Triptans

“The reason why that's important is when people experience this aladenia, if they use certain migraine-specific treatments like Triptans, but they wait too long, those treatments may be less effective.”

“Those studies ended up leading to the development of Triptans. So estrogen has a number of different roles to play in the pain pathways. Has the experiment been done where you take susceptible women and you selectively give estrogen during the period of time in anticipation of that?”

“That could be NSAIDs and acetaminophen, nosteroidal anti-inflammatory, simple analgesics. It could even be Triptans, migraine-specific medications. It could be barbitri-containing combination analgesics medications like fioracetophioranol, opioids. And then if somebody has other pain disorders, obesity is a risk factor for more frequent migraine.”

“In terms of migraine-specific medications, Triptans were the first class that was specifically designed for the acute treatment of migraine. What predated that were the agotamines, which are still used.”

“And so Triptans, the advent of them really ended up was a game changer for migraine. And even now... 20, what, 30 years ago? We're probably going back to the 1990s.”

“It's also available in nasal spray. And then since that time, there are six more that came along. So there are seven Triptans in total. Are these drugs like statins or GLP-1 agonists, where each new version gets more effective and has fewer side effects?”

“Not necessarily. So there are plenty of people. Sumitriptan was the first one. Some people may be sensitive to sumitriptan versus some of the later Triptans. One of the potential side effects of Triptans is a sense of warmth or heat or tightness anywhere in the body.”

“And then other people use sumitriptan, no issues whatsoever, right? Like, God made this for me. Some of the half-lives of the Triptans may be different. So there may be some that are quicker onset, some that may last longer. And so that's where the decision-making may come in.”

“Okay. Success rate for these across all comers? So looking at Triptans, or for any acute treatment, I'm looking at speed of onset, improvement in associated symptoms, functionality, which is very, very important. Generally, the mark of time that's used is by two hours.”

“And certain Triptans may have a higher recurrence than others. And so that's where the decision-making is used based on all the factors that patients tell me about.”