Dodick 2005.

Methods	Multicentre, randomised, double‐blind, placebo controlled, parallel group. Single dose to treat up to 2 attacks Study medication to be taken within 15 minutes of pain becoming moderate or severe intensity. Headaches with moderate/severe intensity upon awakening were not to be treated Assessments made at 0, 0.25, 0.5, 1, 2 and 4 h Rescue medication permitted after 4 h
Participants	Aged 18‐ 65 years, meeting IHS criteria for migraine (1988) with or without aura. At least 1 year history of migraine, with onset <50 years and 2 to 6 attacks/month. No prophylactics or non‐stable dose of SSRI within 2 months. No MAOI within 2 weeks. No analgesics, ergots or triptans within 24 h. Furthermore, no naratriptan within 36 h and no frovatriptan within 5 days. Excluded participants who had hypertension or any medical or physical condition that might put the patient at risk with exposure to zolmitriptan. N = 1869 (1868 for efficacy) M 248, F 1620 Mean age 41 years Without aura 56%
Interventions	zolmitriptan 5 mg nasal spray, n = 935 (1745 attacks) placebo, n = 934 (1718 attacks)
Outcomes	Headache relief (at 1, 2 and 4 h) Pain free (at 2 and 4 h) 24‐h sustained headache relief 24‐h sustained pain‐free Use of rescue medication Improvement in nausea, vomiting, photophobia, phonophobia Return to normal activities Adverse events
Notes	Oxford Quality Score: R1, DB2, W1. Total = 4.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	not described
Allocation concealment (selection bias)	Unclear risk	not described
Blinding (performance bias and detection bias) All outcomes	Low risk	"matching placebo"
Incomplete outcome data (attrition bias) All outcomes	Low risk	drop‐outs described
Study size	Low risk	both groups >200