American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of medication is typically used for migraine patients who do not respond to NSAIDs?

1. Beta-blockers

2. Triptans

3. Antidepressants

4. Antihistamines

The correct answer is: Triptans

Triptans are specifically designed as abortive medications for the acute treatment of migraine headaches. They work by stimulating serotonin receptors in the brain, effectively alleviating migraine symptoms by constricting blood vessels and inhibiting the release of pro-inflammatory neuropeptides. This targeted action makes triptans particularly effective for patients who do not experience relief from nonsteroidal anti-inflammatory drugs (NSAIDs). In cases where patients are unresponsive to NSAIDs, triptans are often the next line of treatment recommended. They have a well-established efficacy profile and are among the most commonly prescribed medications for acute migraine attacks. Additionally, triptans are generally well tolerated, although they may be contraindicated in certain populations, such as those with cardiovascular conditions, due to their vasoconstrictive properties. Other medication classes listed, such as beta-blockers, antidepressants, and antihistamines, predominantly serve different roles. For example, beta-blockers and antidepressants are primarily used for migraine prevention rather than acute treatment, while antihistamines do not have a specific role in migraine therapy. This distinction underscores the appropriateness of using triptans for patients who need an effective acute intervention following inadequate response to NSAIDs.