Treatment of Acute Headache

Serotonin receptors 5-HT1B and 5-HT1D in the cerebral arteries are activated by the 5-hydroxytryptophan agonists (triptans) to relieve the discomfort associated with migraines. Even though triptans are often used to treat acute migraines, there is some debate over their effectiveness.

The present study evaluated the effectiveness of triptans for acute treatment of migraine in young individuals by searching the reputed databases. It identified 1047 studies and finally included 25 articles in the study.

The study observed-

•  Inclusion of 17 RCTs and eight non-randomized trials. 
• Participants aged ranged between 12–17 years in most studies. 
• Among the included studies, 7 reported sumatriptan use, 3 assessed a combination of sumatriptan and naproxen, four were on almotriptan, one on eletriptan, six on rizatriptan, and four on zolmitriptan use.

This study found rizatriptan (good tolerability profile with a dose of 5 mg) and sumatriptan (nasal spray, 10 mg, and 20 mg) to be more efficient than other triptans. Regardless of type or dose, patients generally well tolerate all triptans, but a few adverse effects, such as light-headedness (sumatriptan), nasopharyngitis, and muscular spasms (sumatriptan/ naproxen), somnolence, and dry mouth (rizatriptan), and dizziness (zolmitriptan group) may be associated with the triptans.

Chanchlani R, Agrawal A, Janjua D. et al. The Efficacy of Different Triptans for the Treatment of Acute Headache in Pediatric Migraine: A Systematic Review. Indian Pediatr.2023; 60:663–671. https://doi.org/10.1007/s13312-023-2968-0