Examples
| Brand Name | Chemical Name |
| Imitrex | sumatriptan succinate |
| Zomig | zolmitriptan |
The injected form of sumatriptan is used to treat cluster headaches. Self-injection kits are available so that you can give yourself the shot. Nasal and oral sumatriptan are available but are less effective than the injectable form. Research is being done that shows a stronger dose of sumatriptan nasal spray may be more effective.1
You can take zolmitriptan as a pill (by mouth) or use it as a nasal spray.
How It Works
Triptans (sometimes referred to as 5-HT-1 receptor agonists) shrink the blood vessels in the brain, which may relieve pain by reducing pressure from inflammation that can occur with cluster headaches. Triptans may also affect certain brain chemicals that regulate pain.
Why It Is Used
Sumatriptan may be injected to stop cluster headaches.
Zolmitriptan may be sprayed in the nose (nasal spray) to stop cluster headaches.
How Well It Works
When injected early in a cluster headache, sumatriptan can relieve headache pain within 5 minutes.2 Up to 90% of people have reduced headache pain when given a sumatriptan injection as soon as a cluster headache first begins. The injection also may stop subsequent headaches in the cycle from developing.3
Nasal and oral sumatriptan are less effective than the injectable form. But research is being done that shows a stronger dose of sumatriptan nasal spray may be more effective.1
Zolmitriptan, when used as a nasal spray early in a cluster headache, can relieve headache pain within 20 minutes. A higher dose may relieve headache pain even faster.4
The pill form of zolmitriptan (taken by mouth) does not relieve cluster headache pain as well as injected sumatriptan.5
Side Effects
Triptans may cause side effects such as:
- Nausea.
- Flushing.
- Tingling.
- Dizziness.
- A feeling of warmth or coldness.
- Sleepiness.
- Burning at the injection site (with the injected form of sumatriptan).
- Excessive thirst.
- Frequent urination.
- Temporary rise in blood pressure.
Side effects usually develop shortly after receiving the medication and go away within 1 hour. Some people may experience chest pressure or tightness. This is usually not dangerous.
The U.S. Food and Drug Administration (FDA) has issued a warning about taking triptans, used for migraines, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a serious condition called serotonin syndrome.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Triptans should not be used if you have heart disease, uncontrolled high blood pressure, or are pregnant or nursing.
Triptans should not be combined with certain other medications, such as ergotamines.
Triptans can be very expensive, so the cost of treating frequent cluster headaches can add up. If you are thinking about using triptans to treat your cluster headaches, you may want to weigh the cost of a triptan against the cost of other medications, office visits, and time lost from work.
It is important that you do not use triptans on a daily basis to treat or prevent cluster headaches. Overuse of triptans can cause you to have more headaches when the medicine wears off. These are called rebound headaches. If you feel like you need to use triptans often, talk to your doctor. He or she may have you try a different medicine.
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References
Citations
Schuh-Hofer S, et al. (2002). Treatment of acute cluster headache with 20 mg sumatriptan nasal spray—An open pilot study. Journal of Neurology, 249(1): 94–99.
Rozen TD (2002). New treatments in cluster headache. Current Neurology and Neuroscience Reports, 2(2): 114–121.
Evans RW (2003). Headaches. In Saunders Manual of Neurologic Practice, pp. 25–32. Philadelphia: Saunders.
Rapoport AM, et al. (2007). Zolmitriptan nasal spray in the acute treatment of cluster headache: A double-blind study. Neurology, 69(9): 821–826.
Bahra A, et al. (2000). Oral zolmitriptan is effective in the acute treatment of cluster headache. Neurology, 54(9): 1832–1839.
Credits
| Author | Monica Rhodes |
| Editor | Kathleen M. Ariss, MS |
| Associate Editor | Pat Truman |
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
| Specialist Medical Reviewer | Colin Chalk, MD, CM, FRCPC - Neurology |
| Last Updated | April 21, 2006 |
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