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Triptans for the Management of Migraine

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Abstract

Migraine is a chronic, recurrent, disabling condition that affects millions of people in the US and worldwide. Proper acute care treatment for migraineurs is essential for a full return of function and productivity. Triptans are serotonin (5-HT)1B/1D receptor agonists that are generally effective, well tolerated and safe. Seven triptans are available worldwide, although not all are available in every country, with multiple routes of administration, giving doctors and patients a wide choice. Despite the similarities of the available triptans, pharmacological heterogeneity offers slightly different efficacy profiles. All triptans are superior to placebo in clinical trials, and some, such as rizatriptan 10 mg, eletriptan 40 mg, almotriptan 12.5 mg, and zolmitriptan 2.5 and 5 mg are very similar to each other and to the prototype triptan, sumatriptan 100 mg. These five are known as the fast-acting triptans. Increased dosing can offer increased efficacy but may confer a higher risk of adverse events, which are usually mild to moderate and transient in nature. This paper critically reviews efficacy, safety and tolerability for the different formulations of sumatriptan, zolmitriptan, rizatriptan, naratriptan, almotriptan, eletriptan and frovatriptan.

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Acknowledgements

No sources of pharmaceutical or other funding were used to assist in the preparation of this review.

Dr Johnston has no conflicts of interest that are directly relevant to the content of this review. Dr Rapoport is on the Speakers Bureau of Endo, Janssen-Cilag, Merck, Pfizer and Zogenix, and on the Advisory Board of Pfizer, Zogenix, Map, NuPathe and Nautilus Neurosciences.

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Correspondence to Mollie M. Johnston MD.

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Johnston, M.M., Rapoport, A.M. Triptans for the Management of Migraine. Drugs 70, 1505–1518 (2010). https://doi.org/10.2165/11537990-000000000-00000

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