Triptans

Triptans
Drug class
Chemical structure of sumatriptan, the prototypical triptan
Class identifiers
Use	Migraine, cluster headache
ATC code	N02CC
Biological target	5-HT1B receptor, 5-HT1D receptor

Triptans are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches. This drug class was first introduced in the 1990s. While effective at treating individual headaches, they do not provide preventative treatment and are not considered a cure. They are not effective for the treatment of tension headache or other kinds of pain.

The drugs of this class act as agonists for serotonin 5-HT_1B and 5-HT_1D receptors at blood vessels and nerve endings in the brain. The first clinically available triptan was sumatriptan, which has been marketed since 1991.

Triptans are used for the treatment of severe migraine attacks or those that do not respond to NSAIDs or other over-the-counter drugs. Triptans are a mid-line treatment suitable for many migraineurs with typical attacks. They may not work for atypical or unusually severe migraine attacks, transformed migraine, or status (continuous) migrainosus.

Triptans are highly effective, reducing the symptoms or aborting the attack within 30 to 90 minutes in 70–80% of patients.

A test measuring a person's skin sensitivity during a migraine may indicate whether the individual will respond to treatment with triptans. Triptans are most effective in those with no skin sensitivity; with skin sensitivity, it is best to take triptans within twenty minutes of the headache's onset.

Oral rizatriptan and nasal zolmitriptan are the most used triptans for migraines in children.

Triptans are effective for the treatment of cluster headache. This has been demonstrated for subcutaneous sumatriptan and intranasal zolmitriptan, the former of which is more effective according to a 2013 Cochrane review. Tablets were not considered appropriate in this review.