How do you manage patients with good relief but intolerable chest tightness with sumatriptan?

An abstract I collaborated on was accepted by the European Society of Cardiology reported that patients with angina diagnosed with migraine have a higher prevalence of vasospastic angina, otherwise known as angina and non-obstructive coronary artery disease (ANOCA). We are recommending that these pa...

I have a patient, an Internist, who has long-standing chronic migraine with and without aura, with other different seasonal episodes, usually in the fall or early winter, of a form fruste of cluster headache. He was taking sumatriptan 100mg with excellent relief of his migraines. However, he told me...

Can try a lower dose of sumatriptan. Can try Treximet if available on formulary. Can switch to a different triptan. Naratriptan, frovatriptan are better tolerated. If naratriptan or frovatriptan are less effective can try combining with an NSAID and/or anti-emetic. Ultimately a patient would have to...

Triptan sensations are described as tightness often in the chest which may be accompanied by sensations like burning or tingling. These symptoms are reported in 1-7% of patients compared to 1-2.5% of placebo. They have been investigated with the cause still being unclear, but are not a manifestation...