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- Peer Tfelt-Hansen.
- Department of Neurology, Danish Headache Center, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark. ptha@glo.regionh.dk
- J Headache Pain. 2011 Jun 1; 12 (3): 275-80.
AbstractDose-response curves for headaches relief and adverse events (AEs) are presented for five triptans: sumatriptan, zolmitriptan, naratriptan, almotriptan, and frovatriptan, and the CGRP antagonist telcagepant. The upper part of the efficacy curve of the triptans is generally flat, the so-called ceiling effect; and none of the oral triptans, even in high doses, are as effective as subcutaneous sumatriptan, In contrast, AEs increases with increasing dose without a ceiling effect. The optimal dose for the triptans is mainly determined by tolerability. Telcagepant has an excellent tolerability and can be used in migraine patients with cardiovascular co-morbidity. Based on the literature the triptans and telcagepant are rated in a table for efficacy and tolerability.
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