Neurology Book

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Ditan

Aka: Ditan, Lasmiditan, Reyvow
  1. Indications
    1. Acute Migraine Headache
      1. Third-line agent in acute Migraine Headaches refractory to NSAIDS and Triptans
  2. Mechanism
    1. Selective Serotonin5-HT1F Agonist
      1. Differs from Triptan binding sites
  3. Preparations
    1. Reyvow (Lasmiditan)
      1. Costs $85 per tablet (contrast with 70 cents per Sumatriptan tablet)
      2. Limit to 4 doses per month
  4. Dosing
    1. Single dose, and no benefit from re-dosing <24 hours
  5. Efficacy
    1. NNT 10 for one patient to be pain free at 2 hours
      1. Contrast with NNT 5 for Sumatriptan
  6. Adverse Effects
    1. Does NOT cause vasospasm (in contrast to Triptans)
    2. Transient minor increases in Blood Pressure or Heart Rate
    3. Euphoria and Hallucinations
      1. Do not drive for 8 hours after dose
      2. Schedule V agent
    4. Serotonin Syndrome
  7. References
    1. (2020) Presc Lett 27(3): 13

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