From Ms A. Shaw, MRPharmS
SIR,—It saddened me to notice the omission of isometheptene mucate and
paracetamol (Midrid) from Dr Andrew Dowson’s otherwise excellent review
of migraine and its treatment (PJ, October 7, p519).
Acting as a specific cerebral vasoconstrictor, isometheptene offers a valuable
alternative
approach to the other non-
prescription products available and can be used in teenagers as well as adults.
As Dr Dowson points out, patients may require a range of treatments to achieve
control and the expression of their migraine may vary during their lives. It
is therefore crucial to patient care that information on all licensed products
is included in educational reviews which aim to be balanced and unbiased.
Midrid is an established product, both reimbursable on the National Health Service
and available for sale as a pharmacy only medicine. Its exclusion from this
article was a serious oversight.
Amanda Shaw
Marketing Manager,
Manx Pharma,
Maidstone, Kent
Dr ANDREW DOWSON (author of the article) responds: Isometheptene mucate and
paracetamol (Midrid) offers an alternative strategy for managing the acute migraine
attack and is available both over the counter and on prescription. While some
patients undoubtedly swear by its efficacy, there is a dearth of good evidence
from clinical trials to support its use. Because of this, Midrid does not figure
in many of the commonly used guidelines for migraine management.