Triptans in migraine headaches – the balance of benefits and risk
Klinika Neurologii i Udarów Mózgu, Uniwersytet Medyczny w Łodzi
Adres do korespondencji: Karol Jastrzębski, Klinika Neurologii i Udarów Mózgu, Uniwersytet Medyczny w Łodzi, ul. Żeromskiego 113, 90-549 Łódź, e-mail: karol.jastrzebski@umed.lodz.pl
Aktualn Neurol 2017, 17 (2), p. 104–114
DOI: 10.15557/AN.2017.0011
ABSTRACT

Migraine is a very common problem affecting ca. 15–18% of women and 6% of men. Chronic migraine occurs in ca. 2% of the general population and is associated with the abuse of analgesics. There is a small number of medicines which have a proven prophylaxis effect in episodic and chronic migraine. Such a large market resulting from the epidemiology has been interesting for pharmaceutical companies for years which has led to the inventing of a group of medications referred to as triptans. This group owes its name to the presence of tryptamine in the molecule. Triptans are agonists of serotonin receptors – 5-HT1, mainly of the subtype B and D (5-HT1B, 5-HT1D), and they cause the constriction of vessels in the central nervous system. The result of the research carried out until now by pharmaceutical companies is the introduction of seven triptans into the market. Undoubtedly, they have achieved clinical and commercial success, however, over time it was found that they are not effective in every patient and that they induce specific adverse effects. The paper shortly discusses the pharmacokinetic aspect and the adverse effects and it more thoroughly presents particular triptans in terms of their effectiveness in comparison with the nonsteroidal anti-inflammatory drugs (if such papers have been published) and with other triptans. The conclusion includes several observations which the author deems worth attention and memorizing: 1) The biological/clinical effect of the new group of drugs referred to as triptans is similar to the effect of nonsteroidal anti-inflammatory drugs used for years. 2) The analysis of the data related to the safety of use indicates that these medications are not as safe as was thought. 3) In case of the failure of the therapy performed using one triptan another triptan should be applied because the resistance to one type of triptan does not imply the resistance to the remaining ones.

Keywords: headaches, migraine, triptans, pharmacokinetics, safety