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REVIEW ARTICLE
Year : 2020  |  Volume : 6  |  Issue : 1  |  Page : 11-14

The ditans, a new class for acute migraine: Minireview


Department of Neurology; Department of Medicine, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil

Correspondence Address:
Jamir Pitton Rissardo
Rua Roraima, Santa Maria, Rio Grande do Sul
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrsm.jcrsm_45_19

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Lasmiditan (LDT), a new drug, was approved by the Food and Drug Administration in October 2019 for acute migraines with or without aura. LDT belongs to a new class of drugs “-ditans,” in which the mechanism is different from the triptans since it does not show vasoactive effects. The “-ditans” are more likely to be involved with the trigeminal system without causing vasoconstriction because of its low affinity for 5-HT1B receptors and highly selective 5-HT1F receptor agonist. The LDT probably decreases the neurogenic inflammation of the dura by lowering plasma protein extravasation and inhibits or suppresses neuronal firing in the trigeminal nucleus caudalis. Moreover, 5HT1F agonists have shown to decrease c-fos activity within the trigeminal nucleus, which reduces the level of synaptic activation. The onset of action of LDT is fast, which shows rapid absorption with good oral bioavailability. The peak plasma occurs within 2 h and the distribution is half associated with proteins. The LDT metabolism is hepatic but also nonhepatic by noncytochromes P450.


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