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Trimebutine Speeds Migraine Relief
Andrew Wilner, MD
Posted: August 2005  
CNS News - July 2005

The addition of an inexpensive opioid derivative speeds the action of rizatriptan, leading to quicker relief of migraine headaches, according to a double-blind, randomized, crossover, placebo-controlled study presented at the 2005 annual meeting of the American Academy of Neurology. The additive, trimebutine, is commonly used in Brazil as a gastrokinetic agent for postoperative ileus and irritable bowel
syndrome.

"Gastroparesis may be present during migraine attaché, which can slow the action of orally administered drugs", said lead author Abouch Krymchantowski, MD, director of the Headache Center of Rio, at the Universidade Federal Fluminense in Niteroi, Brazil. "Trimebutine speeds up absorption of other drugs, like Ambien, so I thought it might speed up the action of migraine drugs."

Stephen Silberstein, MD, professor of neurology at Thomas Jefferson University in Philadelphia has used the gastrokinetic agent metoclopramide in the treatment of migraine, as trimebutine is not available in the United States.

Dr. Krymchantowski now uses trimebutine regularly in his practice for patients with migraine, although always in combination, because the drug "does not penetrate the central nervous system. It has already been demonstrated in another trial that trimebutine does not work for migraine when used alone."