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Triptan Use and Potential Undertreatment in Migraine: A Retrospective Cohort Study
Yael Barer1, Moshe Hoshen1, Sivan Gazit1
1Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv 6812509, Israel.
Journal of Clinical Medicine
|February 27, 2026
Summary
Triptan use for migraine in Israel is low, with high discontinuation rates. Most patients stop triptans within 7.7 months, indicating potential undertreatment and the need for better migraine management strategies.
Area of Science:
- Neurology
- Pharmacology
- Public Health
Background:
- Triptans are standard acute migraine treatments, but suboptimal optimization is suggested by low prescribing and high discontinuation rates.
- Understanding triptan usage patterns is crucial for improving migraine patient care.
Purpose of the Study:
- To evaluate triptan initiation and discontinuation patterns among triptan-naïve patients in Israel.
- To identify factors influencing triptan adherence and long-term use.
Main Methods:
- Retrospective cohort study using 10 years of data (2012-2022) from Maccabi Healthcare Services (MHS).
- Analysis of triptan dispensation and prescription data for triptan-naïve individuals aged 21+.
- Kaplan-Meier curves used to assess median time to triptan discontinuation.
Main Results:
- Of 41,297 triptan-naïve patients, 70% discontinued triptans, with a median discontinuation time of 7.7 months.
- Approximately 74% used only one triptan formulation.
- Discontinuation patterns were consistent across demographic and clinical subgroups, with median times generally under 12 months.
Conclusions:
- High triptan discontinuation and low usage rates suggest potential migraine undertreatment in Israel.
- Improved patient/physician education and follow-up protocols are needed for better migraine management.
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