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Triptans (Serotonin Receptor Agonists) for Migraine Headaches

Triptans (Serotonin Receptor Agonists) for Migraine Headaches

Examples

Generic Name Brand Name
almotriptan Axert
frovatriptan Frova
rizatriptan Maxalt
sumatriptan Alsuma, Imitrex, Zecuity
zolmitriptan Zomig

These medicines are available as tablets (you swallow them or they dissolve in your mouth), nasal sprays, shots, and patches you put on your skin.

How It Works

Triptans narrow (constrict) blood vessels in the brain and relieve swelling. Triptans have other properties that may help treat migraine symptoms. It is not clear how they work to stop a migraine.

Why It Is Used

These drugs are used to effectively and quickly relieve headache pain, sensitivity to light and noise, and nausea and vomiting associated with migraines. They are especially helpful if you have moderate to severe headaches that interfere with your ability to perform daily tasks.

How Well It Works

These drugs are effective in reducing migraine symptoms and are well tolerated. 1 But it is hard to know which triptan is the most effective. A triptan that works well for someone else may not work well for you. You may have to try more than one triptan to find the one that works best for you.

Triptans work best when they are taken as soon as the headache starts. But they can still reduce headache pain and other symptoms when taken after the attack has begun.

You may find that combining a triptan with a nonprescription medicine (such as acetaminophen or naproxen) helps to stop your headaches better. Talk to your doctor about this option if triptans alone aren't helping enough.

Some triptan drugs may also help to prevent migraines in women who get them only around the time of their menstrual period . 2

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • Hives.
  • Severe chest pain or pressure or a strange feeling in the chest. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.

Common side effects of this medicine include:

  • Burning, pain, or soreness in the nose (nasal spray).
  • Burning, pain, or redness where the shot was given.
  • Burning, pain, itching, or redness on your skin from the patch.
  • Change in the sense of taste (nasal spray).
  • Dizziness, lightheadedness, or drowsiness.
  • Dry mouth.
  • Feeling hot or cold, weak, or "strange" in some way.
  • Muscle aches or cramps.
  • Nausea or vomiting.

FDA advisories. The U.S. Food and Drug Administration (FDA) has issued a warning about taking SSRIs or SNRIs (used for depression, anxiety, pain, and many other conditions) with triptans. Taking these medicines together can cause a very rare but serious condition called serotonin syndrome.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Overuse of migraine drugs can cause rebound headaches . Rebound headaches are different from migraine headaches. They are usually triggered after pain medicine has worn off, prompting you to take another dose. Eventually you get a headache whenever you stop taking the drug. Be sure to take your migraine medicine only as prescribed by your doctor.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Drugs for migraine (2011). Treatment Guidelines From The Medical Letter, 9(102): 7–12.
  2. Silberstein SD, et al. (2012). Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 78(17): 1337–1345.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Colin Chalk, MD, CM, FRCPC - Neurology
Last Revised June 4, 2013
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