What is Lasmiditan Succinate used for?

Lasmiditan Succinate: A New Hope for Migraine Sufferers

Introduction to Lasmiditan Succinate

Lasmiditan Succinate, sold under the trade name Reyvow, is an innovative drug designed to address the needs of individuals suffering from acute migraine attacks. Unlike many conventional migraine medications, Lasmiditan belongs to a novel class of drugs known as "ditans." Lasmiditan targets serotonin receptors, specifically the 5-HT1F receptor, distinguishing it from traditional triptans that target the 5-HT1B and 5-HT1D receptors. This difference in receptor targeting allows Lasmiditan to provide effective relief without causing vasoconstriction, making it a crucial option for patients who have cardiovascular risk factors or cannot tolerate the vasoconstrictive properties of triptans.

The research and development of Lasmiditan were spearheaded by Eli Lilly and Company, a global pharmaceutical giant. The drug was first approved by the U.S. Food and Drug Administration (FDA) in October 2019 for the acute treatment of migraine with or without aura in adults. Since its introduction, Lasmiditan has garnered attention for its unique mechanism of action and promising clinical outcomes, thus representing a significant advancement in migraine therapy.

Lasmiditan Succinate Mechanism of Action

Lasmiditan’s mechanism of action is centered around its highly selective binding to the 5-HT1F receptor, a subtype of the serotonin receptor. This receptor is predominantly found in the central nervous system, particularly within the trigeminal pathway, which plays a crucial role in the pathophysiology of migraines. By activating the 5-HT1F receptor, Lasmiditan modulates the release of neurotransmitters and neuropeptides involved in pain transmission, thereby mitigating the migraine attack.

Unlike triptans, which also target 5-HT1B and 5-HT1D receptors leading to vasoconstriction, Lasmiditan’s selective action on 5-HT1F does not cause narrowing of blood vessels. This is particularly beneficial for patients with cardiovascular conditions, for whom triptans pose significant risks due to their vasoconstrictive effects. Consequently, Lasmiditan offers a safer profile for a broader range of patients.

How to Use Lasmiditan Succinate

Lasmiditan is administered orally in the form of a tablet. It is available in two dosages: 50 mg and 100 mg. A patient is advised to take the medication as soon as possible after the onset of migraine symptoms. The onset of action of Lasmiditan is relatively fast, with patients often experiencing relief within 30 minutes to 2 hours post-administration.

The recommended starting dose is 50 mg, but depending on the severity of the migraine and the patient’s response to the initial dose, healthcare providers may adjust the dosage to 100 mg. It is important to note that Lasmiditan should not be taken more than once within a 24-hour period, and it is not intended for the prevention of migraines but rather for acute treatment. Patients are also advised to avoid activities requiring full alertness, such as driving or operating heavy machinery, for at least 8 hours after taking the medication, due to the risk of significant drowsiness and dizziness.

What is Lasmiditan Succinate Side Effects

Like all medications, Lasmiditan is not without its side effects. Common adverse reactions reported by patients include dizziness, fatigue, paresthesia (a tingling or prickling sensation), and somnolence (drowsiness). These side effects are typically transient and tend to subside as the drug is metabolized.

However, more severe side effects may occur, albeit rarely. These include serotonin syndrome, a potentially life-threatening condition characterized by symptoms such as agitation, hallucinations, rapid heart rate, fluctuating blood pressure, and increased body temperature. Patients are advised to seek immediate medical attention if they experience any of these symptoms.

Lasmiditan is contraindicated in patients with hypersensitivity to any of its components. Additionally, due to the drug’s central nervous system effects, it should be used with caution in patients with a history of epilepsy or seizure disorders. Pregnant and breastfeeding women should also consult their healthcare provider before using Lasmiditan, as its safety in these populations has not been thoroughly established.

What Other Drugs Will Affect Lasmiditan Succinate

Drug interactions are an important consideration in the administration of Lasmiditan. Because Lasmiditan is metabolized primarily by hepatic enzymes, particularly CYP2D6, concomitant use of drugs that inhibit or induce these enzymes can alter the drug’s efficacy and safety profile. For instance, potent CYP2D6 inhibitors such as fluoxetine, paroxetine, and quinidine may increase the plasma levels of Lasmiditan, thereby heightening the risk of adverse effects.

Similarly, the concurrent use of central nervous system depressants, including benzodiazepines, opioids, and certain antipsychotic medications, can potentiate the sedative effects of Lasmiditan, leading to enhanced drowsiness and impaired motor function.

Moreover, patients on serotonergic drugs, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs), should be closely monitored for signs of serotonin syndrome when taking Lasmiditan. It is imperative for patients to inform their healthcare provider of all medications they are currently taking, including over-the-counter drugs and herbal supplements, to mitigate the risk of harmful interactions.

Conclusion

In summary, Lasmiditan Succinate represents a significant advancement in the treatment of acute migraines, offering a unique mechanism of action that caters to a broader patient population, particularly those with cardiovascular risks. While it presents a promising alternative to traditional triptans, its use requires careful consideration of potential side effects and drug interactions. As always, patients should consult their healthcare provider to determine the most appropriate treatment plan tailored to their individual needs.