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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Triptans: Peter Goadsby on mode of action
        
(Message started by: Bob_Johnson on Nov 13^th, 2006, 8:17am)

Title: Triptans: Peter Goadsby on mode of action
Post by Bob_Johnson on Nov 13^th, 2006, 8:17am

Interesting to note that he is saying that the primary mode of action is NOT as a vasoconstrictor but on its effect on the central nervous system. Doesn't change our appreciation of this class of meds but suggests we need to change how we think about the nature of CH.
==============================
Handb Exp Pharmacol. 2007;(177):129-43.

Serotonin receptor ligands: treatments of acute migraine and cluster headache.

Goadsby PJ.

Institute of Neurology, Queen Square, London WC1N 3BG, UK. peterg@ion.ucl.ac.uk

Fuelled by the development of the serotonin 5-HT(1B/1D) receptor agonists, the triptans, the last 15 years has seen an explosion of interest in the treatment of acute migraine and cluster headache. Sumatriptan was the first of these agonists, and it launched a wave of therapeutic advances. These medicines are effective and safe. Triptans were developed as cranial vasoconstrictors to mimic the desirable effects of serotonin, while avoiding its side-effects. It has subsequently been shown that the triptans' major action is neuronal, with both peripheral and central trigeminal inhibitory effects, as well as actions in the thalamus and at central modulatory sites, such as the periaqueductal grey matter. Further refinements may be possible as the 5-HT(1D) and 5-HT(1F) receptor agonists are explored. Serotonin receptor pharmacology has contributed much to the better management of patients with primary headache disorders.

PMID: 17087122 [PubMed]

Title: Re: Triptans: Peter Goadsby on mode of action
Post by MJ on Nov 13^th, 2006, 12:29pm

on 11/13/06 at 08:17:44, Bob_Johnson wrote:

Interesting to note that he is saying that the primary mode of action is NOT as a vasoconstrictor but on it effect on the central nervous system. Doesn't change our appreciation of this class of meds but suggests we need to change how we think about the nature of CH.

Bob I find your statement interesting.

I have often wondered since Oxygen has an opposite effect on me (more pain) from what most people report as a vasoconstrictive remedy, if this doesnt somehow trigger a serotonin response trigger as well. With me it may just be triggering an incorrect receptor response as there is a multitude of differing receptors..
To date I have not seen anything to support or denounce this

Just a thought.

Some additional reading on understanding serotonin and triptans.

http://www.clusterbusters.com/Scientific.htm

Title: Re: Triptans: Peter Goadsby on mode of action
Post by Kevin_M on Nov 13^th, 2006, 7:58pm

on 11/13/06 at 08:17:44, Bob_Johnson wrote:

==============================
Handb Exp Pharmacol. 2007;(177):129-43.

Serotonin receptor ligands: treatments of acute migraine and cluster headache.

Goadsby PJ.

Institute of Neurology, Queen Square, London WC1N 3BG, UK. peterg@ion.ucl.ac.uk

Fuelled by the development of the serotonin 5-HT(1B/1D) receptor agonists, the triptans, the last 15 years has seen an explosion of interest in the treatment of acute migraine and cluster headache.
-----/ /-----
It has subsequently been shown that the triptans' major action is neuronal, with both peripheral and central trigeminal inhibitory effects, as well as actions in the thalamus and at central modulatory sites, such as the periaqueductal grey matter
-----/ /------
Further refinements may be possible as the 5-HT(1D) and 5-HT(1F) receptor agonists are explored.
PMID: 17087122 [PubMed]

Gears still churning.

Thanks again Bob. :)