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Medication overuse headache is a recognized ICHD (International Classification of Headache Disorders) classification. [4] Over the years different sets of diagnostic criteria have been proposed and revised by the major experts of headache disorders. The term MOH first appeared in the ICHD 2nd edition in 2004.
The triptan drug class includes 1st generation sumatriptan (which has poor bioavailability), and second generation zolmitriptan. [2] Due to their safety, efficacy and selectivity, triptans are considered first line agents for abortion of migraines. [2]
Triptans are a mid-line treatment suitable for many migraineurs with typical attacks. They may not work for atypical or unusually severe migraine attacks, transformed migraine, or status migrainosus (continuous migraine). Triptans are highly effective, reducing the symptoms or aborting the attack within 30 to 90 minutes in 70–80% of patients. [6]
Cipriani noted that, “despite their effectiveness, triptans are underused,” as, “according to European population-based data, only 3.4–22.4% of people with migraine are using triptans.”
Triptans are not addictive, but may cause medication overuse headaches if used more than 10 days per month. [33] [34] Sumatriptan does not prevent other migraine headaches from starting in the future. [29] For increased effectiveness at stopping migraine symptoms, a combined therapy that includes sumatriptan and naproxen may be suggested. [35]
Like all triptans, almotriptan has a high and specific affinity for serotonin 5-HT 1B/1D receptors. Binding of the drug to the receptor leads to vasoconstriction of the cranial (brain) blood vessels and thus affects the redistribution of blood flow. Almotriptan significantly increases cerebral blood flow and reduces blood flow through ...
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