Pain Research and Management (Jan 2000)
Use of the Triptans
Abstract
In the past 10 years, there have been great advances in the understanding of the pathophysiology of the migraine. This has been due in part to the realization that the migraine attack can be blocked by activating the serotonin receptor, namely the 5-hydroxytryptamine/1D receptor. This switches off the inflammatory process around the blood vessel, which is the cause of the migraine pain, and constricts the blood vessel involved, thus relieving pressure on it. The first drug that was developed to activate this system was sumatriptan, followed by zomitriptan, naratriptan and rizatriptan. These drugs are, as a group, called the 'triptans'. This review summarizes the pathophysiology of migraine, examines the guidelines for the diagnosis of migraine, which is important because the drugs are relatively specific for migraine itself, and discusses the differences among the components in this class.