Key takeaways
Naratriptan and dihydroergotamine (Migranal) are both used to treat migraines, but they have several differences. Naratriptan is a triptan, available only as an oral tablet, and works by tightening blood vessels in the brain and reducing swelling. It is typically taken as a single dose, with the option to take a second dose after 4 hours if needed. Dihydroergotamine, on the other hand, is an ergot derivative available as a nasal spray or injection. It binds to multiple receptors in the brain, including serotonin and dopamine receptors, to relieve migraine and cluster headaches. Dihydroergotamine kicks in faster than naratriptan, with the nasal spray form starting to work in as little as 15 minutes. However, dihydroergotamine may cause nasal irritation. Both medications can cause serious side effects like heart problems and stroke. But dihydroergotamine has a higher risk of causing these issues due to its stronger blood vessel tightening effects.
