How does sumatriptan work?

How does sumatriptan work? 

Sumatriptan (or sumatriptan succinate) is a medication that belongs to a class of drugs called triptans, used to treat migraine headaches. Migraines cause moderate to severe throbbing pain on one or both sides of the head, sometimes including the face and neck. Some migraine sufferers also experience nausea, weakness, and sensitivity to light.

Sumatriptan is also known as Imitrex and Treximet and is available as a generic medication. In the United States, it is only available by prescription. 

To understand how sumatriptan works, it’s important to understand migraines. 

What are migraines?

While almost everyone gets headaches, migraines can be excruciating and debilitating. Researchers have not been able to pinpoint a cause for migraines. However, there is evidence that they may have a genetic component. 

Environmental factors also contribute to migraines. These headaches can be triggered by a various factors, from lifestyle choices to foods, and differ from person to person. 

Common migraine triggers include (but are not limited to): 

• Stress
• Bright and flashing lights
• Strong smells
• Hormonal changes in women 
• Inadequate sleep
• Caffeine (or the cessation of caffeine use)
• Alcohol
• Monosodium glutamate (MSG)
• Fermented or pickled goods

There is no cure for migraines, but treatments such as sumatriptan can help alleviate their symptoms. Migraine medications are most effective when taken in the earliest phases of a migraine or at the onset of pain. 

The four phases of a migraine

Migraine headaches can have four phases (though not everyone goes through every phase), some of which signal to sufferers that a migraine is starting. These include: 

• Prodromal Phase: This can occur up to 48 hours before the onset of pain and is often signaled by symptoms such as irritability, yawning, stiffness of the neck, and food cravings. 
• Aura Phase: Migraine sufferers may experience a visual aura (such as seeing flickering or bright lights or developing blind spots), auditory aura (during which they may hear noises or music), sensory aura causing numbness or tingling), and motor aura (which can present as weakness on one side of the face or body). 
• Headache Phase: This phase involves headache and sometimes nausea, vomiting, and photophobia (light sensitivity). 
• Prodromal Phase: After the main headache phase, pain may linger, especially during sudden head movements. This stage is also characterized by extreme fatigue. 

How does sumatriptan work on migraine headaches?

Sumatriptan is a selective serotonin receptor agonist and can be administered as a pill, a nasal spray, or an injection. It is most effective and fast-acting when delivered as an injection. Sumatriptan is approved by the FDA for the acute treatment of migraines and cluster headaches, but not for their prevention. It can also be administered alongside naproxen for pain relief. 

Because we don’t fully understand how migraines work, it’s difficult to pinpoint the exact mechanisms that help treat them. What we do know is that sumatriptan works in part by narrowing the blood vessels in the head and preventing the release of vasoactive peptides that lead to vasodilation (the widening of blood vessels). It also inhibits the release of inflammatory peptides that cause pain, nausea, and other migraine symptoms.

Sumatriptan is considered a generally safe and effective treatment for migraine headaches that have already begun. You will need a doctor to diagnose your migraine before being eligible for a prescription if you live in the United States.