Triptans - what are they and do they help?

Triptans where developed to treat migraine, they control the serotonin imbalance, which is believed to cause migraine. They are taken at the first signs of a migraine, in the hope to stop one developing

There are seven types of triptans:

Almotriptan (Almogran)
Eletriptan (Relpax)
Frovatriptan (Migard)
Naratritan (Naramig)
Rizatriptan (Maxalt)
Sumatriptan (Imigran)
Zolmitriptan (Zomig)

Imigran is the only over the counter one - all the others are available on prescription from your doctor. They are not for everyone.

Which ones have you tried and how have you found them?

Hi,

I've have tried all the triptans and the only two that I continue to use are Imigran s/c injections and Almotriptan. I have given all the others a fair try but these are the ones that give me the best results. Imigran is used for when I have a left-sided migraine and the almotriptan for a right-sided migraine. Neither work for the opposite side and if a migraine is affecting both sides of my head then again neither work. My consultants find this rather strange but hey that's me!

I do experience so horrible side-effects with both: Imigran causes tightness in my chest and neck, discomfort in my arms, and I experience a burning sensation of the surface of my brain that can take 1 hour to resolve. When these side-effects have resolved then my migraine is cleared for 2 to 4 hours. Almotriptan causes the tightness and discomfort like Imigran but to a lesser degree but it does give me the burning sensation. It also makes me feel very sleepy and can sleep for up to 2 hours after taking it. The migraine can be cleared for about 2 to 4 hours like Imigran.

I also take Ibuprofen whenever I take a triptan, as well as cyclizine (anti-emetic). It it known that taking a triptan with a NSAID (non-steroid anti-imflammatory drug) gives a better response than using either on their own.

My consultants say that I have a hypersensitivity to triptans and although I have set rules to abide by I do have to take breaks from using them for several weeks at a time.

The rules set by my consultants are:

1. Not to use triptans on more than 2 days a week, including any other acute treatments (i.e paracetamol, ibuprofen, naproxen, aspirin, etc) meaning I have 5 days a week without using a triptan or any other acute treatment.

2. Not to use a triptan more than twice a day.

3. Not to mix my triptans, i.e. if I use Imigran first I am not allowed to use Almotriptan in the same day and vice versa.

They set these rules to prevent Medication Overuse Headache (MOH).

Michala
x

Hi

Just like you Kala I have tried almost all of these and the only one I have remained with is Imgrad.

And again like you I have to follow a set of rules:

1. Not to use triptans or any pain killers for more than 4 days a month.

2. Not to use a triptan more than twice a day.

They set these rules to prevent Medication Overuse Headache (MOH).

I must say I love codine and it is the only thing that takes the pain away (masks it really) but I only use this 2 times a month.

I have a bit of a love-hate relationship with triptans too. I have gradually worked my way through them, and usually found that they become less effective over time (eg Maxalt - first it was brilliant, then by the end I had nothing but side effects with no migraine relief).

The one I have stuck with for about 4 years now is Frovatriptan. I hate the side effects (it zonks me out, and makes me very sensitive to hot water - having a bath or shower, or even washing my hands, is horrible for about 24 hours after). I also find that it only works if I take it and sleep straight after. This is obviously not particularly practical!!

Still, it's a lot better than nothing!

Yeah I agree with Tee and Kala..the only thing that can have an effect with me are the imigran injections and even then it will only lower the pain.
I only take them now if I absolutely can't cope as they wipe me out. Not good with two 4years olds. They serve a limited purpose for me in a crisis but as I have migraine symptoms all the time I can't judge when to take them...so I just wait till I am practically punch drunk with pain and do them then.

For a lot of people they are great but I think for suffers with constant symptoms they are a juggling act and you eventually find out what works for you best through trial and error. We are all different in our symptoms and the side effects can be a problem.

Stick to the rules to avoid over use and you can use them safely.

Jane
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Yes, that's the point where I use them too, Jane - at the point where I can bear it no more. Everything else I just put up with.

I agree knowing when to take them can be a nightmare, especially as I normally have an 8-10/10 pain 24/7, and due to the limits placed on their use, how I am supposed to know whether tomorrow or the next day will be worse than what I am experiencing today.

I must say that in my previous post I said the the triptans "clear my migraine" and feel I need to clarify this. I have constant pain in the back of my head, left occipital mainly but right side occipital pain too. The triptans provide no relieve of this pain but when the pain radiates into my frontal lobes (what I now call a migraine) the triptans can clear this pain for 2-4 hours before it returns.

