Triptans - treating migraine headaches

(Click under Resources at right of the Consumer Reports URL site to download full 16-page report)                           Available en espagnol
Triptans are effective medicines used to treat migraine headaches. For about 60% of people who take one, a triptan reduces pain within two hours. While complete pain relief is not common, it can be enhanced if you take a triptan early in a migraine attack. The triptans also help relieve other migraine symptoms, such as nausea, vomiting, and sensitivity to light, noise, and motion.

If you have mild and less frequent migraine attacks, try other pain relievers first, including aspirin, an NSAID (such as ibuprofen), Excedrin Migraine or Excedrin Extra Strength. If your migraines are moderate to severe, frequent, and/or disrupt your life, you are likely to need a triptan.

However, the triptans should not be taken by people with certain conditions because of risks they pose to the heart. This includes people with coronary artery disease or angina (chest pain), those who have had a heart attack or stroke, and people who have peripheral vascular disease, uncontrolled high blood pressure, diabetes, or who smoke.

In addition, the triptans should be prescribed with caution for men over 40, women over 50, people who have high cholesterol, diabetes, or who are significantly overweight and those with a family history of early heart disease or stroke.

There are seven triptans and they differ in their effectiveness and the side effects they cause. They are expensive drugs (with none yet available as a generic) and tend to be priced about the same on a per pill basis ($21-$26). The nasal spray and injectable forms cost more. We have chosen three triptans as Consumer Reports Best Buy Drugs:

• Sumatriptan (Imitrex) - for people with moderate to severe headache pain and symptoms
• Rizatriptan (Maxalt) - for people with moderate to severe headache pain and symptoms
• Naratriptan (Amerge) - for people with milder migraines who are sensitive to triptan side effects and/or have longer-duration migraines

Each of these three drugs have unique strengths which are discussed in detail in our full report. They are chosen Best Buys largely on their clinical merits, and not their cost. The cost for triptan treatment depends entirely on how often you have to use one, since triptans are only taken when a migraine occurs. Frequent use can be expensive.