instead, Sinai neurologist Howard Weiss arrived with something better: sumatriptan, the newest weapon against migraines. Ten minutes after the injection,Dr. Collawn's hideous migraine was gone.
"I couldn't believe it," the 30-year-old physician recalls. "I got up and did my 36-hour call without any problem."
Eagerly anticipated for several years, the drug sumatriptan, sold under the name Imitrex, has been helping migraine sufferers since its March release in the United States, local physicians say. It has been used in England and Holland for two years and in Canada for more than a year. Currently, it is only available in the United States by injection.
(It is also available for children under the age of 16, although its safety and effectiveness have not been formally tested.)
Even as they praise its general efficacy, physicians caution that it will not work for everyone."The hype is that this is the solution to migraines. It is a step in the right direction, but it's not the answer. It won't prevent headaches," Dr. Weiss says.
But it may prevent many people from having to miss work. A 1992 study funded by Glaxo Inc., the manufacturer of sumatriptan, estimated that migraine headaches cost U.S. employers more than $5 billion a year in lost labor costs.
Sumatriptan acts by stemming the dilation of blood vessels in the brain that cause the painful headaches. Non-narcotic, it may be used safely once or twice a week, according to the American Council for Headache Education (ACHE).
Formerly, migraine sufferers tended to use an ergotamine derivative -- effective for many patients, but often causing nausea -- or a narcotic analgesic such as Demerol.
A costly condition
Improved relief does not come cheaply. With sumatripta costing as much as $35 per injection, Dr. Weiss calls it "a designer drug."
"The cost still beats missing a day's work," he says. "But for those patients who get one or more migraines a week, sumatriptan is clearly not the answer."
