What are triptans?
According to modern research, one of the causes of migraines lies in congenital serotonin deficiency.
In the 90s of the last century, substances that were derivatives of serotonin were synthesized, and therefore have a high tropism for the 5HT1D and 5HT1B serotonin receptors. This class of drugs is called triptans.
One of the causes of migraines lies in serotonin deficiency
What does serotonin do in migraines?
Normally, the supply of serotonin is contained in platelets - blood cells responsible for blood clotting. If the lack of this neurotransmitter reaches a critical level, it is released into the blood from platelets, which, along with other factors, leads to a sharp narrowing of the blood vessels in the brain. With the subsequent depletion of serotonin reserves and the expansion of the branches of the carotid artery going to the membranes of the brain, a large volume of blood rushes into them. The result is neurogenic inflammation and an attack of acute pain. The nuclei and branches of the trigeminal nerve are included in the pain reaction process.
Admission rules
Triptans can be used for migraines both with and without an aura before an attack. They can be used only after the aura ends, but no later than two hours after the onset of pain. When the headache is growing slowly, and the person is not sure that it is a migraine attack, it is not advisable to use triptans; it is better to start with a regular analgesic. If a person is sure that the pain is migraine in nature, you can combine taking a triptan with other drugs for the accompanying symptoms of migraine, for example, antiemetics.
If the headache returns after taking a certain remedy, but it is quite bearable, it is better to replace the triptan with a regular analgesic. An additional dose of the drug can be taken no earlier than two hours after the first use, and you need to follow the maximum permitted daily dose of the drug indicated in the instructions. Triptans for migraines can be used regularly, but in total no more than 10 days a month.
During the most severe migraine attacks, when there is no response to either conventional analgesics or triptans, doctors can develop an optimal treatment regimen for the patient, which will include triptans, beta blockers, and anticonvulsants.
How do triptans help with migraines?
Triptans are effective for moderate to severe migraines. They prevent the pathological expansion of blood vessels in the head and block pain at the receptor level of the trigeminal nerve.
Taking triptans helps:
- quickly relieve the condition during an attack;
- reduce or completely remove pain;
- remove swelling and inflammation of the blood vessels of the head without affecting the general blood flow;
- eliminate other symptoms of migraine: nausea, phono- and photophobia;
- prevent relapse of the attack.
How to quickly and effectively stop a migraine attack?
In order to get rid of a migraine attack, there is an effective and proven scheme:
- first of all, you should take 1000 mg of aspirin, 10-20 mg of Motilium and drink a cup of drink with caffeine and sugar;
Motilium - if after 45 minutes there is no visible relief, you need to take one of the triptans;
- if the use of analgesics does not bring the desired result for three attacks in a row, you should immediately take triptans;
- in cases where migraine is accompanied by an aura, acetylsalicylic acid should be taken immediately after the onset of unpleasant symptoms, and after the onset of headaches, a triptan should be taken immediately.
In addition, you can alleviate the condition of a migraine if you lie down in a dimly lit room, periodically take a cool shower, and drink soothing decoctions of medicinal herbs.
You can rub ointments containing menthol or regular “Star” into your temples, and also massage the points that are responsible for brain activity.
Migraine is a disease that can affect anyone. There are medications to relieve attacks, they are called triptans. This group has a large list of medications. Thanks to its use, you can eliminate the unpleasant symptoms of migraine. The most important thing is to consult a doctor to select a medication and adhere to the information specified in the instructions for use.
Triptans tablets
Sumatriptan (Sumamigren, Imigran, Amigrenin), eletriptan (Relpax), and zolmitriptan (Migrepam) are widely used in Russia.
Sumatriptan is considered the gold standard treatment for migraine. Studies have found that 70% of people experience headache relief after taking sumatriptan, and 60% return to their normal lives within two hours.
All migraine medications have contraindications and restrictions for use, as well as possible side effects: be sure to read the official instructions before taking them.
