Current and Emerging Second‐Generation Triptans in Acute Migraine Therapy: A Comparative Review

@article{Deleu2000CurrentAE,
  title={Current and Emerging Second‐Generation Triptans in Acute Migraine Therapy: A Comparative Review},
  author={Dirk Deleu and Yolande Hanssens},
  journal={The Journal of Clinical Pharmacology},
  year={2000},
  volume={40}
}
Sterile neurogenic inflammation within cephalic tissue, involving vasodilation and plasma protein extravasation, has been proposed as a pathophysiological mechanism in acute migraine. The action of 5‐hydroxytryptamine (5‐HT1B/1D) agonists—so‐called triptans—on receptors located in meningeal arteries (5‐HT1B) and trigeminovascular fiber endings (5‐HT1D) has an inhibitory effect on this neurogenic inflammation. Recently, a series of second‐generation 5‐HT1B/1D agonists (almotriptan, eletriptan… 
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This review will be particularly focussed on the similarities and differences between the triptans and the ditans, their proposed sites of action, side effects and their cardiovascular risk profile.
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TLDR
The development of agents targeting the 5-HT1B/1D and 5- HT1F receptors and the clinical evidence supporting the use of these agents for acute migraine treatment are summarized.
Mechanisms of action of the 5-HT1B/1D receptor agonists.
TLDR
The high affinity of the triptans for 5-HT(1B/1D) receptors and their favorable pharmacologic properties contribute to the beneficial effects of these drugs, including rapid onset of action, effective relief of headache and associated symptoms, and low incidence of adverse effects.
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    Expert opinion on investigational drugs
  • 2002
While oral formulations of agonists at the serotonin (5-HT) receptor subdivisions 5-HT1B/1D – the ‘triptan’ class of drugs – dominate the market for migraine therapy and while still more triptans are…
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TLDR
If CNS sideeffects are a clinically relevant concern in the individual patient, use of a triptan with a low incidence of CNS side-effects may offer the potential for earlier initiation of treatment and more effective outcomes.
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TLDR
A quick but exhaustive schedule type is established, merely in order to standardize all data obtained through a few fixed parameters and therefore directly comparable on the currently available compounds.
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TLDR
As the contraindication between zolmitriptan and SSRIs is theoretically, not empirically, based and the opportunity to coprescribe these agents is likely to be frequent, a re-evaluation of the contraineddication is justified.
Renal Infarction During the Use of Rizatriptan and Zolmitriptan: Two Case Reports
TLDR
Although both rizatriptan and zolmitriptan are effective in the treatment of migraine and cluster headaches, they may induce peripheral vasospasm leading to renal infarction.
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