[Clinical pharmacology of triptans].

The 5HTI receptor antagonists currently used for the treatment of migraine headache all belong to the "triptan" group of drugs and have a chemical formula derived from serotonin. This structural similarity explains in part the MAO-A metabolism of certain triptan drugs used in human medicine. Chemical substitutions explain the variable role of different cytochrome P450 isoenzymes and differences in terms of drug interactions. Beyond the analysis of clinical trials, the pharmacologist must examine the epidemiological data on triptans. Prescription studies show an erroneously frequent use of sumatriptan for non-migraine headache. A low percentage of patients consume a large proportion of the sumatriptan prescribed and could be considered as "drug abusers". Epidemiological observation provides better knowledge of adverse effects and a better statistical definition of risk. The high cost of triptans, compared with older drugs, suggests the need to examine the pharmacoeconomical aspects of the question. Much more costly than ergot derivatives, triptans have a favorable cost-benefit and cost-usefulness ratio as is demonstrated by the reduction in loss of productivity, improved quality of life, and cost effectiveness studies.