More details about headache and triptans

Triptan is a modern drug for treating migraines and cluster headaches. Migraines are very frequent as they affect 10-20% of the entire population. Cluster headaches are much more infrequent. A strong one sided pain around the eye is characteristic, which is accompanying by tears, red eye and a sagging eyelid (ptosis).

Triptan works on serotonin receptors (5-HT) in the brain. Unfortunately, they are not effective in all patients with migraines. There is a greater number of triptans in use, which differ from one another especially according to the quickness of results and the duration.

We are familiar with them under different name: sumatriptan (Imigran), naratriptan (Naramig), zolmitriptan (Zomig), elmetriptan (Relpax), rizatriptan (Maxalt), almotriptan (Almogran). Triptans are tied to serotonin receptors type 5-HT (1B) and 5-HT(D). These receptors participate with the molecule named G-protein, which is located on the inside of the cell membrane and transmits a signal along the connection to the 5-HT receptor in the inside of the cell. G-protein is composed of three albumin sub-units: alfa, beta and gama. Each sub-unit is defined by a special gene. A small change in the genetic record or SNP rs5443 in the gene, which encodes the sub-unit beta (GNB3) defines the effectiveness of transmitting the signal to the inside of the cell. As a result this also defines the effectiveness of different drugs, which work on the serotonin receptors 5-HT(1B/1D), amongst them also the effect of triptans.

Preliminary research on 180 patients with cluster headaches who took triptans showed that these drugs worked on only 70% of the patients. Triptans were the most effective in the group with the gene type 5443 (C;T), in which the headaches stopped in 85% of patients. By all means, this research still needs to be confirmed on a much larger sample.

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