(FDA approved in bold)

• Migraine
  
• Cluster headache (nasal spray)

• Selective 5-HT1 receptor agonist, working predominantly at the B and D receptor subtypes. Effectiveness may be due to blocking the transmission of pain signals from the trigeminal nerve to the trigeminal nucleus caudalis and preventing the release of inflammatory neuropeptides rather than just causing vasoconstriction

• 1 hour or less

• Continue to take as needed. Patients taking acute treatment more than 2 days/week are at risk for medication-overuse headache, especially if they have migraine

• Treat early in the attack – triptans are less likely to work after the development of cutaneous allodynia, a marker of central sensitization
  
• For patients with partial response or reoccurrence, add an NSAID
  
• Change to another agent

• NSAIDs or neuroleptics are often used to augment response

• None required