5HT1 agonists

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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

Last reviewed 01/2018