Study: Triptans give best pain relief for migraines, but have more side effects than newer drugs

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Oct. 11 (UPI) — A class of drugs called triptans remains the most effective treatment for migraines, an analysis of data from more than 60 studies published Monday by JAMA Network Open found.

Adults treated with a triptan were up to three times more likely to report being free from pain two hours later than those given the migraine drugs lasmiditan, which is sold as Reyvow; rimegepant, branded as Nurtec ODT; or ubrogepant, branded as Ubrelvy, the data showed.

However, the newer medications — of drug classes called gepants and ditans — appear to have fewer side effects and may be safer for people with a history of heart disease or stroke, they said.

“New acute migraine treatment drugs, gepants or ditans, are effective when compared to placebo, but they are not as effective as triptans, the current standard prescribed acute migraine medication,” study co-author Dr. Shuu-Jiun Wang told UPI in an email.

“Nonetheless, both gepants and ditans are safe for those with cardiovascular risks, and gepants had a much lower rate of adverse events” compared with triptans, said Wang, a neurologist at Taipei Veterans General Hospital in Taiwan.

Triptans such as sumatriptan, or Imitrex, naratriptan, or Amerge, and zolmitriptan, or Zomig, have been used for years to relieve pain acute migraines, or severe headaches as they occur, according to the American Migraine Foundation.

However, the drugs do not work for everyone with migraine, and can cause serious health complications in those with a history of heart disease or stroke, the foundation says.

Newer options mitigate some of these health risks, but they may not be as effective as older-line drugs, Wang said.

In all cases, triptans out-performed newer drugs in terms of pain relief, the data showed.

However, rimegepant and ubrogepant were both safer for people with a history of heart disease or stroke, and generally had fewer side effects than the triptans, the researchers said.

Common side effects of triptans include nausea, rapid heart rate, fatigue, numbness-tingling and a burning sensation over the skin, according to the American Migraine Foundation.

“These new drugs provide more choices for migraine patients,” Wang said.

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