triptans

Triptans & Migraines – Class 101

Triptans are medication commonly prescribed for migraines. Here's everything you need to know about them.

Triptans are a class of pharmacological medication commonly prescribed for migraines. They are prescribed for acute migraine relief, meaning they are taken at the onset of an attack. Their effectiveness is dependent on how soon during an attack they are taken; the sooner you take triptans, the more effective they are.

ARE TRIPTANS FOR ME?

Triptans are usually prescribed as first line treatment, for migraineurs who have only ever used over-the-counter medication to relieve their migraine symptoms.

Triptans have a statistically high success rate; a 2004 study found the drug to be effective for 4 out of 5 migraine patients. Specialists have re-evaluated the drugs effectiveness, and are prescribing them more often. Triptans are generally considered safe for children and pregnant women.

HOW ARE TRIPTANS TAKEN?

Triptans are available in various forms. You can take them as a tablet, a nasal spray or a shot. Having more than one delivery method is very helpful if you feel nauseous during an attack and can’t swallow a tablet. Triptans do not need to be taken after meals, so you can safely take them without the need for a snack.

Do not feel pressured to use only brand name Triptan medication. Generic medication should be just as good as its brand name counterpart. What we would advise is not to keep swapping brands once you find one you are happy with. There might be slight differences in dosage and delivery efficacy, which will create confusion when you notice fluctuations in migraine relief effectiveness.

You should take Triptans as conservatively as possible. Start by taking one dose as soon as you feel a migraine. If you still feel pain two hours after the first dose, a second dose can be administered.

HOW LONG DOES IT TAKE FOR TRIPTANS TO TAKE EFFECT?

Triptans usually start taking effect within two hours of taking the medication. Some Triptans can even start taking effect within 20 minutes, such as Sumatriptan.

Two hours is a long time to be suffering with migraines, so you should be spending that time practising any non-pharmacological therapies you know to be effective, such as sitting in a dark room, doing breathing exercises or anything else which can help sooth your migraines before the medication kicks in.

WHAT IF TRIPTANS DON’T WORK FOR ME?

If after two hours you do not notice any positive effect from the Triptan, you should try other medication, such as NSAIDs, for that particular attack. Any non-pharmacological therapies you know to be effective should also be utilised, such as: a cold compress; sitting in a quiet, dark room; breathing exercises etc

Triptans can take a few tries before you notice any therapeutic effect from them, so do not throw away the box after only one attempt. Try the same Triptan 2 or 3 times (in separate migraine attacks, not all at the same time!). If you still do not notice any sort of positive symptomatic relief at this point, consult your Doctor about changing medication. Your Doctor will likely prescribe another Triptan. If one Triptan does not work, it doesn’t mean that all Triptans are useless for that person; it simply means that the patient must experiment with a few before they find the one best for them.

CAN I TAKE OTHER MEDICATIONS WITH TRIPTANS?

Triptans can be taken safely in combination with certain other medications. NSAIDS have been shown in studies to be an effective mix with Triptans at managing pain.

Anti-nausea medication is another good combination to take with Triptans. Medication such as Metoclopramide works effectively alongside Triptans, reducing migraine or medication related nausea.

Preventative medication is also completely fine to take alongside Triptans. Preventative medication works to reduce the incidence of migraine attacks, so the need for acute migraine relief medication is diminished. 

CAN TRIPTANS BE TAKEN LONG TERM?

Taking Triptans long term is anecdotally said to reduce its effectiveness. There are no scientific studies which support this assertion. The only real worry from taking too many doses of Triptans is the risk of Medication Overuse Headache (MOH). Research shows that taking more than 2 or 3 doses a week can increase your risk of suffering with MOH. This risk is low, at approximately 1 -2 percent of all patients, but is significant enough to recommend keeping your Triptan dosage at below 3 doses per week.

If you are suffering more than 2 migraine attacks a month, it is usually recommended you take preventative medication, and not solely rely on Triptans for migraine relief.

WHAT SIDE  EFFECTS  CAN  I GET FROM TRIPTANS?

So, as has been repeated numerous times already, Triptans are considered safe. This does not mean, however, that they are completely risk free. Like almost any other medication, there is the possibility of side effects. Contact your Doctor for advice if you notice:

  • Dizziness
  • Fatigue
  • Hot/cold flashes
  • Pressure in your chest, jaw, neck or throat
  • Tingling sensation
  • Tiredness
You need to make sure you contact your Doctor immediately if you notice:
 
  • Allergic reactions
  • Stroke symptoms – face drooping, trouble speaking, weakness on one side of body
  • Heart attack symptoms – chest pain, excessive sweating, shortness of breath
  • Heart pathology symptoms – severe chest pain, fast heart rate, irregular heart beat, palpitations
  • Digestive system symptoms – abdominal pain, bloody diarrhea
  • Serotonin syndrome symptoms – big pupils, hallucinations, fast heart rate

FINAL THOUGHTS

Triptans are an effective, generally well tolerated class of medication which should be part of every migraineur’s treatment plan. They can quickly help reduce the intensity of migraine attacks, whenever they strike. Healthy lifestyle choices, alternative therapies and preventative medication are excellent at helping to reduce the incidence of migraines; together with Triptans, migraineurs have a potent combination of acute and preventative therapy: to help make manageable, what was once considered unmanageable.

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