Definition
Triptans are a specific group of drugs used in the treatment of headaches, especially migraines. Unlike other painkillers, triptans are not necessarily effective for normal headaches. Especially migraine headaches and so-called cluster headaches can be successfully treated with triptans. The reason is the very special mechanism of action, which is different with triptans than with other painkillers.
Effect of the triptans
Triptans, once ingested, bind to special receptors called 5-HT. There are two subgroups of the receptors that are stimulated by the docking of the triptans. The 5-HT receptors are normally intended for serotonin, which docks there during normal metabolism and leads to corresponding effects in the body.
It is assumed that during a migraine attack, blood vessels in the meninges begin to dilate and for this reason the throbbing, throbbing pain typical of migraines is triggered. When a triptane docks on a serotonin receptor, the blood vessels begin to contract again, which leads to a relatively rapid improvement in the symptoms. Another mechanism of action of triptans is seen in the inhibition of the release of inflammatory substances, which is triggered by the body during a migraine attack.
This inhibition results in no or only slight spreading of the inflammatory reaction in the body. A third mechanism of action is seen as the general inhibition of pain transmission via the cerebral cortex. All three mechanisms of action together ensure that migraine headache and cluster headache are very quickly restricted in their development and that headache does not occur at all to the feared extent. Triptans are not taken preventively to prevent migraine and cluster headache, but should only be taken after the migraine headache has started.
Indications of the triptans
Triptans are commonly prescribed in the last 10-15 years. They have their main use in the treatment of migraine and cluster headache. In migraine, triptans can be used for migraine accompanied by aura or for migraine without aura.
Triptans are usually taken separately and do not require combination treatment with other drugs. In some exceptional cases, a combination with paracetamol or ibuprofen may be considered if the effect of the triptans is not sufficient and a rapid dose increase of this drug should be avoided. Migraine is the main use of triptans.
It should not be taken as a preventive measure, but only when the first signs of migraine appear. Migraine is classified by the fact that it is usually a unilateral pain spreading behind the eye. The pain is almost always throbbing and throbbing and often pulse synchronous.
As a rule and depending on the severity of the migraine attack, moderate to severe accompanying symptoms may also occur. These include nausea and vomiting, weakness, indisposition, visual disturbances. Very frequent and characteristic for a migraine headache is also the sensitivity to light, which the affected persons usually allow to spend the day in a completely darkened room.
There are forms of migraine that are associated with a so-called aura. An aura is a neurological complaint, such as impaired vision, sensory disturbances or other neurological deficits, which typically occur before a migraine attack. In this case, the affected person notices several minutes in advance that a migraine attack is approaching.
Visual disturbances before a migraine attack are classically pronounced. For example, the field of vision of one eye is very much restricted by small flashes that rotate very quickly like a calliope. The limitation of the field of vision can last from a few minutes to an hour.
Shortly afterwards, the often very strong mirgreen-like headaches begin, while the visual disturbances subside. Migraine, together with tension headache, is the most common form of all known headaches. A genetic component is suspected in the development of migraine.
Hormonal connections are also held responsible for the development of migraine. For example, women are more frequently affected by migraine than men, and young patients before menopause are more likely to suffer from migraine than after menopause. Many patients report that migraine frequency has decreased after the menopause or that migraine has disappeared completely.
Sometimes a connection is also seen between migraines and the consumption of some foods.Therapy of migraine, homeopathy for migraineThe dosage of triptans depends on the medication used. The very frequently used sumatriptan should be taken once in a dosage of 50 mg as a tablet. If the symptoms reoccur or do not disappear completely, another tablet can be taken 4 hours after the first intake.
The maximum daily dose is 100 mg. Further dosage forms of Sumatriptan are available as nasal spray and also as injection. The effect is similar for all dosage forms. Zolmitriptan is available in a dosage of 2.5 mg or 5 mg. This drug is also approved as a very fast-acting nasal spray in the dosage of 5 mg. Rizatriptan is available as 5 mg and 10 mg tablets.
