Cardiovascular Safety of 5Ht1B/1D Agonists—Is There a Cause for Concern?

@article{Dahlf1998CardiovascularSO,
  title={Cardiovascular Safety of 5Ht1B/1D Agonists—Is There a Cause for Concern?},
  author={Carl G. H. Dahl{\"o}f and Nirmal Mathew},
  journal={Cephalalgia},
  year={1998},
  volume={18},
  pages={539 - 545}
}
Several well-controlled clinical trials have been perfonned in patient populations where the 5HT18/10 agonist sumatriptan (tablet or subcutaneous injection) has been convincingly demonstrated to have good efficacy in the acute treatmern t of lrJgraine attacks (1, 2). On average, three out of four patients have become totally painfree or have obtained considerable relief from headache, nausea, and photophobia (I, 2). Prescribing procedures for surnatriptan differ from cou....,tryto cO'Jntrj, but… 
Tolerability of the Triptans
TLDR
A report on a very large population of patients tested during clinical trials and in postmarketing studies, confirms that these triptans are safe and well tolerated when correctly used.
Sumatriptan: Pharmacological Basis and Clinical Results
  • C. Dahlöf
  • Medicine
    Current medical research and opinion
  • 2001
TLDR
All triptans appear to be very similar with respect to efficacy and tolerability as well as safety in clinical practice, in particular after dose adjustments have been made.
Almotriptan: a review of its use in migraine.
TLDR
Almotriptan is likely to become a useful treatment option in the management of adults with moderate or severe migraine headaches and has a good adverse event profile and a generally similar overall tolerability profile to sumatriptan.
Rizatriptan: a new 5-HT1B/1D receptor agonist for the treatment of migraine.
TLDR
Rizatriptan is an effective and well-tolerated acute treatment for migraine, which may offer some advantages over oral sumatripta, which has a shorter Tmax and greater bioavailability.
Tolerability and Efficacy of Almotriptan in the Long-Term Treatment of Migraine
TLDR
This large, open study indicates that the new, specific 5-HT1B/1D agonist almotriptan, at a dose of 12.5 mg, is a well tolerated and effective treatment for migraine pain when used over a period of up to 1 year.
Integrating the triptans into clinical practice
  • C. Dahlöf
  • Medicine
    Current opinion in neurology
  • 2002
TLDR
The triptans are becoming the first‐line alternatives in the acute pharmacological treatment of migraine, at least for attacks of moderate‐to‐severe intensity, and the tablet is the most commonly used triptan formulation.
Rizatriptan in the treatment of migraine.
TLDR
The marketed 10-mg and 5-mg oral doses of rizatriptan are effective in relieving headache pain and associated migraine symptoms and both doses are generally well tolerated.
Pharmacokinetics and Pharmacodynamics of the Triptan Antimigraine Agents
TLDR
The pharmacological properties of the triptans (time to peak plasma concentration, half-life, bioavailability and receptor binding) are reviewed and related to efficacy and time of onset and the effects of concomitant medication, food, age and disease are considered.
Safety Trial with the 5Ht1B/1D Agonist Avitriptan (BMS-180048) in Patients with Migraine who have Experienced Pressure, Tightness, and/or pain in the Chest, Neck, and/or throat following Sumatriptan
TLDR
It is concluded that the typical 5HT1B/1D agonist-induced chest/throat/neck symptoms are most unlikely to be of cardiovascular origin.
The safety of triptans in the treatment of patients with migraine.
  • D. Jamieson
  • Medicine
    The American journal of medicine
  • 2002
TLDR
Although triptans are contraindicated in patients with cardiac or cerebrovascular disease, they are safer than many other medications used to treat patients with migraine, including the nonspecific serotonin-agonist ergot preparations.
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Clinical studies have shown 311C90 to be rapidly and consistently effective in relieving migraine headache, with initial doses of between 2.5 and 5 mg providing an optimal balance between efficacy and safety considerations.
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Zolmitriptan is well tolerated, particularly at the recommended dose of 2.5 mg, and is well suited as an acute oral treatment for migraine in the outpatient setting, and has a well-defined dose-response, proving highly effective and optimizing the benefit/risk ratio of treatment.
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Zolmitriptan is well tolerated, particularly at the recommended dose of 2.5 mg, and is well suited as an acute oral treatment for migraine in the outpatient setting, despite pre-clinical and neurophysiological evidence of a dual peripheral and central action of zolMITriptan.
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TLDR
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