Triptans are effective medicines used to treat migraine headaches. For about 60 percent of people who take one, a triptan reduces pain within two hours. While complete pain relief is not common, it can be enhanced if you take a triptan early in a migraine attack. The triptans also help relieve other migraine symptoms, such as nausea, vomiting, and sensitivity to light, noise, and motion.

If you have mild and less frequent migraine attacks, try other pain relievers first, including aspirin, an NSAID (such as ibuprofen), Excedrin Migraine or Excedrin Extra Strength. If your migraines are moderate to severe, frequent, and/or disrupt your life, you are likely to need a triptan.

However, the triptans should not be taken by people with certain conditions because of risks they pose to the heart. This includes people with coronary artery disease or angina (chest pain), those who have had a heart attack or stroke, and people who have peripheral vascular disease, uncontrolled high blood pressure, diabetes, or who smoke.

In addition, the triptans should be prescribed with caution for men over 40, women over 50, people who have high cholesterol, diabetes, or who are significantly overweight and those with a family history of early heart disease or stroke.

There are seven triptans and they differ in their effectiveness and the side effects they cause. They are expensive drugs (with none yet available as a generic) and tend to be priced about the same on a per pill basis ($21 to $26). The nasal spray and injectable forms cost more. We have chosen three triptans as Consumer Reports Best Buy Drugs:

• Naratriptan (Amerge) - for people with milder migraines who are sensitive to triptan side effects and/or have longer-duration migraines
• Rizatriptan (Maxalt) - for people with moderate to severe headache pain and symptoms
• Sumatriptan (Imitrex) - for people with moderate to severe headache pain and symptoms

Each of these three drugs has unique strengths, which are discussed in detail in our full report. They are chosen as Best Buys largely on their clinical merits and not their cost. The cost for triptan treatment depends entirely on how often you have to use one, since triptans are only taken when a migraine occurs. Frequent use can be expensive.

Ordinary periodic 'tension- type'	Chronic daily1	Cluster	Migraine
Generally mild in intensity Does not occur regularly, just every once in a while Usually lasts ½ to 3 hours Dull ache Pain on both sides of head Not throbbing No nausea or vomiting No visual disturbance or auras2 Mild sensitivity to light or noise, but only one and never both	Can be mild or severe in intensity Occurs at least 15 days per month for 3 months Pain can be dull or stabbing and jolting (often described as ice-pick-like) Lasts at least 4 hours if untreated No nausea or vomiting No visual disturbance or auras Mild sensitivity to light and noise, if any May result from overuse of pain relievers	Pain is usually severe and centered on one side, behind the eye or temple Pain is sharp, stabbing Short attacks usually last 30 minutes to 1 hour but can be up to 3 hours if untreated Can be more than one attack a day and usually up to three Comes in waves, with attacks daily or near-daily for 2 weeks to 3 months and then disappears for months or even years	Pain is moderate to severe and often located on one side Often pulsating or throbbing Periodic attacks (several a year to one or two a month) that last from 4 to 72 hours if untreated3 Nausea with or without vomiting is quite common Sensitivity to movement, light and/or noise common May have auras or visual disturbances4