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5HT1 agonists

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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