Triptans

What Are Triptans?

Triptans, also known as serotonin receptor agonists, are a class of drugs used to treat acute attacks of migraines. They are available in different formulations and include:

  • Sumatriptan

  • Naratriptan

  • Zolmitriptan

  • Rizatriptan

  • Almotriptam

  • Frovatriptan

  • Eletriptan

How Do Triptans Work?

Triptans work by binding to serotonin receptors in the brain, called 5-HT1B and 5-HT1D. When you have a migraine, the blood vessels in your head become swollen and enlarged. When triptans attach to 5-HT1B receptors on blood vessels in the brain, they cause these vessels to narrow, which reduces the pain.

When triptans attach to the neurogenic and central 5-HT1D receptors, they prevent the release of certain protein-like molecules known as vasoactive neuropeptides by inhibiting trigeminal nerve activation and blocking the transmission of pain signals to the central nervous system.1

What Is the Efficacy of Triptans for Period Migraines?

Method: Several studies were conducted to assess the effectiveness of triptans in treating menstrual migraine. Both acute treatment and short-term prevention were evaluated.2,3,4

Results: Triptans like sumatriptan, rizatriptan, zolmitriptan, and almotriptan provided rapid relief from menstrual migraines. Many women achieved pain-free status within 2 hours, with sustained relief up to 24 hours. Frovatriptan 2.5 mg twice daily, taken for about 5–6 days around menstruation, significantly reduced the frequency, severity, and recurrence of menstrual migraines.

Conclusion: Based on the studies, triptans are effective and well-tolerated treatments for menstrual migraines. As acute therapy, they provide fast and effective relief from migraine attacks, and as short-term prevention, especially with frovatriptan, they help prevent migraines when taken in the days around menstruation.

What Are the Side Effects of Triptans?

  • Short-term effects: Nausea, dizziness, tingling

  • Long-term effects: Coronary vasoconstriction, paresthesia, arrhythmias, myocardial infarctions, and strokes1


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References
  1. Nicolas S, Nicolas D. Triptans. InStatPearls [Internet] 2024 Feb 25. StatPearls Publishing.

  2. Zhang H, Qi JZ, Zhang ZH. Comparative efficacy of different treatments for menstrual migraine: a systematic review and network meta-analysis. The Journal of Headache and Pain. 2023 Jul 3;24(1):81.

  3. Hu Y, Guan X, Fan L, Jin L. Triptans in prevention of menstrual migraine: a systematic review with meta-analysis. The Journal of Headache and pain. 2013 Dec;14(1):7.

  4. Khoo CC, Liu CC, Lu M, Huang YC, Weng HY. Acute and preventive treatment of menstrual migraine: a meta-analysis. The Journal of Headache and Pain. 2024 Sep 4;25(1):143.

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