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        New Message Board Archives >> Jan-Mar 2004 >> 'Triptans for Migraine&Cluster
        
(Message started by: Svenn on Mar 10^th, 2004, 2:16pm)

Title: 'Triptans for Migraine&Cluster
Post by Svenn on Mar 10^th, 2004, 2:16pm

'Triptans for Migraine Do Not Increase Risk of Heart Attack or Stroke: Study Results'

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Migraine patients without cardiovascular risk factors can take triptan drugs, such as Imitrex or Zomig, without increasing their risk of stroke or heart attacks. This was the conclusion of a major British study undertaken to see if triptan use is an independent risk factor for cardiovascular events in migraine patients.

Triptans are very effective migraine-specific drugs that are taken at the first sign of an attack. They have proven effectiveness in migraines ranging from mild to severe and have documented effectiveness during all stages of migraine pain, from early to full-blown.

Additionally, research indicates that the triptans are effective for the associated symptoms that accompany migraine in addition to the pain, such as nausea and vomiting. The first triptan to be developed and tested was sumatriptan, followed by zolmitriptan, naratriptan, and rizatriptan. There are currently several others in clinical development.

It was originally thought that triptans might be dangerous for all patients, based on early reports of stroke1,2, heart attack3,5, and irregular heart rhythms6 with triptan use. Because the blood vessels in the brain expand when a migraine occurs and narrow when a triptan is given, they can cause serious cardiovascular side effects in patients at risk. Therefore, they are not recommended for use in people with or at risk of developing cardiovascular disease.

In this study, researcher Dr. Gillian Hall from Barnet, U.K., and colleagues examined data from the General Practice Research Database, which collects information about primary care practices throughout the U.K. Data included approximately 64,000 patients with a record of migraine between 1992 and 1999, and 77,000 subjects without migraine used as a comparison. Triptans were used by 21.5% of the migraine patients.

Dr. Hall says there were fairly small increase in the risk of stroke and cardiovascular disease in migraine patients compared with non-migrainous subjects. However, there were no significant differences between triptan-treated subjects and the control subjects.

The researchers explain that patients with risk factors for cardiovascular and cerebrovascular events were less likely to be prescribed a triptan by their doctors. Therefore, they say, they cannot generalize these findings for migraine patients who already have risk factors for these conditions, such as existing heart disease or uncontrolled hypertension.

References:
1. Cavazos JE et al. Sumatriptan-induced stroke in sagittal sinus thrombosis. Lancet 1994;343:1005-1006.
2. Jayamaha JE et al. Fatal cerebellar infarction in a migraine sufferer whilst receiving sumatriptan. Intensive Care Med 1995;21: 82-83.
3. O’Connor P et al. Oral sumatriptan-associated transmural myocardial infarction. Neurology 1995;45:2274-2276.
4. Mueller L et al. Vasospasm-induced myocardial infarction with sumatriptan. Headache 1996;36:329-331.
5. Abbrescia VD et al. Sumatriptan-associated myocardial infarction: report of case with attention to potential risk factors. J Am Osteopath Assoc 1997;97:162-164.
6. Laine K et al. Fatal cardiac arrhythmia after oral sumatriptan. Headache 1999;39:511-512.

Source:
Hall Gillian C et al. Triptans in migraine: the risks of stroke, cardiovascular disease, and death in practice. Neurology 2004;62:563-568.

Just something that i found on http://www.w-h-a.org/wha2/index.asp

Svenn

Title: Re: 'Triptans for Migraine&Cluster
Post by thomas on Mar 10^th, 2004, 2:17pm

You've been a busy viking. lol.

Title: Re: 'Triptans for Migraine&Cluster
Post by stuey on Mar 10^th, 2004, 2:54pm

Thanks for that. I get more palpitations from caffeine than any triptan I've taken. That's reassuring to hear. I recall first neuro was afraid to write me an Imitrex scrip saying that it could cause sudden death in some people. So can tylenol in some or the flu shot. At the time I was in a cycle and had the doctor said eat shit three times a day, if that would have stopped the pain I would have done that.

Title: Re: 'Triptans for Migraine&Cluster
Post by pubgirl on Mar 10^th, 2004, 3:02pm

Svenn

Interesting and reassuring stuff.
Thank you, will keep that one!

One add-on warning though (have posted this before but it matters A LOT)
There IS a major risk of stroke if you take Triptans and you suffer from Basilar arterial migraines (BAM).
I try and keep an eye out for anyone here who describes symptoms that could be BAM, as most GP's seem to almost automatically prescribe triptans now and many have never heard of BAM.
It is also possible to have CH and BAM. Imigran or any other triptan would be dangerous to anyone with this combination.

Wendy

Title: Re: 'Triptans for Migraine&Cluster
Post by Prense on Mar 10^th, 2004, 3:08pm

on 03/10/04 at 14:16:27, Svenn wrote:

The researchers explain that patients with risk factors for cardiovascular and cerebrovascular events were less likely to be prescribed a triptan by their doctors. Therefore, they say, they cannot generalize these findings for migraine patients who already have risk factors for these conditions, such as existing heart disease or uncontrolled hypertension.

The medical community considers smokers as having a risk factor for these cardiovascular events.

Title: Re: 'Triptans for Migraine&Cluster
Post by catlind on Mar 10^th, 2004, 3:19pm

And remember not to MIX triptans, under no circumstances is it safe to mix them.

Cat

Title: Re: 'Triptans for Migraine&Cluster
Post by stuey on Mar 10^th, 2004, 3:48pm

And don't mix tryptans with anything containing Ergotamine such as Cafergot.

Title: Re: 'Triptans for Migraine&Cluster
Post by pubgirl on Mar 10^th, 2004, 6:43pm

Right Stuey

I only just found out last weekend that Sumatriptan was a designer drug developed from Ergotamine.

The doctors found Ergotamine to be too much of a "dirty drug" with too many side effects (like fingers going black and coming off!), so they identified what the acvtive part of it was that was helping cure the headaches. Out of that came Imigran/trex.

Wendy

Title: Re: 'Triptans for Migraine&Cluster
Post by Cooked Brain on Mar 11^th, 2004, 4:12pm

thanx for sharing Svenn!

Title: Re: 'Triptans for Migraine&Cluster
Post by Cathi04 on Mar 14^th, 2004, 4:24pm

AWW, Svenn, you say the nicest things!

Thank you for sharing this, Svenn...as always, sharing important info, and looking out for Clusterville.

CHUCK, PLEASE READ THIS....