Ditans are a class of
abortive medication
A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis.
As a rule, each therapy has indications and contraindications. There are many different ...
for the treatment of
migraine
Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
s.
The first ditan,
Eli Lilly's
lasmiditan, 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, th ...
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 vessel ...
compared to triptans in susceptible patients, such as those with
ischemic heart disease
Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...
,
Raynaud's phenomenon 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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