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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.
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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
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.
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.
Migraine Headaches: By the Numbers
3 Women are three times more likely to get migraine than men.
4-48 Number of hours a migraine episode usually lasts
12 Percent of all types of headaches that are migraine
25-55 Age range at which migraine is most common
80 Percent of migraine patients who are pain free within two hours if triptan medication is taken early during episode
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