Panel: Triptans Safely Relieve Migraine Pain
4 out of 5 Sufferers Could Benefit From Migraine Treatment With Triptans
May 5, 2004 -- As many as four out of five people who suffer
from painful migraines could benefit from treatment with a class of drugs known
as triptans, according to a new report. But as little as one in five migraine
sufferers actually get the drugs.
A panel of headache experts found that the potential for pain
relief and improvement in quality of life provided by triptans, such as
Imitrex, Zomig, and others, far outweigh the potential risks for most people
Researchers say many doctors may be reluctant to prescribe
triptans for migraine treatment due to concerns that these drugs may cause
serious heart problems.
But the panel's review of nearly three dozen studies as well as
the FDA's adverse event reports on triptans showed that these concerns are
generally unfounded for people without heart disease risk factors.
"While serious cardiovascular adverse events have been
reported after the use of triptans, their occurrence appears to be extremely
low, on the order of less than one per 1 million," says researcher David
Dodick, MD, director of the Mayo Clinic Headache Program in Scottsdale,
Dodick headed the Triptan Cardiovascular Safety Expert Panel
convened by the American Headache Society to look at the safety of triptans in
migraine treatment. Their findings appear in the May issue of the journal
Panel Recommends Triptans for Migraine Treatment
Seven triptans are approved by the FDA for migraine
The pain of migraines is caused by inflammation and increased
blood flow through arteries in the head due to enlarged blood vessels. Triptans
work by narrowing blood vessels and relieving some of this swelling associated
with migraines. In people with heart disease or high blood pressure, this
effect may reduce blood flow to the heart too much and lead to
But in their review, researchers found no serious heart-related
problems, such as heart attack, reported in 18 studies of triptan use in people
with no known heart disease. The studies showed that chest pain or pressure
occurred in 1% to 10% of people who take triptans, but these effects were
Overall, the study showed the risk of a serious heart-related
complication due to triptans was less than one in 1 million.
In contrast, Dodick says the risk of death associated with
another class of medications that migraine sufferers frequently turn to, known
as nonsteroidal anti-inflammatory drugs (NSAIDs), is as much as one in 200.
NSAIDs, such as ibuprofen, aspirin, and naproxen, have been
linked to more than 16,000 deaths per year from people who take them to relieve
arthritis pain. The deaths are mostly due to stomach or intestinal
Although many drugs come with a certain level of risk, Dodick
says the overwhelming benefit that this class of drugs gives to migraine
patients favors their use in the absence of certain situations.
Triptans are not recommended for migraine treatment in people
with heart disease, pregnant women, or those with certain rare forms of