The results of an observational study recently published in Headache: The Journal of Head and Face Pain found that insufficient success was the main reason people stopped using triptans. The authors conclude:

As expected, discontinuation was most correlated with lack of efficacy, but other important factors associated with those who had discontinued use included greater migraine-related disability, depression, and the use of opioids for migraine attacks. Compared with patients who had discontinued triptans, current triptan users felt more: educated about their triptan, control over their migraine attacks, and confidence in their prescribing provider. Current triptan users had their triptan prescribed by a specialist and used other abortive medications with their triptan more often compared with patients who had discontinued triptans. Given the cross-sectional nature of this study, we cannot determine if these factors contributed to triptan discontinuation or reflect the impact of such discontinuation. Interventions that address modifiable risk factors for triptan discontinuation may decrease the likelihood of triptan discontinuation and thus improve overall migraine control.

Because lack of efficacy was most strongly associated with triptan discontinuation, future research should determine why triptans are effective for some patients but not for others.

Dr Robbins adds that another study looking at over 500,000 triptan users found that over half of first time triptan prescriptions were never renewed for various reasons……   Wiley Online Library   September 2013

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