Lasmiditan: A New First-in-Class Drug for Migraine Relief
Migraines aren’t just “bad headaches”—they’re a global health problem. In fact, migraines are responsible for half of the disability caused by all neurological conditions worldwide. For decades, the go-to treatment has been the triptans, like sumatriptan (Imitrex), which are highly effective for stopping migraine attacks in progress.
But triptans have their drawbacks. Because they work by narrowing blood vessels, they aren’t safe for people with heart disease, angina, or other vascular problems.Concerning side effects include shortness of breath and stiffness in the chest. For many patients, this has left a frustrating gap in treatment options.
Now, a new drug offers hope: lasmiditan (Reyvow), the first of a new class of migraine medications known as the “ditans.”
How is lasmiditan different?
Rather, it acts on a particular kind of serotonin receptor found on the neurons that carry migraine pain. Lasmiditan can prevent a migraine without further taxing the cardiovascular system by inhibiting such impulses.
Compared to those receiving a placebo, patients taking lasmiditan had a much higher chance of being pain-free within two hours throughout clinical studies. Dizziness and drowsiness were the most frequent adverse effects, which makes sense given that the drug acts directly on the brain (unlike triptans).
Why this is important
A better knowledge of migraines led to the development of lasmiditan.
Later research, however, showed that triptans worked by altering particular serotonin receptors involved in pain communication rather than by constricting blood vessels.
This insight led to the development of drugs like lasmiditan, which lessen migraine pain without obstructing blood flow.
FDA approval and safety considerations
Lasmiditan pills, available in multiple dosages, have been approved by the FDA. However, there are significant limitations:
Dosage: No more than four times a month, and no more than once a day.
Activity restrictions: Patients must refrain from driving or performing other tasks requiring awareness for at least eight hours following a dose due to the effects of dizziness and drowsiness.
Pregnancy: It is not advised for women who are or may become pregnant since animal research indicates that it may not be safe during pregnancy.
For the right patients, lasmiditan could be especially useful—such as those who can’t take triptans or those who usually manage migraines by resting or sleeping afterward.
What comes next?
The approval of Lasmiditan marks more than just the introduction of a new drug; it marks a shift in the treatment of migraines. Lasmiditan's widespread adoption will depend on how well it functions outside of clinical trials and how well patients tolerate it.And this might just be the start. Millions of people with migraines may have more options if lasmiditan proves effective, opening the door for a whole new class of "ditan" drugs.
For the time being, it is a thrilling development in a field that has long needed innovation.
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