Sumatriptan (Imigran, Imitrex, Imigrane) naratriptan (Amerge, Naramig)

<p>From: Reviving the Broken Marionette: Treatments for CFS/ME and Fibromyalgia

The triptans are effective abortive drugs for migraine attacks and cluster headaches, but they can also help other kinds of headaches. They most likely act by binding to the 5–HT1B and 5–HT1D receptors. This causes vasoconstriction of the cranial blood vessels, which are thought to be excessively dilated in migraine. The triptans have two actions that can be beneficial in both fibromyalgia and CFS/ME: they increase growth hormone secretion53 and inhibit release of substance P.54

Sumatriptan is sometimes used to treat CFS/ME symptoms in general. It can alleviate muscle pain55 and trigeminal neuralgia.56 Jay Goldstein usually prefers naratriptan, because it is the most potent 5–HT1B agonist and has the longest duration of action, but he thinks it may be worthwhile to try all of the triptans.57 He notes that they are often helpful for patients who get side effects from all SSRIs and he also uses them for IBS pain.58

Possible side effects include chest pain, dizziness, fatigue, drowsiness, worsening of the headache, nausea and psychiatric symptoms.

Sumatriptan should not used in patients who are allergic to sulfa drugs.

The triptans should be used with caution in patients with epilepsy and those with cardiovascular disease. They should never be combined with ergot derivatives or MAO inhibitors. SSRI drugs and St. John’s wort also cause problems.

Sumatriptan is available in the United States, the United Kingdom, Canada, Australia and many other countries. Naratriptan is available in the United States, the United Kingdom, Canada, Australia and a few other countries.

Sumatriptan is available as tablets, intranasal spray and subcutaneous injection, but naratriptan is only sold in tablet form. Sumatriptan tablets are available over–the–counter in the United Kingdom. The triptans are extremely expensive even in the oral form and often insurance companies only reimburse a few doses a month.</p>