Triptans are an effective remedy for migraines
Migraine is an inherited disorder characterized by severe throbbing headaches and bouts of nausea, as well as increased sensitivity to bright light and sounds. Migraine often affects women (18% of the total population versus 6% of men), frequent attacks reduce performance and worsen the quality of life.
People with regular migraine attacks rarely see a doctor trying to relieve pain on their own. Not knowing the correct treatment regimen, they take analgesics too late, which is why they have to increase the number of pills. Exceeding the dosage of analgesics puts an excessive burden on the liver and kidneys, which can provoke the so-called drug-induced migraine. In this case, the use of painkillers loses all meaning.
The ability to determine the approach of seizures by the first signs is necessary for the correct relief of pain.
Migraine has four phases:
- The harbinger phase can be fixed due to the feeling of weakness and fatigue in the absence of real reasons. Chronic fatigue can signal many ailments, but most often it occurs due to pathologies of the central nervous system. Do not be lazy to visit the hospital for a full examination, no matter how confident you are;
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The second phase is called the aura phase, at this stage the patient develops autonomic disturbances, distortions of vision, smell, tactile and taste sensations. The patient usually does not have pain, but it is difficult for him to concentrate and speak, the outlines of objects may blur, dizziness and dark spots appear before the eyes;
- Painful phase - throbbing pain usually starts from the temple and gradually covers the entire forehead area, increasing every minute;
- The period after the attack is a feeling of fatigue and weakness, as at the beginning of the attack, which disappears after sleep.
Sometimes the aura phase may be absent, then the attack immediately begins with a headache, the increase of which takes from 10 minutes to several hours.
Now drugs of a new generation, triptans, are used as a therapy for migraine attacks. These are specific analgesics that act on the neurotransmitters of serotonin, derivatives of 5-hydroxytryptamine, which is why this group of drugs got its name.
Triptans show real efficacy in the management of migraine headaches and are available to patients of various categories. Another advantage of this group of drugs is that they can be taken prophylactically between attacks.
Content:
- The action of triptans - migraine pills
- What are the triptans for migraines and how to take them
- The correct method for relieving migraine attacks
- Limiting the use of analgesics and triptans for migraine attacks
The action of triptans - migraine pills
All drugs in this group relieve headaches by triggering the same biochemical mechanism, but usually only 1-2 types of drugs help the patient. To determine how a particular triptan is suitable for a patient, you need to test it in three migraine attacks.
What are the triptans based on:
- Triptans bind to receptors of the vascular walls and affect them, causing the vasoconstriction that supplies the meninges;
- They have a selective effect, binding only with cerebral vessels;
- Triptans block pain sensations by affecting the receptors of the spinal nucleus and reducing their sensitivity;
- Cope well with other symptoms of migraine - phobia and sound, nausea;
- As a prophylaxis, they can be used to prevent recurrence of the disease.
Clinical trials confirm the positive effect of triptans in 60% of cases - this figure is much higher than that of traditional drugs for the treatment of migraines.
What are the triptans for migraines and how to take them
The drugs in this group include: Zomig, Relpax, Naramig, Imigran, Sumatriptan, Rapimed, Amigrenin, Trimigren, Sumamigren - in tablets; Trimigren - suppositories; Imigran - spray.
Triptans must be taken no later than within two hours after the onset of the attack, which occurs immediately after the end of the aura phase. If the onset of pain is too slow so that it is impossible to accurately determine its migraine origin, traditional analgesics are prescribed.
If the patient knows for sure that the headache is caused by a migraine attack, then taking triptans should be combined with prokinetic drugs, which include, for example, metoclopramide.
For severe vomiting and nausea during a migraine, it is better to take triptans not in tablets, but as a spray. Imigran in the form of a spray is used to treat patients with migraine status. Prophylaxis of migraine with triptans in the period between attacks is advisable if the attacks occur more often than twice a month, do not respond to NSAID treatment and significantly disrupt the patient's quality of life.
The correct method for relieving migraine attacks:
- When fixing the precursor or aura phase, give the patient motilium (dosage 10 mg), aspirin (dosage 1000 mg) and give him strong sweet coffee or other caffeine-containing drink;
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After 45 minutes, provided that the pain does not subside, you must take a triptan tablet;
- For the treatment of migraine with a pronounced phase of the aura, triptan is prescribed to the patient for headache, and during the manifestation of the aura itself - aspirin;
- If, after taking a nonspecific analgesic, there is no relief for three attacks, you should immediately drink triptan.
After two days, according to statistics, about half of the patients experience pain again. When there are signs of relapse, it is recommended to take another pill of the drug that was previously used. Treatment should be continued without exceeding the daily maximum dose two hours after the onset of the first symptoms. With a weak return of pain, Naproxen or another similar drug is sufficient.
Severe migraine attacks, in which the headache does not go away both after triptans and after conventional analgesics, require a special treatment regimen. The doctor combines triptans, anticonvulsants and beta-blockers, which include drugs such as Labetalol, Betaxolol, Penbutolol, Nadolol.
The feasibility of using triptans in the treatment of migraine has been proven by clinical practice. But the effect of triptans on the human body with long-term use has not been studied enough, which is why their research continues now.
Find out more: How to reduce the frequency of migraine attacks? All the information you need to treat migraines
Limiting the use of other analgesics and triptans for migraine attacks
- The constant use of triptans to combat migraine attacks is recommended by doctors for no more than 10 days during a month.
- Traditional migraine analgesics are used for no more than half a month in a row. If you use them more often, then the combination with other drugs can provoke headaches. The circle is closed, therapy becomes useless.
- Tempalgin, Analgin, Pentalgin, Baralgin and similar drugs (based on sodium metamizole) are prohibited in most developed countries. Barbiturates, as well as opiates in the composition, contribute to the transition of the disease into a chronic form, and can also cause dependence on drugs. Phenobarbital in Pentalgin can be addictive. Codeine impairs the absorption of analgesics. Therefore, in most cases, drugs from the above groups, as well as the not mentioned Sedalgin and Kaffetin, should be abandoned.
Contraindications to the use of triptans:
- It is forbidden to use while breastfeeding and during pregnancy;
- Any serious diseases associated with the cardiovascular system: hypertension, angina pectoris, ischemic heart disease, cerebrovascular accident;
- Past or present pathologies of the liver and kidneys;
- Allergic sensitivity to the individual components of the drug.
Possible side effects of triptan therapy:
- From the nervous system: regular dizziness, heaviness in the limbs, sometimes manifested by a constant feeling of warmth;
- From the side of the cardiovascular system: attacks of tachycardia and angina pectoris, permanent cardiac arrhythmias, increased blood pressure;
- From the digestive tract: gastritis, dry mouth, accompanied by nausea and diarrhea, ischemic colitis, spleen or intestinal infarction;
- In the work of the genitourinary system, disorders such as polyuria and increased urination may occur;
- Musculoskeletal system: myalgia and muscle weakness;
- Allergic reactions: anaphylactic shock, hyperemia, rashes, very rarely - Quincke's edema.
Triptans are well tolerated, with little expression of side effects that go away on their own without any treatment. Adverse reactions to the drug occur only in the first four hours after taking the drug and do not worsen with a repeated dose.
Triptans do not combine well with pharmaceuticals of the following classes:
- Antidepressants;
- Antibiotics;
- Antifungal medications
- Antiviral agents.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".
