Definition
Almotriptan is a drug that is mainly used in the treatment of migraine. It belongs to the group of triptans and its chemical structure makes it a so-called 5-HT1 receptor agonist. Like all triptans, the drug is not intended for preventive treatment, but should only be used when the first symptoms of migraine begin.
Effect and duration
Almotriptan works by stimulating the 5-HT1 receptors that are distributed throughout the body. Almotriptan works in three different ways. Firstly, after the drug binds to a 5-HT1 receptor, the vessels that are dilated during a migraine attack become narrower, which leads to a decrease in the throbbing pain stimulus.
In a second step, mediators that are released by the body during a migraine attack and that cause inflammatory changes are prevented from being released, which reduces the inflammation. In the third way, almotriptan works by reducing the transmission of pain stimuli via the cerebral cortex, i.e. the pain is not perceived in the same way when taking almotriptan as it would be without medication. In addition to its headache relieving effect, almotriptan can also often successfully reduce the often very massive accompanying symptoms of a migraine attack.
These include nausea and vomiting, impaired vision and sensitivity to light. In the best case, no other medication besides almotriptan needs to be taken at all. After taking the drug, which should be taken immediately after the first headache symptoms, there is an initial improvement in symptoms within the first 30 minutes to 2 hours.
In the best case the headache disappears completely and no further medication is necessary. In some cases, either the headache returns after about 4-6 hours or the accompanying symptoms. Exactly when a triptan starts to take effect depends on the one hand on each organism individually, and on the other hand on which preparation was chosen and in which dosage form it is used. Thus triptans taken as tablets usually take a little longer to set in than triptans taken as nasal sprays, for example.
Side effects
Almotriptan is usually quite well tolerated. However, there are some side effects and interactions with other drugs that need to be considered. Because the drug causes the blood vessels to contract, the blood vessels of the heart can also contract, which can lead to a condition called angina pectoris.
In very severe cases this can result in a heart attack. In addition, a drop in blood pressure and a rapid pulse have been observed when taking triptan. Sometimes there can also be neurological side effects when taking almotriptan.
These include paresthesia and numbness of the arms, legs and hands or fingers. Dizziness is relatively common when taking almotriptan. This is usually a mixed picture of swaying and rotational vertigo.
This is probably also caused by a drug-induced narrowing of the blood vessels. The use of almotriptan is absolutely contraindicated if one of the following diseases is present in the patient: coronary heart disease, stroke, liver or kidney failure. Furthermore, Almotriptan should not be taken during pregnancy or when breastfeeding.
As with many other painkillers, excessive use can have the opposite effect to headaches. To be more precise, this is a paradoxical effect that can occur if Almotriptan is taken for an excessively long time. Sometimes the headaches are even triggered by almotriptan.
It also happens that the headaches improve after taking almotriptan, but then within a few hours the headaches reoccur, which causes the person to take almotriptan again. If such symptoms have occurred over long periods of use, weaning of the triptan should be considered. Weaning treatment should not be carried out at home alone, but preferably as an in-patient in a pain clinic.
Here you can then specifically address the symptoms caused by weaning of almotriptan with medication. Patients who have had to take 15 tablets or more per month or more are usually enrolled for a triptan withdrawal treatment. After the withdrawal period, a new course of treatment must be determined, as triptans should not be taken again.