I think as chronic sufferers having constant pain at such a high level it is very difficult to know when a triptan will be beneficial or not, although through my own experiences I have been able to work out what works for me. Although there are times (and I have had plenty of them) when they don't work, for whatever reason, maybe I have left it too long as I think maybe tomorrow will be worse. Unfortunately I believe with this illness it is a lot about learning about your own migraine experiences (and hopefully learning from other peoples too) and seeing what works for you through trial and error.

However, at the moment my botox has reduced my pain scores to 6-7/10 most of the time so again it is easier to indicate when my pain scores are rising and so when I need to take a triptan.

Michala
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I'm the same, Michala, in the sense that the migraine has to be in exactly the right place for a triptan to work (just to the right of my right eye).

Yes that makes perfect sense to me too. X

I am the same - knowing when to take them oh ummm Since I can only have 4 a month, I tend to wait until I can take no more pain and then pop one - or I save them for when I know I am going to have a busy day and I will wobble over.

Must say it was easier when I just had classic migraine (in my teens) and got a tingle in my hand - It was a great warning sign to pop one

Have used sumatriptan for a fair while but it doesn`t seem to be as efficient so changed to migard and zolmitriptan now .
Did find sumatriptan very effective to begin with if i caught symptoms early enough if pain was in the left eye needeed additional pain relisf alongside it and usually like you all zonked out .
Have unfortunately needed zomig twice this week wasn`t an instant relief but did get rid of pain in left eye and head ,like you all i only use the triptans when it is unbearable and can`t function ,like you Tee i find codeine good but try not to use much as quite harsh on the stomach .x

Why have I first found this forum now?!?! I love reading peoples experiences and find there are people out there with the exact same effects of the triptans - I could have written this:

michala

I must say that in my previous post I said the the triptans "clear my migraine" and feel I need to clarify this. I have constant pain in the back of my head, left occipital mainly but right side occipital pain too. The triptans provide no relieve of this pain but when the pain radiates into my frontal lobes (what I now call a migraine) the triptans can clear this pain for 2-4 hours before it returns.

Except with mine it doesnt come back again. It gets so muddled saying it takes the migraine away when you are still left feeling not quite functional with a lot of pain. it is just different pain.
i have to say now on the once a year hangover after overindulgence i laugh in the face of a hangover headache!!!

I tried Imigran but it made me feel really ill for quite a few hours, so my GP told me to try another triptan, rizatriptan, in the form of Maxalt Melts. These literally dissolve on the tongue so get in your system really fast. Great that you don't need water to take them so good when out and about. Also good in the night when you don't even need to sit up to take them! (and we all know how ill that can make you feel...) At my first 6 month review I told my GP that they were a bit hit and miss in whether they worked or not, so I was advised to take something like paracetamol with them too. It is a magic combination and has transformed my life -I can wake with a real cracker and usually it is gone within the hour. I use the combination tabs of paracetamol, asprin and caffeine, which work well for me for just normal headaches too. I woke at 5 this morning with a really bad migraine, so took a Maxalt on its own, but it was still really bad at 6, so took 2 paract on top and by 7 it had gone. Wonderful!!

I found Maxalt Melts rather hit and miss - no better than taking a combo of aspirin, paracetamol and caffeine. When they did work, the simply reduced the pain for a few hours, but had practically no effect on my other migraine sysmptoms

I have now tried all of them - woooopy do.............. and have gone back to Sumatriptan (Imigran) - I still get the rapid heart beats - and they take a little while to kick in BUT they last... and I have worked out it better to wait a little while for the first kick in and a long relief than it coming back at the same high level and not being able to take anything.

I still have a blimp round my period - so I am back on the magnesium and have been given the go ahead to take one triptan a day - 2 days before and upto 5 days after - to see if that can keep them away over the blimp.... we shall see

Hi

well my experiences with triptans are these........I take Zomig (Zolmitriptan 5mg) rapimelt which usually help, and I am very careful that I take them when the pain is migraine. Sometimes I take to my bed and hope to just get rid of the pain with sleep and cocodamol, and then if its persistent out comes the Zomig, and a 'golden bullet' a volterol (Diclofenac) suppository.

The only side effect from Zomig is the hot water previously mentioned, I notice this when the pain is over because I like a nice cup of tea, and I have to be careful when I drink it as it can burn my throat

I can only take 2 Zomig in 24 hours and one Volterol, so if the pain isn't cleared then its back to the cocodamol because that all I have, and the hope it doesn't get worse