The new triptans.

In the past 10 years, new compounds have been developed for the acute treatment of migraine. Studies of a group of compounds called the triptans are summarized. The triptans are derived from the serotonin molecule and act on the 5-hydroxytryptamine 1B/1D receptors. The receptors are on the blood vessels, trigeminal neurons and trigeminal nucleus caudalis. Activation of these receptors causes constriction of extracerebral intracranial vessels, abolition of the dural extravasation and neurogenic inflammation, and inhibition of trigeminal neuronal discharge. The drugs are sumatriptan, zolmitriptan, naratriptan, rizatriptan and eletriptan. Their pharmacology and clinical properties are reviewed and compared.