Unfortunately, there is a real lack of studies comparing one triptan medication to another but in the absence of head-to-head studies, this is what we do know about triptans, one of the most commonly used medications to treat migraines.

Triptans were first approved by the FDA for use in treating migraines in 1992 with the introduction of Imitrex (sumatriptan). Since that time there are 6 more triptans that have come to market. They are (including sumatriptan):

1. Almotriptan (Axert)
2. Eletriptan (Relpax)
3. Frovatriptan (Frova)
4. Naratriptan (Amarge)
5. Rizatriptan (Maxalt)
6. Sumatriptan (Imitrex)
7. Zolmitriptan (Zomig)

Originally, it was thought triptans worked by causing vasoconstriction of blood vessels but now there is some speculation that triptans also work by suppressing certain neurotransmitters that trigger pain. So which medications do patients say have the better response?

According to an article published recently in the NEJM, sumatriptan has the fastest onset of action (10 minutes) when administered subcutaneously and is therefore a good drug of choice for rapidly developing migraine or for those who suffer nausea and vomiting. Oral preparations take anywhere from 20 to 60  minutes before their effects can be felt.

Naratriptan and frovatriptan were generally less effective in reducing migraine pain after 2 hours and this was felt to be related to its long half-life. Half-life refers to the time it takes for the medication to fall to half its level in the blood. In other words, these two medications circulate longer in the system so it may be helpful for those whose migranes develop more slowly and linger. In addition, for those migraine sufferers who are sensitive to the side effects of triptan medications (flushing, mild, transient neck tightness or chest tightness, somnolence, loss of energy), naratriptan and frovatriptan may be tolerated better.

Some people should not take triptans – talk to your provider if you have uncontrolled blood pressure, angina or coronary artery disease, diabetes or peripheral vascular disease before taking any triptan medications.

For more information about migraines, you’ll find the following helpful:

Do Migraines Damage the Brain 

Migraine Brain: An Interview With Neurologist Carolyn Bernstein, MD

Feverfew for Migraine Prevention

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