Triptans to Treat Migraines

It took many years for migraine sufferers to get an effective treatment. Over 28 million Americans have long hoped for something like triptans. While no miracle cure, they are among the most effective class of drugs available for that intense, throbbing pain that can strike any time.

Triptans are a class of drugs that are chemically similar to the neurotransmitter serotonin, believed to play a role in migraines. In many drug treatments, the compound is chemically similar to some natural one, allowing it to substitute at a critical point.

Triptans are of this type. They sit on receptors where the natural biochemical would be found, but have behavior just different enough to alleviate the condition. These are in a technical class called 5-HT1B/1D agonists.

Some studies suggest that triptans are more effective among migraine sufferers who lack skin sensitivity. For those who experience the sensitivity during an attack, triptans can still be helpful, but are best when taken within 20 minutes of migraine onset.

Many migraine sufferers experience a so-called 'aura', allowing them to know when to dose. The term 'aura', in this case has nothing to do with alleged fields around the body, but is a cluster of pre-cursor symptoms, such as seeing light flashes.

Triptans, introduced in the 1990s, come in a variety of commercial types and names, such as sumatriptan (Imitrex) and others. Second generation triptans now on the market are even more effective than the original drugs. Among these are zolmitriptan (Zomig) and rizatriptan (Maxalt).

These are so called 'aborters' or 'interrupters' - they help stop the migraine before it ramps up to the intense, pulsating pain familiar to migraine sufferers. The second generation is more effective in that, among other things, they don't have to be taken at the precise onset of (sometimes unpredictable) symptoms. They also last longer, which is important for those many who have symptoms that can last for days.

Many of the common accompanying symptoms are relieved by triptans as well. Nausea and vomiting are common among migraine sufferers. Triptans help reduce and can often eliminate these effects entirely.

Delivery systems have changed over the years, too. Once available in pill form only, many now come in nasal sprays and other forms. Rizatriptan (Maxalt) is available in the form of a wafer that dissolves rapidly on the tongue, making it unnecessary to have a glass of water nearby. Nasal sprays are very effective, since they provide a method of introducing the drug very rapidly into the bloodstream through the thin nasal membranes.

Any drug carries risk and potential side effects. Tradeoffs between symptom relief and harmful effects may need to be made. Always consult a physician before taking any medication.