Triptans: Features of the choice of targeted migraine therapy

Among the many non-communicable diseases that reduce quality of life, migraine is one of the top three, significantly ahead of cerebrovascular and oncological diseases, injuries and diabetes. A pulsating, intense headache, typical of migraine, is accompanied by a combination of nausea, vomiting, photophobia and phonophobia, and significantly affects daily activity and work capacity. An attack can begin suddenly, sometimes at the most crucial moment, and in the absence of proper therapy can last from 4 to 72 hours. Therefore, the selection of effective abortive therapy for migraine is a priority task in the management of such patients. Triptans are the first specific agents for the treatment of acute migraine attacks, due to their agonist properties in relation to serotonin (5-HT) receptors. Over the half-century of use, 3 generations of triptans have been synthesized, various dosage forms have been developed, from the usual tablet to forms in the form of a spray or orally disintegrating tablet.

With the increasing number of available forms of therapy, treatment approaches require revision and more careful selection based on individual patient characteristics such as attack severity, frequency of occurrence, comorbid conditions, and patient preferences. This article discusses aspects of targeted migraine therapy, as well as approaches to choosing triptans, taking into account modern clinical guidelines and the results of recent studies. The mechanism of action and points of application of triptans, the pharmacokinetic features of individual representatives of the triptan series are described in detail. The results of the latest clinical studies of the effectiveness and safety of triptans in stopping migraine attacks are presented.

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