Triptans are a class of molecules used as a first-line treatment for acute migraines with or without aura, and cluster headaches.
Triptans act by selectively agonizing the serotonin 5-HT 1b
and 5-HT 1d receptors, determining vasoconstriction of cranial vessels. The
action on the 5-HT 1d receptor also is responsible for inhibiting the release
of vasoactive neuropeptides and blocking the transmission of pain signals.
There are available at least 7 triptans but not all of them
are approved in all countries. Triptans include the pioneer molecule
Sumatriptan (), Zolmitriptan, Frovatriptan, Eletriptan, Rizatriptan,
Almotriptan, and Naratriptan. The only FDA-approved triptan in adolescents is
Almotriptan. The use of triptans in children is off-label.
Triptans should be administered as soon as the first
symptoms start.
Common side effects of triptans are best known as “triptan
sensations” and include nausea, dizziness,
paresthesia, flushing, pain in the neck, tingling, and chest tightness.
Based on the fact that triptans may increase the risk of
coronary vasoconstriction, they are contraindicated in patients that have had a
myocardial infarction, uncontrolled hypertension, and coronary artery disease.
Triptans should be avoided during pregnancy and breastfeeding, except for
Sumatriptan which has been shown to be safe.
Concomitant use of Triptans and MAOIs, SSRIs, and ergot
alkaloids should be avoided due to the risk of serotonin syndrome.
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