Triptans have been proven to be effective for the treatment of migraine, but only when following certain guidelines.

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Triptans are effective for the treatment of migraine headaches, according to one of the most comprehensive review of studies ever published. The findings, based on the results of 133 trials between 1991 and 2012, were reported in a 2015 edition of the journal Headache, the official publication of the American Headache Society.

The study compared the effectiveness of triptans alone and in combination with other drugs. Standard-dose triptans were associated with better outcomes than ergots (medications containing chemicals that come from a fungus), non-steroidal anti-inflammatory drugs, and aspirin.

How They Work

Triptans, now considered to be the first-line therapy for many patients with moderate to severe migraine, are serotonin receptor agonists. They work by selectively constricting blood vessels that have expanded during migraine episodes.

The drugs do not prevent migraine attacks, but the study showed that early intervention with triptans rapidly reduces headache pain, lessens the likelihood of the headache recurring, and limits side effects, including nausea, vomiting, and sensitivity to light and sound.

Timing Is Important

Eighty percent of those who take the prescribed medication early (when the pain is milder) become pain free within two hours, compared to 36 percent who get relief when the drug is taken later in the attack.

Seven (Plus One) Triptans Currently Available in U.S.

Seven currently available triptans approved by the FDA, plus one drug that is a combination of a generic triptan (sumatriptan) and naproxen. No single triptan is more effective than another, but some patients respond better to a particular triptan and its correct dosage than others. Here is the list.

Generic Name                   Trade Name                        

Almotriptan                            Axert

Eletriptan                               Relpax

Rizatriptan                             Maxalt

Frovatriptan                           Frova

Naratriptan                            Amerge

Sumatriptan                          Imitrex

Zolmitriptan                           Zomig

Sumatriptan/Naproxen       Treximet

Fast, Intermediate, and Long Acting

Triptans are classified as fast acting, intermediate acting, and long acting, depending on the drug, the dosage, and how the person responds. Each has advantages and disadvantages. Frova and Amerge, for example, have a slow onset (take longer to work), but longer-acting results. Fast-acting and ultra-fast triptans (Imitrex) take effect sooner, but relief doesn’t last as long. Imitrex has a 70 percent response rate. As a group, all triptans have a headache recurrence rate of 20-45 percent.

It is possible to match individual patient needs with specific characteristics of a certain triptan. They are available in tablets to be swallowed whole, dissolving tablets, patches, nasal sprays, and injections. Talk with your doctor to determine which one works best for you.

Not for Everyone

If your migraines are infrequent, mild, and non-disabling, try over-the-counter medications first. Your doctor may suggest a triptan plus an OTC pain medication.

People who should not take triptans include those with coronary artery disease, high cholesterol, or have had a heart attack or stroke, and those who presently have uncontrolled blood pressure.

Men older than 40 and women over 55 are at greater risk for dangerous side effects. Others are those who smoke, are obese, have diabetes, or are pregnant. Again, check with your doctor regarding other factors that might preclude your use of triptans.

Effective, But With Conditions

Triptans have been proven to be effective for the treatment of migraine, but only when following the guidelines regarding the exact triptan type, dosage, method of taking the medication, and the individual who needs medical help.