Ditans are a class of
abortive medication for the treatment of
migraine
Migraine (, ) is a complex neurological disorder characterized by episodes of moderate-to-severe headache, most often unilateral and generally associated with nausea, and light and sound sensitivity. Other characterizing symptoms may includ ...
s.
The first ditan,
Eli Lilly
Eli Lilly (July 8, 1838 – June 6, 1898) was a Union Army officer, pharmacist, chemist, and businessman who founded Eli Lilly and Company.
Lilly enlisted in the Union Army during the American Civil War and recruited a company of men to ...
'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 ...
, 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 medication, 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 h ...
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 vesse ...
compared to triptans in susceptible patients, such as those with
ischemic heart disease
Coronary artery disease (CAD), also called coronary heart disease (CHD), or ischemic heart disease (IHD), is a type of heart disease involving the reduction of blood flow to the cardiac muscle due to a build-up of atheromatous plaque in the ...
,
Raynaud's phenomenon
Raynaud syndrome, also known as Raynaud's phenomenon, is a medical condition in which the spasm of small arteries causes episodes of reduced blood flow to end arterioles. Typically the fingers, and, less commonly, the toes, are involved. Rare ...
or after a
myocardial infarction
A myocardial infarction (MI), commonly known as a heart attack, occurs when Ischemia, blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. The most common symptom ...
.
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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