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Alan M. Rapoport, MD; Stewart J. Tepper, MD
From The New England Center for Headache, Stamford, Conn, and the Department of Neurology, Yale University School of Medicine, New Haven, Conn.

Corresponding author and reprints: Alan M. Rapoport, MD, The New England Center for Headache, 778 Long Ridge Rd, Stamford, CT 06902-1251.

Arch Neurol. 2001;58:1479-1480.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

THERE ARE 4 triptans currently available in the United States, and 3 more are expected to be approved by the Food and Drug Administration. Although they are all 5-HT_1B/1D(serotonin_1B/1D) agonists, they each have slightly different pharmacokinetic characteristics and clinical strengths and weaknesses, and they can be used in special ways to optimize migraine therapy. Thus, triptans differ significantly clinically, and the astute clinician uses these differences to optimize patient treatment.^{1, 2}

Sumatriptan (Imitrex) was the first triptan synthesized. It offers flexibility of form, with 3 separate modes of administration: self-administered subcutaneous injection, tablet, and nasal spray. The multiple-dose forms enable the physician to match the medication to the specific characteristics of the attack. Sumatriptan has the lowest lipophilicity of the triptans. It has a relatively short plasma half-life (2 hours) and is extensively metabolized via first-pass metabolism in the liver by . . . [Full Text of this Article]