Ditans are a class of
abortive medication for the treatment of
migraines.
The first ditan,
Eli Lilly
Eli Lilly (July 8, 1838 – June 6, 1898) was an American soldier, pharmacist, chemist, and businessman who founded the Eli Lilly and Company pharmaceutical corporation. Lilly enlisted in the Union Army during the American Civil War and ...
's
lasmiditan
Lasmiditan, sold under the brand name Reyvow, is a medication used for the acute (active but short-term) treatment of migraine with or without aura (a sensory phenomenon or visual disturbance) in adults. It is not useful for prevention. It is t ...
, was approved by the FDA in 2019.
Ditans selectively bind to the
5-HT1F receptor subtype. A number of
triptan
Triptans are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches. This drug class was first commercially introduced in the 1990s. While effective at treating individual headaches, t ...
s have been shown to act on this subtype as well, but only after their affinity for
5-HT1B and
5-HT1D has been made responsible for their anti-migraine activity. The lack of affinity for these receptors might result in fewer side effects related to
vasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, in particular the large arteries and small arterioles. The process is the opposite of vasodilation, the widening of blood vess ...
compared to triptans in susceptible patients, such as those with
ischemic heart disease,
Raynaud's phenomenon
Raynaud syndrome, also known as Raynaud's phenomenon, eponymously named after the physician Auguste Gabriel Maurice Raynaud, who first described it in his doctoral thesis in 1862, is a medical condition in which the spasm of small arteries cau ...
or after a
myocardial infarction
A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...
.
A 1998 review has found such side effects to rarely occur in most patients taking triptans.
One clinical trial showed that 200 mg lasmiditan provided pain freedom by 2 hours in 32% of individuals with migraine attacks of moderate or severe intensity, and 100 mg lasmiditan did so in 28%, compared with 15% after a placebo. Subsequently, these results were confirmed in another trial.
References
5-HT1 antagonists
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