zolmitriptan / Generic mfg. - LARVOL DELTA

Trigeminal autonomic cephalalgia triggered by a viral upper respiratory tract infection (EHF-EHC 2025) - "There was only mild past response to paracetamol and no acute response to zolmitriptan...Secondary cephalalgias are uncommon, but there are cases described associated with tumors, rhinosinusitis. Management is challenging in the absence of definitive guidelines, and in this case patient preference for a short-acting treatment was taken into account."

CNS Disorders • Cough • Infectious Disease • Migraine • Otorhinolaryngology • Respiratory Diseases • Sinusitis

Refractory chronic cluster headache: A new therapeutic option (EHF-EHC 2025) - "Acute therapy with oral zolmitriptan 5 mg, subcutaneous sumatriptan 6 mg, and oxygen were used, with moderate effect. Preventive treatment included prednisolone and occipital nerve block during exacerbations, and verapamil, both as monotherapy and in combination with topiramate and lithium in various regimens...Treating refractory chronic cluster headache is challenging, as it is highly disabling for the patient. Although other therapies targeting CGRP have not shown clear benefit in clinical trials, especially in chronic forms, atogepant may offer a promising alternative."

Anorexia • Cardiovascular • Chronic Cluster Headache • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Hypertension • Migraine • Pain

Efficacy and safety of almotriptan for treatment of menstrual migraine: A systematic review (EHF-EHC 2025) - "In a large trial (n=255), almotriptan 12.5 mg and zolmitriptan 2.5 mg were compared and both demonstrated comparable efficacy. Almotriptan is effective and well tolerated for the acute treatment of menstrual migraine, showing superiority over placebo and comparable efficacy to other triptans. Frovatriptan may reduce recurrence more effectively, but larger, dedicated trials are needed to confirm these findings."

Clinical • Review • CNS Disorders • Migraine • Pain

Assessing the effectiveness of personalized migraine treatment – A 22-year N-of-1 study (EHF-EHC 2025) - "No significant adverse effects were reported Topiramate (2006) was ineffective (+8.3% headache days); amitriptyline (2008) increased headache days (+20.4%) but reduced zolmitriptan use (−37.7%)...Erenumab (2020–2021) worsened both metrics (+4.1%, +37.8%). Flunarizine (2023) had modest benefit (−17%), and oxitriptan (2023–2024) had minimal effect. Despite long-term triptan overuse, the patient never developed medication-overuse headache, and zolmitriptan remained effective throughout We report a case of chronic refractory migraine with long-term triptan overuse but without evidence of medication-overuse headache. This case raises the question of whether pharmacological resistance to preventives may be linked to preserved responsiveness to acute treatments"

CNS Disorders • Migraine • Mood Disorders • Obsessive-Compulsive Disorder • Pain • Personality Disorder

Cluster headache impairs quality of life and daily functioning of Portuguese patients (EHF-EHC 2025) - "Acute-phase treatment with two or more therapies was reported by 47.6% of participants, most commonly zolmitriptan and high-flow oxygen...Cluster headache is associated with significant impairment in quality of life and daily functioning among Portuguese patients. These findings highlight the need for strategies to prevent or mitigate this burden."

Clinical • HEOR • Chronic Cluster Headache • CNS Disorders • Migraine • Mood Disorders • Pain

Some observed problems of the evidence presented for zolmitriptan nasal spray in the "Evidence-Based Recommendations of Pharmacological Treatment of Migraine Attacks". (PubMed, Cephalalgia) - No abstract available

Journal • CNS Disorders • Migraine • Pain

Response to the Letter by Tfelt-Hansen and Hougaard "Some observed problems of the evidence presented for zolmitriptan nasal spray in the "Evidence-Based Recommendations of Pharmacological Treatment of Migraine Attacks". (PubMed, Cephalalgia) - No abstract available

Journal • CNS Disorders • Migraine • Pain

Characteristics and management of headache among psychiatric outpatients at a Japanese general hospital: A retrospective study with an exploratory CGRP case series. (PubMed, PCN Rep) - "At the agent level, acetaminophen (n = 38), loxoprofen (n = 33), zolmitriptan (n = 14), goreisan (n = 8), sumatriptan (n = 6), kakkonto (n = 6), diclofenac (n = 4), valproic acid (n = 4), and naratriptan (n = 3) were among the most frequently listed. CGRP-targeted therapy yielded headache relief even under psychiatric comorbidity, while psychiatric symptoms did not uniformly improve, underscoring the need for parallel mental-health interventions alongside headache-specific care. Strengthening cross-specialty pathways and early headache evaluation within psychiatry are warranted."

