5HT1 agonists
Last reviewed 01/2018
5HT1 agonists e.g. sumatriptan, are of considerable value in the treatment of acute migraine. Sumatriptan may be used during the established headache phase of a migraine attack. Sumatriptan may also be of value in the treatment of cluster headache.
Newer 5HT1 agonists include zolmitriptan, naratriptan and rizatriptan.
Cautions include:
- conditions which predispose to conrary artery disease
- pregnancy and breast feeding
- hepatic impairment
- 5HT1 agonists are recommended as monotherapy - a 5HT1 agonist should not be taken concurrently with other acute migraine treatments
Contra-indications include:
- not to be used for migraine prophylaxis
- ischaemic heart disease
- previous myocardial infarction
- coronary vasospasm e.g. Prinzmetal's angina
- uncontrolled hypertension
Side effects include:
- sensations of heat, tingling, heaviness, tightness or pressure of any part of the body including throat and chest - discontinue if intense, symptoms may be due to anaphylaxis or coronary vasoconstriction; dizziness, flushing, weakness, fatigue, nausea and vomiting also reported