Comparing Naproxen to Sumatriptan for Emergency Headache Patients

Two-thirds of the five million headache patients who present to US emergency departments (ED)
annually are suffering an acute exacerbation of a primary headache disorder. Of these acute
primary headaches, migraine is the most frequently encountered disease entity in the ED,
accounting for 60% of primary headaches, followed by tension-type headaches, which represent
10% of all primary headaches seen in the ED. About ¼ of all acute primary headaches seen in
the ED cannot readily be given a specific diagnosis3. Multiple parenteral treatments are used
to treat acute primary headaches1, but to date, regardless of specific headache diagnosis, no
medication eliminates the frequent recurrence of headache after ED discharge. To date, it is
unknown which medication patients should be given when discharged from an ED after treatment
for a primary headache. This study will compare two oral headache treatments to determine
which one relives pain more effectively.

Specific aims:

1) To determine which of two oral medications is more efficacious for all acute primary
headache patients who are discharged from an ED.

Primary hypotheses:

In the 48 hour period following ED treatment for a primary headache, sumatriptan 100mg will
relieve pain better than naproxen 500mg, as measured by an 11-point numerical rating scale
for pain.

Inclusion Criteria:

- Treated in the emergency department for acute primary headache

Exclusion Criteria:

- Allergy, intolerance, or contra-indication to one of the study medications