Sumatriptan - instructions for use
Side effects of drugs
Such drugs can be taken only 10 days a month. Otherwise some problems may arise. More frequent use of triptans may lead to the development of headaches that occur while taking the drug. In addition, drugs of this type have side effects, including:
- Feeling of warmth and stiffness in the limbs, drowsiness, asthenia, dizziness, sensory disturbance.
- Gastric or splenic infarction, ischemic colitis, hemorrhagic diarrhea, dry mouth, abdominal pain and nausea.
- Myalgia and muscle weakness.
- Spasm of coronary vessels, myocardial infarction, angina pectoris, tachycardia, rapid heartbeat.
- Polyuria and frequent urination.
- Anaphylactic shock, Quincke's edema, urticaria.
Despite all this, triptans for migraines are a quick-acting cure. If you take the medications strictly according to the instructions, then there will be no problems. The only noticeable drawback of such medications is the cost. Not everyone can afford to purchase such a drug.
How to take triptans?
Any drug from the triptan class should be taken once and preferably at the very beginning of an attack, before a severe headache develops. A single dose for an adult is a 50 or 100 mg tablet. The maximum effect of triptans occurs within 2-4 hours after taking the first dose and lasts for several hours.
It is permissible to take the next tablet if the attack subsides and then resumes (no less than 2 hours later).
You should not take several drugs from this group at the same time, or together with other serotonergic drugs.
It is permissible to use triptans alternately with anti-inflammatory analgesics to prevent the development of dependence on these drugs.
Treat migraines with antispasmodics and painkillers?
Migraine differs from ordinary headaches in its increased intensity and localization in a certain part of the head (temples, back of the head, frontal lobe, etc.). It is associated with the dilation of blood vessels in the brain, and the duration of the attack can vary from several hours to three days, so patients try to eliminate the excruciating pain as soon as possible.
What medications are not recommended for use in this case? First of all, these are all products containing sodium metamizole (“Analgin”, “Pentalgin”, “Spazgan”), since it can cause serious harm to health - it is for this reason that the substance is prohibited in many developed countries.
In addition, some drugs contain phenobarbital, which can be addictive, and codeine, which slows down the absorption of painkillers. As for other medications, barbiturates and opiates increase the risk of the disease becoming chronic, and conventional analgesics, as a rule, do not bring the desired effect. Therefore, the best option for everyone who suffers from migraines is to turn to new generation drugs that can effectively and quickly stop an attack of the disease.
Release forms
With nausea, gastric atony and vomiting, which often accompany a migraine attack, the bioavailability of the drug in tablets is greatly reduced. Along with taking tablets, there are other ways of administering the drug: intranasal, subcutaneous, in the form of suppositories, etc.
Nasal spray
Imigran nasal spray became an innovative form of sumatriptan. The technique for using it is similar to a regular runny nose spray. The effect of this administration of sumatriptan occurs twice as quickly as from taking a tablet. Also an undeniable advantage is the ability to use the spray for nausea and vomiting.
Skin patch
There is another dosage form of sumatriptan, which, unfortunately, is not registered in Russia. It is a microprocessor-powered, battery-powered transdermal patch-style system that releases the drug under the patient's skin through microinjections. The patch with the system is glued to the skin of the shoulder directly during an attack. The effect occurs within 10-15 minutes.
What to do if it doesn't help
Today, triptans are officially recognized as the most effective drugs used to treat migraines. But there are times when even their use does not bring the expected result. As a rule, these are severe forms of migraine in the presence of any concomitant pathology. When such a patient begins to experience migraine status and all medications are ineffective (the pain does not go away), hospitalization will definitely be necessary.
In the inpatient department of the neurology department, such a patient will undergo a comprehensive examination, all diseases that aggravate the pathogenesis of migraine will be identified, and based on this, a suitable therapeutic treatment regimen will be selected, it will include drugs from the following pharmacological groups:
- Anticonvulsants (Depakine, Valprocom)
- Selective B blockers
- Triptans
- Nonsteroidal anti-inflammatory drugs
The scheme presented above is used in most cases, but it is possible to prescribe drugs from other pharmacological groups. Neurologists often recommend taking Cipralex in parallel with triptans.
