Frequent triptan use: observations on safety issues.
OBJECTIVE
To examine the safety of frequent triptan use over extended periods. For a small group of patients with refractory migraine plus chronic daily headache, triptans are effective.


METHODS
This retrospective study primarily evaluated the cardiac safety of daily triptan use in 118 patients and, in addition, hematologic tests were assessed. Each patient had utilized a triptan for a minimum of 4 days per week for at least 6 months. Patients with rebound headache had been withdrawn from the triptans. Most patients (97 of 118) averaged 1 tablet daily; most would occasionally go for several days without a triptan. Forty patients had taken a triptan for 6 months to 2 years, 37 patients from 2 to 4 years, and 41 for 4 or more years.


RESULTS
Routine hematologic tests were performed periodically on all patients, and no abnormalities were attributable to triptans. Almost all patients had an electrocardiogram, and no abnormal electrocardiograms were felt to be related to triptans. Cardiac echocardiography was performed in 57 patients. The 10 abnormal echocardiograms were not due to triptans. All 20 cardiac stress tests revealed normal findings. Adverse events were minimal; 9 patients described fatigue due to triptans, and 5 had mild chest tightness.


CONCLUSIONS
This long-term study of 118 patients indicates that frequent triptan use may be relatively safe.
Robbins
L
L
Department of Neurology, Rush Medical College, Chicago, Ill. 60062, USA.
D000328:Adult; D000368:Aged; D005260:Female; D020773:Headache Disorders / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D012189:Retrospective Studies; D012651:Self Medication; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage* / Q000009:adverse effects*
D017366:Serotonin Receptor Agonists