The role of triptans in the management of migraine

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Published: 2016-02-26
DOI: https://doi.org/10.18051/UnivMed.2009.v28.49-58
Keywords:
Tiptans, migraine, serotonin reseptor

Main Article Content

Meiyanti Meiyanti
Department of Pharmacology, Medical Faculty, Trisakti University

Abstract

Migraine is one of the most prevalent disorders seen in clinical practice today and also a major cause of disability in the workplace. The prevalence of migraine is highest during the years of peak productivity, ie, between the ages of 25 and 55 years. The triptans are a group of selective 5-hydroxtriptamine (HT)1 serotonin receptor agonists that activate the 5-HT1B/1D receptor and possibly also the 5-HT1A dan 5-HT1F receptors. To date 7 subclasses of serotonin receptors have been identified, namely subclasses 5-HT1 to 5-HT7. Triptan causes cranial vasoconstriction, inhibits peripheral trigeminal activity and the trigeminal afferents. With its triple action, triptans can control acute attacks of migraine. Triptan is contraindicated in patients with previous ischemic or coronary artery disease, cerebral or peripheral vascular disease and other cardiovascular disorders. Triptans should be given immediately after an acute attack of migraine. The triptans are useful in the management of an acute migraine, but are not indicated for preventive therapy of migraine. Several new advances in migraine management have been made in regard to the recognition of the disease, the pathogenesis of migraine, and the phenomenon of central sensitization. More treatment options become available to patients and prescribers, the impact of such therapy on worker productivity will become more important in determining the value of such interventions.

Article Details

Issue

Vol. 28 No. 1 (2009)

Section

Review Article

The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.

How to Cite

The role of triptans in the management of migraine. (2016). Universa Medicina, 28(1), 49-58. https://doi.org/10.18051/UnivMed.2009.v28.49-58

References

Blanda M. Headache, Migraine. Available at : http://www.emedicine.medscape.com. Accessed August 20, 2008.

Srivastava SS. Pathophysiology and treatment of migraine and related headache. Available at: http://www.emedicine.medscape.com. Accessed August 20, 2008.

Lipton RB, Liberman JN, Kolodner KB, Bigal ME, Dowson A, Stewart WF. Migraine headache disability and health-related quality of life: a population-based case-control study from England. Cephalalgia 2003;23:441-50.

Magnusson JE, Becker WJ. Migraine frequency and intensity: relationship with disability and psychological factors. Headache 2003;43:1049-59.

Terwindt GM, Ferrari MD, Tijhuis M, Groenen SM, Picavet HS, Launer LJ. The impact of migraine on quality of life in the general population: the GEM study. Neurology 2000;55:624-9.

Lofland JH, Johnson NE, Batenhorst AS, Nash DB. Changes in resource use and outcomes for patients with migraine treated with sumatriptan: a managed care perspective [published correction appears in Arch Intern Med 1999;159:2228]. Arch Intern Med 1999;159:857-63.

Villalon CM, Centurion D, Valdivia LF, Vries P, Saxena PR. Migraine: pathophysiology, pharmacology, treatment and future trends. Curr Vasc Pharmacol 2003;1:71-84.

Li TH, Wong LK. Advances in headache diagnosis and treatment. Medical Progress 2009;161-5.

Srivastava SS. Medication for migraine headache: a review of adverse effect profile and safety. Headache 2004;44:S31-9.

Sanders-Bush E, Mayer SE. 5-Hydroxytryptamine (serotonin): receptor agonists and antagonits. In: Hardman JG, Limbird LE, Gilman AG, editors. Goodman & Gilman’s The pharmacologic basis of therapeutics. 10th ed. New York: MC Graw-Hill; 2001.p.269-90.

Goadsby PJ, Lipton RB, Ferrari MD. Migraine current understanding and treatment. N Engl J Med 2002;346:257-70.

Spierings ELH. Mechanism of migraine and action of antimigraine medications. Med Clin North Am 2001;85:943-58.

Aurora SK. Pathophysiology of migraine. Available at: http://www.touchneurology.com. Accessed April 28, 2009.

Tepper SJ. Safety and rational use of the triptans. Med Clin North Am 2001;85:959-70.

Reuter U, Moskowitz MA. New insights into migraine pathophysiology. Curr Opin Neurol 2006; 19:294-8.

Jamieson DG. The safety of triptan in the treatment of patients with migraine. Am J Med 2002;112:135-40.

Tfelt-Hansen P, De Vries P, Saxena PR. Triptans in migraine: a comparative review of pharmacology, pharmacokinetics and efficacy. Drugs 2000;60: 1259-87.

Jhee SS, Shiovitz T, Crawford AW, Cutler NR. Pharmacokinetics and pharmacodynamics of the triptan antimigraine agent: a comparative review. Clin Pharmacokinet 2001;40:189-205.

Vincenza S, Kweiss K, Wall AM, Pilson CM. Pharmacologic management of acute attacks of migraine and prevention of migraine headache. Ann Intern Med 2002;137:840-9.

Oldman AD, Smith LA, McQuay HJ, Moore RA. Pharmacological treatments for acute migraine: quantitative systematic review. Pain 2002;97:247-57.

Waeber C. Emerging drugs in migraine treatment. Expert Opin Emerg Drugs 2003;8:437-56.

Kaniecki R. Headache assessment and management. JAMA 2003;289:1430-3.

Armstrong SC, Cozza KL. Triptans: med-psych drug-drug interactions update. Psychosomatics 2002;43:502–4.

US Food and Drug Administration. Information for healthcare professionals: selective serotonin reuptake inhibitors (SSRIs), selective serotonin– norepinephrine reuptake inhibitors (SNRIs), 5-hydroxytryptamine receptor agonists (triptans). Available at: http://www.fda.gov/CDER/DRUG/Info Sheets/HCP/triptansHCP.htm. Accessed Sept 14, 2008.

Wooltorton E. Triptan migraine treatments and antidepressants: risk of serotonin syndrome. CMAJ 2006;175:874-5.

Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005;352:1112-20.

Birmes P, Coppin D, Schmitt L. Serotonin syndrome: a brief review. CMAJ 2003;168:1439-42.

Ferrari MD, Roon KL, Lipton RB, Goadsby PJ. Oral triptans (serotonin 5-HT 1B/1D agonist) in acute migraine treatment: a meta-analysis of 53 trials. Lancet 2001;358:1668-75.

Ferrari MD, Goadsby PJ, Roon KI, Lipton RB. Triptans (serotonin, 5-HT 1B/1D agonists) in migraine: detailed results and methods of a meta-analysis of 53 trials. Cephalalgia 2002;22:633-58.