Journal • Retrospective data • Autism Spectrum Disorder • Bipolar Disorder • Cardiovascular • CNS Disorders • Depression • Genetic Disorders • Mental Retardation • Migraine • Pain • Post-traumatic Stress Disorder • Psychiatry • Rheumatology • Schizophrenia • Social Anxiety Disorder

BIPOLAR PATIENT ON LITHIUM MAINTENANCE THERAPY WITH REVERSIBLE CEREBRAL VASOCONSTRICTION SYNDROME AFTER COVID-19 INFECTION (WCN 2025) - "She was diagnosed with bipolar II disorder and migraine, and taking lithium carbonate 600 mg daily for years...Two months after lomerizine, headache resolved. Zolmitriptan and celecoxib were effective... Headaches should not be overlooked when treating patients with psychiatric disorders, and consultation with a neurologist or headache specialist is necessary."

Clinical • Bipolar Disorder • CNS Disorders • Mental Retardation • Migraine • Psychiatry

Response to intravenous dihydroergotamine (DHE) for the treatment of refractory chronic migraine in adolescent patients (IHC 2025) - "Pre-infusion ondansetron 150 mcg/kg and prochlorperazine 5 mg/kg were administered PRN...For management, 54% (14/26) used sumatriptan,19% (5/26) used rizatriptan, 23% (6/26) used zolmitriptan, and 4% (1/26) used eletriptan. Preventively, 31% (8/26) had used propranolol, 23% (6/26) topiramate, 23% (6/26) amitriptyline, and 23% (6/26) pizotifen...This may include infusion slowing and increasing anti-emetic breadth and doses. Larger longer-term follow up studies are needed."

Clinical • CNS Disorders • Migraine

Research and Management Gaps in Cluster Headache Through Patient Perspectives (IHC 2025) - "Table 1. Treatment methods used for Cluster Headache management (N=137) Treatment Types N (%) Acute Prescription medications (e.g., sumatriptan, dihydroergotamine, zolmitriptan) 118 (86%) Over-the-counter pain medications (e.g., paracetamol, ibuprofen) 109 (80%) Oxygen therapy 68 (50%) Transitional Prednisolone 69 (50%) Nerve Block 44 (32%) Preventative Prescription medications (e.g., verapamil, lithium carbonate, divalproex sodium, melatonin, topiramate) 99 (72%) Lifestyle changes (e.g., sleep, diet) 89 (65%) Non-invasive vagal nerve stimulation 19 (14%) Conclusion Survey participants with cluster headache highlighted treatment limitations, identified key research priorities, and showed interest in clinical trials, particularly for psilocybin and combination therapies."

Clinical • Migraine

Impact of nasal congestion on intranasal rescue medication absorption and efficacy: A systematic review. (PubMed, Allergy Asthma Proc) - "Three additional studies that evaluated epinephrine, glucagon, and fentanyl found no effect of congestion on absorption. In the sixth study, congestion had no effect on zolmitriptan efficacy...Congestion may actually increase absorption of some intranasal epinephrine formulations. The impact of congestion on intranasal medication absorption is likely dependent on each drug's properties, mode of action, and formulation."

Journal • Review • Allergic Rhinitis • Immunology • Inflammation

Profile of triptan use and efficacy in migraine patients treated with Anti-CGRP monoclonal antibodies (EAN 2025) - "Fremanezumab was the prevailing mAb (66,28%)...Before starting mAbs, 69 patients (80.29%) used triptans, mainly zolmitriptan (36.23%) and eletriptan (34.78%)... As previously suggested in other studies, preliminary findings indicate that anti-CGRP mAbs may reduce the need for triptans in migraine management. Despite anecdotal reports of triptan efficacy loss, so far our data did not support this. Further studies are needed to explore this interaction."

Clinical • CNS Disorders • Migraine • Pain

Sustained Serotonergic Stimulation Platform for Peripheral Axonal Regeneration. (PubMed, J Hand Surg Glob Online) - "This study aimed to evaluate the potential of serotonergic peripheral neuroregeneration using Zolmitriptan, a serotonin receptor agonist...This study presents promising results regarding the potential of serotonin agonists to aid in peripheral nerve recovery. Additional investigation into these findings could inform new treatment strategies for peripheral nerve injuries."

