Triptan drugs used in the treatment of migraine are not recommended if the patient has risk factors for cardiovascular diseases, according to a recent study.
Triptans are used in the treatment of migraine as a specific medicine. Adobe stock/AOP
A recent study warns against the use of triptans, the precision medicine used in the treatment of migraine, in patients with coronary artery disease, among others.
For otherwise healthy patients, triptans are considered quite safe, but according to research, they can expose them to brain and heart attacks if the patient is at increased risk of cardiovascular diseases.
The results of the study have been published in the journal JAMA Neurology.
According to the study, the patient’s risk of developing a heart or cerebral infarction increased shortly after starting triptan medication. In practice, however, the risk was very small and illnesses were very rare. The risk mainly concerned patients who already had cardiovascular disease risk factors.
In light of the results, the use of triptans should still preferably be avoided if the patient suffers from coronary artery disease or has suffered from cerebrovascular disease.
Uutispalvelu Duodecim reported the results of the study.
Migraine headaches can sometimes go away with rest, but usually medicine is needed. Adobe Stock / AOP
Effective care
In the treatment of migraine, paracetamol, an anti-inflammatory drug or both together in a large enough single dose is used.
If painkillers do not help or if the pain returns quickly, triptans are recommended. They are specific medicines for the pain phase of migraine, of which there are several types.
The medicine is effective in more than two-thirds of migraine attacks.
A triptan is taken immediately after the onset of a migraine headache or nausea. The medicine can be taken orally, as a nasal spray or as an injection.
According to the Migraine Käypä hoito recommendation, taking a triptan already in the mild phase of the pain prevents the sensitization of pain pathways, which is associated with the risk of chronicity and worsening of migraines.
However, the drug should not be used in migraine with aura until the aura symptom is completely over. In addition, they should not be used if the patient is using combined birth control pills and also smokes, as this combination acts as at least a theoretical risk factor for cerebrovascular disorders.
In migraine, the headache is throbbing, on one side, and is accompanied by nausea and vomiting, as well as sensitivity to light and smell. The pain phase lasts from hours to even a few days. Adobe Stock / AOP
Many things trigger
Migraine is a common general neurovascular cerebrovascular disease that occurs in people of all ages. About 5 percent of men and 15 percent of women suffer from it.
Some migraine patients have a precursor symptom, or aura, before the headache. More often than not, it’s a vision problem. It is estimated that aura symptoms occur in about 15 migraine patients out of a hundred.
Bright or flashing lights, heat, large temperature changes, smells, alcohol, being watched, and some foods can trigger a seizure.
Migraine patients have a lower than usual threshold for overexcitability of neurons. The brain then reacts more sensitively than usual to, for example, smells or light.
THE FACTS
Now is the worst time to attack:
1. Migraine attacks are often caused by certain external factors that vary from person to person.
Now, the increasing light in spring causes migraine attacks for many. In spring and summer, the risk of seizures is also increased by an irregular sleep pattern, when you stay up longer on brighter evenings.
2. If the bright light of spring causes seizures, wear sunglasses. Avoid looking directly into the sun.
3. Get decent blackout curtains.
4. Later, when the weather starts to warm up, take extra care to drink enough water. Eat regularly, even if you are not hungry.
5. Learn to recognize migraine-causing foods and avoid them if possible. These can include, for example, hard cheeses, sausages, chocolate, cola drinks and wines.
6. Use alcohol in moderation. That and being watched can trigger a migraine attack.
7. If a seizure occurs, take a sufficient amount of painkiller in time. A sufficient amount of medicine is important so that the seizure ends quickly.
It is recommended to use an anti-inflammatory medicine as a medicine. The single dose should be quite large: ibuprofen 800-1200 mg, tolfenamic acid 200 mg or naproxen 500-1000 mg.
If the effect of the painkillers is not sufficient, specific migraine medicines, i.e. triptans, which have several different names, can be used.
The medicine is taken immediately after the migraine headache starts.
8. Migraine attacks should be treated well, because treating a prolonged migraine attack is already more difficult. Ineffective seizure treatment easily leads to chronic migraine.
If there are at least 2 or 3 migraine days per month, or the migraine makes everyday life difficult, you can start preventive medication.
Source: Iltalehti archive, neurology specialist Petra Keski-Säntti
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