Why is sumatriptan restricted?

Cardiovascular risk

Taking sumatriptan – especially more than a couple of times per week – may increase your risk of heart attack or stroke. This is because sumatriptan can cause a disruption to the rhythm of your heart. 

Approximately one in ten may experience adverse effects such as nausea, dizziness, or shortness of breath.

Tightness in the chest or difficulty breathing are also possible, and serve as indicators of a potentially serious reaction. Those who are overweight, smokers, or are over the age of 40 are at increased risk. Men and women with preexisting medical conditions such as hypertension or elevated cholesterol should also be mindful of regulating their usage of sumatriptan.

Other cardiovascular risk factors could present for individuals with:

• Angina or a family history of heart attacks
• Circulation issues
• A history of seizures 
• Unregulated high blood pressure

In general practice, taking a sumatriptan tablet as a migraine treatment will not put you at risk for more serious side effects, however there are some individuals who should take extra precaution.

Medicine overuse headache

Also known as a rebound headache, a medication overuse headache is caused by taking too many triptans or opioids within a short period of time.  Studies have shown that taking sumatriptan in excess of ten days per month may trigger the onset of persistent rebound headaches. The condition presents via aggravating migraine-like symptoms that can begin to reoccur daily. 

What’s worse, medications like Imigran that can cause rebound headaches also lose their effectiveness to combat them, leaving migraine sufferers in worse shape than when they started seeking relief.

Quality of life

If you find that you’re in need of a drug like sumatriptan on a regular basis, it could mean that your migraines are not controlled. This can have a significant impact on your life, as the symptoms can be extremely debilitating. 

Consulting your doctor or GP is important, as they can intervene in order to help restore your quality of life. Together you may be able to design and implement an alternative treatment plan that reduces your pain and allows you to get back to your daily routine.

Alternative Treatments

Alternative treatments can include use of prevention medications and techniques you may not typically associate with pain relief, such as:

Acupuncture

Some studies suggest that acupuncture is effective for aiding in the dissolution of symptoms associated with frequent episodic or chronic-type tension headaches. By stimulating nerves located in muscles and other tissues, acupuncture can help modulate intracranial and extracranial blood flow. Since migraines are often caused by changes in the brainstem and its interactions with the trigeminal nerve, acupuncture is believed to offer a reduction in the pressure and associated pain signals travelling through neural pathways.

The World Health Organization has endorsed acupuncture as a promising migraine aid since the 1970’s.

Treatment is recommended at twice per week, in order to determine if the procedure reduces symptoms over time.

Botulinum toxin type A (Botox)

A type of nerve toxin that paralyses muscles, botox or botulinum toxin type A has been administered by headache specialists to combat the effects of migraine pain. For individuals suffering from headaches as frequently as every other day, the treatment most commonly touted for its anti-aging benefits has been implemented with positive results. 

Delivered by injection, studies have shown that botulinum toxin type A is a powerful medicine for the reduction of headaches. Treatment is suggested once every 90 days.

Hormonal treatments

An array of hormonal contraceptives – such as the birth control pill or patch – have been used to treat migraine headaches. Progesterone contraceptives, such as pills or injections, have also been implemented by women seeking to relieve the pain associated with severe headaches and migraines.

If you’re a woman suffering from menstrual migraines or cluster headaches, consult your doctor or healthcare professional. Together you may be able to determine if hormonal treatment will impact the severity of your symptoms. 

Amitriptyline

Originally prescribed to treat depression, amitriptyline has been shown to reduce the effects of  a migraine attack. Taken in tablet form, the cumulative ingestion of this powerful drug works cumulatively over the course of six weeks. 

First touted for its migraine relief properties back in 1979, amitriptyline offers an alternative medication in the event an oral triptan such as Imigran isn’t working for you.

Propranolol

Although propranolol  is traditionally used to treat anxiety and high blood pressure, it has been an effective source of migraine relief. 

When taken daily in pill form, propranolol helps stabilise blood vessels in the brain, preventing the dilation associated with the onset of a migraine. The medication may also reduce the excitability of the brain, which in turn can have a positive effect on the frequency of headache-related episodes.

The bottom line

Regardless of your preferred treatment protocol, your doctor or pharmacist can ensure you’re getting the most of your medicine. Drugs like sumatriptan can offer vast relief from the pain associated with your migraines, but only if you’re willing to adhere to dose adjustment protocols. Although sumatriptan isn't a controlled drug, a GP prescribing the medication is likely to limit your dosage to an 8 tablet per-month ratio.

Whilst the temptation to seek refuge from the effects of a migraine can be overwhelming, remember that too much of any medication can have potentially long-lasting consequences. With this in mind, relying on a specialist recommendation can eliminate the worry associated with the potential overuse of sumatriptan. 

To learn more about how sumatriptan can be best utilised as part of a prevention protocol, read our handy guide. 

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.