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Intranasal Empagliflozin Modulates Synaptic Plasticity in Migraine: Insights into Calcium Signaling and Epigenetic Regulation. (PubMed, Eur J Pharm Sci) - "Using an animal model of chronic migraine headache, the effect of oral (PO)/intranasal (IN) (brain-targeted)-EMPA versus Zolmitriptan (ZOL) on serum pain marker; Substance-P and migraine symptoms; pain, and photophobia were assessed biochemically and behaviorally. Further, unlike EMPA-IN, ZOL, and EMPA-PO demonstrated significant hypoglycemic effects. In conclusion, EMPA-IN shows potential as a novel therapeutic approach for managing migraine headaches by enhancing synaptic plasticity and modulating altered migraine-related epigenetic mechanisms."

Journal • CNS Disorders • Diabetes • Migraine • Pain • BDNF • CALCR • MIR155 • SYP

Recent and on-going trials for the treatment of levodopa-induced dyskinesia: a review of the clinical trial databases. (PubMed, Neurodegener Dis Manag) - "Promising results were obtained in Phase II trials with the serotonin type 1A (5-HT1A) agonist befiradol, the dopamine D3 receptor antagonist mesdopetam and the phosphodiesterase inhibitor CPL500036. In contrast, the metabotropic glutamate 4 (mGlu4) receptor negative allosteric modulator foliglurax and JM-010 (a combination of the 5-HT1A partial agonist buspirone and the and the 5-HT type 1B and 1D [5-HT1B/1D] agonist zolmitriptan) did not meet their endpoints in Phase II studies. Lastly, robot-assisted Repetitive Transcranial Magnetic Stimulation (rTMS) of the pre-supplementary motor area may be a promising non-pharmacological approach to alleviate dyskinesia."

Journal • Review • CNS Disorders • Movement Disorders • Parkinson's Disease

Evaluating Triptan Safety in Pediatric Migraine Management: A Comprehensive Pharmacovigilance Analysis. (PubMed, J Pain Res) - "We conducted a pharmacovigilance analysis using the FDA Adverse Event Reporting System (FAERS) database from 2004-2024, focusing on adverse events associated with sumatriptan, rizatriptan, zolmitriptan, and almotriptan in patients aged 6-18 years. Age-stratified analysis revealed distinct profiles: younger children (6-11 years) showed higher risks for gastric emptying impairment (ROR=331.24) and throat tightness (ROR=77.14), while adolescents (12-18 years) experienced more diverse adverse events, notably pharyngeal swelling (ROR=133.81) and chest discomfort (ROR=19.05). Real-world triptan safety profiles reveal age-specific risks in pediatric populations, emphasizing the need for tailored monitoring strategies and age-appropriate safety protocols."

Adverse events • Journal • CNS Disorders • Migraine • Pain • Pediatrics • Respiratory Diseases

Long-term safety and discontinuation for rimegepant versus triptans: A matching-adjusted indirect comparison (AHS 2025) - P2/3 | "Despite the bias against rimegepant due to shorter follow-up in the zolmitriptan study, these results suggest patients were less likely to discontinue rimegepant than zolmitriptan, both due to AEs or lack of efficacy, and also less likely to experience AEs of dizziness, somnolence, paresthesia, nausea, or asthenia over 12-months of PRN use, reflecting better long-term tolerability and persistence. TABLE 1. MAIC safety and discontinuation results for rimegepant versus zolmitriptan."

Clinical • CNS Disorders • Migraine • Pain

Efficacy and safety of rimegepant and other acute treatments in patients with migraine: An interim analysis from a national cross-sectional study in China (AHS 2025) - P=N/A | "The proportions of patients with pain freedom within 2 h after dosing was higher for rimegepant (50.0%) than for all other drugs (rizatriptan 20.3%, zolmitriptan 26.9%, ibuprofen 16.7%, loxoprofen 15.6%, diclofenac 15.0%, acetaminophen 23.0%, aminopyrine and caffeine tablets 19.1%,aminopyrine caffeine and calcium glycerophosphate tablets 28.6%, compound aminopyrine phenacetin 35.7%, EVE (main ingredients: ibuprofen, propyl urea, caffeine) 40.7%, paracetamol caffeine and aspirin powder 41.8%, Chinese herbal medicine: Yangjiao tablet 0.0%, Chinese herbal medicine: Zhengtian pill 9.5%, Chinese herbal medicine: decoction 0.0%). The findings of this study demonstrate that rimegepant outperforms some other acute treatment drugs in terms of overall therapeutic efficacy and has a low incidence of adverse reactions. This suggests that rimegepant may provide a more desirable therapeutic effect for patients. FIGURE."

