Sumatriptans and Reuptake Inhibitors
Certain types of pain are sometimes successfully treated with drugs that are not analgesic for other types of pain. Two examples are sumatriptan and related compounds (triptans) and inhibitors of neuronal reuptake of NE or 5HT. Triptans (eg, almo, ele, frova, nara, riza, and sumatriptan) are often the firstline therapy for treatment of acute severe migraine attacks. Reuptake inhibitors (eg, tricyclics and more selective NE or 5HT reuptake inhibitors) are used for some patients with migraine and for some patients experiencing neuropathic pain with hyperalgesia (increased sensitivity to painful stimuli) or allodynia (painful sensitivity to nonpainful stimuli). Neither the triptans nor the reuptake inhibitors are very effective against inflammatory or acute pain. Adverse cardiovascular effects can occur with the triptans, and numerous ANS effects can occur with the reuptake inhibitors.