Triptans and Migraine Treatment

If you're one of the 37 million Americans who get migraine headaches, you know these painful headaches can make you miss work or school and can last several days if they're not treated.

In some cases, over-the-counter pain relievers may help. But if they don't, your doctor may suggest you try a triptan drug. This kind of medicine can't keep migraine headaches from happening. But it can treat your headache once it starts.

Triptans can help with:

  • Headache pain
  • Nausea and vomiting
  • Sensitivity to light and sound
  • Your doctor may give you triptan tablets you'll take by mouth. You also could get it as a nasal spray or shot. Most people feel better within 2 hours of taking it.

How Do They Work?
Triptan drugs tell work like a brain chemical called serotonin. This helps quiet down over active pain nerves. In other words, triptans reverse the changes in your brain that caused your migraine.

There are seven different triptan medicines plus a combination drug that has a triptan and naproxen, a non-steroidal anti-inflammatory drug (NSAID). Your doctor will choose one for you based on your symptoms and how long your headaches tend to last.

For example, you can get sumatriptan (Imitrex) as a shot or nose spray. So that might be good if you often get sick to your stomach or throw up during a migraine. Frovatriptan (Frova) and naratriptan (Amerge) stay in your body a long time, which would be helpful if your migraine headaches tend to last a while. If the triptan you try doesn't help much, tell your doctor. You may need to try a different one.

All triptans work best when they're taken soon after your headache starts and your pain is still mild.

Side Effects
Most people do well on triptans. But side effects can include:

  • Dizziness
  • Dry mouth
  • Feeling heavy in your face, arms, legs, and chest
  • Feeling sleepy
  • Flushing
  • Muscle weakness
  • Nausea
  • Skin reaction (if you take the triptan as a shot)
  • Tightness in your throat
  • Tingling sensations
  • Most of the time, these side effects are mild and go away on their own.

In very rare cases, triptans have been linked to heart attacks or strokes. If you're a man over the age of 40 or a woman over 55, your doctor may want to give you a thorough exam before writing you a prescription.

Who Shouldn't Take Triptans?
These drugs aren't right for people who have certain health conditions. Because they can narrow your arteries, you shouldn't take them if you have or are at risk for:

  • High blood pressure
  • Heart disease
  • High cholesterol
  • Bad pain in your chest
  • Problems with your liver
  • Diabetes
  • Stroke

Hemiplegic migraine headaches -- you become weak on one side of your body
Migraine headaches with brain stem auras, which cause vertigo and speech problems
It's important that your doctor knows what other medicines you take. Some drugs can interact with triptans and cause severe problems. These include:

  • Ergotamines
  • Monoamine oxidase inhibitors (MAOIs.)
  • Selective serotonin reuptake inhibitors (SSRIs)

Could Triptans Cause Other Problems?
If you take a triptan drug too often, you may start to have medication-overuse headaches (MOH). Instead of easing your headaches, the triptan could start to cause them.

Unlike a migraine, an MOH is a dull, constant headache that's often worse in the morning. To keep from getting these, try not to use a triptan drug more than 2 or 3 times a week or 10 days each month.

If you find you get migraine headaches more than this, talk to your doctor. Instead of waiting to treat your headaches until after they've started, you may need a drug that can try to prevent them.

Drugs that can help with this include anti-depressants, some blood pressure medications (beta-blockers and calcium channel blockers), and some anti-seizure drugs.

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