Clinical • Observational data • CNS Disorders • Migraine • Pain

Mendelian Randomization Uncovers Potential Repurposable Medications for Neuropsychiatric Disorders. (PubMed, Curr Neuropharmacol) - "MR-based drug repurposing is a promising approach for the treatment of neuropsychiatric disorders. Further validation is necessary to effectively integrate these medications into clinical practice."

Journal • Alzheimer's Disease • Cardiovascular • CNS Disorders • Dementia • Epilepsy • Hematological Disorders • Mental Retardation • Mood Disorders • Multiple Sclerosis • Psychiatry • Subarachnoid Hemorrhage

Variant angina associated with a CGRP receptor antagonist: a case report. (PubMed, BMC Neurol) - "This case suggests that atogepant may be associated with coronary vasospasm in patients with cardiovascular risk factors. Given CGRP's role as a potent vasodilator, its blockade may predispose to vasospasm in vulnerable individuals. Caution and close monitoring are warranted when prescribing CGRP receptor antagonists, particularly in those with cardiovascular comorbidities."

Journal • Cardiovascular • CNS Disorders • Glomerulonephritis • Hematological Disorders • Hypertension • IgA Nephropathy • Migraine • Pain • Renal Disease • Thrombosis

Pharmacodynamic and Physicochemical Evaluation of Intranasal Zolmitriptan-Loaded Nanostructured Lipid Carriers: for Enhanced Antimigraine Potential. (PubMed, Assay Drug Dev Technol) - "NLCs offer improved bioavailability and targeted brain therapy for effective migraine management. The findings suggest that NLCs are a promising approach for enhancing the therapeutic efficacy of ZMP."

Journal • PK/PD data • CNS Disorders • Migraine • Pain

Substrate-specific inhibition of organic cation transporter 1 revealed using a multisubstrate drug cocktail. (PubMed, Drug Metab Dispos) - "Here, we describe a multisubstrate drug cocktail that allows for the simultaneous testing of drug-drug interactions using 8 different victim drugs: fenoterol, salbutamol, sumatriptan, zolmitriptan, ipratropium, trospium, methylnaltrexone, and metformin...Group 1 comprised verapamil, quinidine, fenoterol, and ipratropium, and group 2 comprised metformin, sumatriptan, and trimethoprim...Here, we demonstrate this for organic cation transporter 1 (OCT1, SLC22A1) and presents a drug cocktail designed to identify varying inhibitory potencies in vitro and prevent false-negative drug-drug interaction results during early drug development. This approach can be extended to other polyspecific drug transporters."

Journal • SLC22A1

Extracts of Chuanxiong and Baizhi Attenuate Neuroinflammation in Chronic Migraine Rats by Inhibiting TLR4/MyD88/Nuclear Factor Kappa B Signal Pathway. (PubMed, J Physiol Investig) - "This study investigates the mechanism by which a compound mixture of Chuanxiong and Baizhi (CMCB) modulates the TLR4/MyD88/nuclear factor kappa B (NF-κB) pathway to alleviate neuroinflammation in nitroglycerin (NTG)-induced chronic migraine (CM) rat models...Results showed that CMCB concentrations below 16 μM were nontoxic to BV2 cells and effectively reduced cell apoptosis and inflammation, akin to the effects of a TLR4 pathway inhibitor, TAK-242...In vivo experiments demonstrated that both zolmitriptan and CMCB treatment ameliorated symptoms like red ear, head scratching, and cage climbing in CM rat models. High dosages of CMCB exhibited comparable efficacy to zolmitriptan in reducing inflammatory responses, indicating that CMCB alleviates neuroinflammation in CM rat models through the inhibition of the TLR4/MyD88/NF-κB signaling pathway."

Journal • Preclinical • CNS Disorders • Inflammation • Migraine • Pain • MYD88 • TLR4

Optimizing Transdermal Drug Delivery with Novasome Nanocarriers: A Quality by Design (QbD) Framework. (PubMed, Curr Drug Deliv) - "It has been shown that novasome technology may be used to deliver various drugs, such as vaccines, niflumic acid, zolmitriptan, and terconazole...These may be applied for both scale-up and lab-scale applications. This manuscript includes a detailed view of novasomes and the involvement of QBD."

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