Triptan and Migraine answers

The triptan and migraine connection is probably familiar to anyone who's dealt with migraine attacks for any length of time.  Triptan medication is the probably the most familiar modern migraine-targeted treatment.  Let's take a quick look at the background of this treatment, where it's at today, and how it can help you.

The origin of the triptan and migraine solution

As migraine treatments progressed, it became known that an injection of serotonin could relieve migraine symptoms.  It was also discovered that methysergide, used in ergotamine, had the ability to narrow blood vessels specifically around the brain.

Armed with this information, UK scientist Pat Humphrey began to look for the specific serotonin receptors in these blood vessels.  He wanted to see if they could use a molecule that was similar enough to serotonin that it might trick the receptors and relieve the symptoms.  In 1972, they investigated sumatriptan - now known most commonly under the brand names of Imitrex or Imigran.  It started selling in 1992 in Europe.

In the years since, other triptans have been discovered and used in migraine treatment. These include naratriptan, almotriptan, eletriptan, frovatriptan, rizatriptan and zolmitriptan.

What is the triptan and migraine connection?

Although we do not yet fully understand the cause of migraine, we are able to observe much of what it does in the body.  Triptan medication works not only on migraine but also on cluster headache.  They do not prevent or cure migraine, but they do lessen the symptoms.  We once believed that triptans worked by binding certain serotonin receptors in the blood vessels in the head, causing them to constrict.

However, we now realize that migraine is much more complex than just what happens in the blood vessels - and the same goes for cluster.

Triptan medications do seem to inhibit the release of pro-inflammatory chemicals.  Still, we're not 100% sure how triptans stop the migraine chain-reaction.  Triptans are not "pain killers" - in fact the good thing about them (when they work) is that they relieve a variety of symptoms related to migraine.  Migraine attacks do not always involve pain.

Why the triptans don't always work

Triptans and Migraine

As time goes by we're learning more about why triptans sometimes work and sometimes don't.  Here are a few things that might help you make an informed decision:

1. Try a different triptan:  If you tried one triptan and migraine treatment and it didn't work, try another triptan.  For example, a study released on October 20, 2003 showed that eletriptan (Relpax) would help many patients that hadn't been helped by other triptans.  Similar studies have shown that some triptans may be better for certain types of migraine.

2. Take it right away:  The triptan and migraine connection is that of an abortive drug.  In other words, you take the triptan when you feel the symptoms coming on.  It may be that if you wait too long to take the drug, it will no longer work.  Try taking it as soon as you feel the migraine attack beginning.

This is especially true if you have skin sensitivity (cutaneous allodynia).  Research seems to show that if you reach a stage where your skin gets sensitive, it may be too late for the triptan.

3. New triptan technologies:  Much of the new technology when it comes to triptan and migraine is focused on getting the drug into your system as soon as possible.  Some are designed to dissolve in your mouth, for example.  RT technology is used with Imitrex to help the drug dissolve quickly after swallowing.  Some come as a nasal spray, some can even be injected.  Remember, the quicker you can get the drug into your system, the more likely it is to work.

What are the dangers?

Triptans are generally safe and free of side effects.  However, you still need to take them with caution, and talk to your doctor first.

Every medication may have side effects, even if some have less than others.  If you're feeling pain in your chest, or pressure or pain elsewhere, talk to your doctor right away.

Your doctor may suggest something different if you have a history of stroke or heart condition, uncontrolled diabetes or hypertension, or high cholesterol.  You can read more about triptan and migraine side effects here.

Dosage and other information

Dosages will vary depending on your condition and medical history.  You can search for information on various triptans hereWebMD has this excellent overview of triptan and migraine disease.   From there you can search for a specific triptan medication.

Much of this information was first published in the Headache and Migraine News blog, and in the free ezine, HeadWay.  Sign up here for the monthly ezine for the latest tips and treatments for dealing with headache and migraine.  Thanks also to Dr William B Young and Dr Stephen D Silberstein for their book "Migraine and other Headaches".