The Short Answer Educational content only. Any suspected concussion warrants medical evaluation. New, severe, or changing headache after head injury warrants prompt assessment by a physician, neurologist, or headache specialist to confirm the diagnosis and exclude dangerous causes. Consult a concussion-experienced clinician for individualized care. Post-concussion headaches respond differently to different triptans because the triptans vary in how fast they act, how long they last, and how well they suit a given attack, and individual brain chemistry means one person responds to a triptan that fails another (Ashina et al., 2019). Triptans are a class of migraine-specific medications that act on serotonin receptors to switch off an attack, and they are used for the migraine phenotype of post-traumatic headache. Within the class, individual triptans differ in onset speed, duration of action, and available formulations. Because attacks differ, fast versus slow, short versus long, with or without nausea, and because people respond individually, the best triptan varies from person to person and attack to attack. A structured trial of different triptans and formulations, guided by a clinician, finds the one that works. Triptans are migraine-specific medications that switch off an attack. They differ in speed, duration, and formulation, and response is individual. A structured trial finds the triptan and form that suits the attack. What Triptans Are and How They Work Triptans are a family of medications developed specifically for migraine. They act on particular serotonin receptors to constrict dilated cranial blood vessels, reduce the release of inflammatory pain signals from trigeminal nerve endings, and dampen pain transmission in the brainstem. By targeting the trigeminovascular mechanism of migraine directly, they can abort an attack rather than simply mask the pain, which is why they often work when ordinary painkillers do not. They are used for the migraine phenotype of post-traumatic headache, which is common after concussion. Why the Triptans Differ From Each Other Although all triptans share a mechanism, they differ in properties that matter clinically. Some act quickly but wear off sooner, suiting attacks that peak fast. Others act more slowly but last longer, suiting attacks that build gradually or recur. They also come in different formulations, tablets, orally dissolving tablets, nasal sprays, and injections, which change how fast the drug is absorbed and whether it can be taken despite nausea and vomiting. A fast, severe attack with early vomiting may need a nasal spray or injection that a slow tablet cannot match, while a gradual attack may be well controlled by an oral form. Why Individual Response Varies Beyond these built-in differences, people respond to triptans individually. A triptan that reliably aborts one person's attacks may do little for another's, and someone who fails one triptan often responds well to a different one. This individual variation reflects differences in brain chemistry, receptor sensitivity, and how each person absorbs and metabolizes the drug. It means that failing to respond to a single triptan does not mean triptans will not work, an important point, because people sometimes abandon the whole class after one disappointing trial. The evidence supports trying at least two or three different triptans before concluding the class is ineffective. Matching the Triptan to the Attack Fast-peaking attacks suit fast-acting triptans or non-oral routes Slow-building or long attacks suit longer-acting triptans Attacks with early nausea or vomiting suit nasal sprays or injections Recurring attacks within a day may need a longer-acting agent or a second dose plan Early treatment, at the first sign of the attack, improves response for any triptan Assessment A clinician confirms that the headache is the migraine phenotype for which triptans are appropriate, since they do not treat tension-type or cervicogenic headache, and reviews the pattern of attacks, speed of onset, duration, and presence of nausea, to match a triptan and formulation. The assessment screens for cardiovascular risk factors, because triptans constrict blood vessels and are avoided in certain vascular conditions. A headache diary tracking which triptan was used, at what point in the attack, and the response guides the structured trial. Treatment Approach Finding the right triptan is a structured process rather than a single try. The clinician selects a first triptan and formulation matched to the attack pattern, ensures it is taken early and at an adequate dose, and reviews the response over several attacks. If it fails or is poorly tolerated, a different triptan or formulation is tried, since individual response varies and a second or third agent often succeeds where the first did not. Non-oral routes are used when nausea or speed demands them. Triptan use is limited to protect against medication overuse headache, generally no more than about ten treatment days per month, and frequent need signals that preventive treatment should be added. The general measures still apply: treating early, managing the stacking triggers of sleep, hydration, and stress, addressing the cervical contribution, and supporting brain recovery all improve how well acute treatment works. A clinician balances triptan choice against the person's cardiovascular profile throughout. Post-traumatic headache often has a cervical and autonomic component that responds to daily mobility and nervous system regulation alongside medical care. Start your 3-day free trial to build a supportive routine. Supporting Mobility Routine JME 155 Diaphragmatic breathing lowers the sympathetic drive that fuels headache and supports steady cerebral blood flow. Ten slow breaths, several times daily. JME 14 Chin tucks activate deep cervical flexors and reduce the upper cervical tension that refers pain to the head. Ten repetitions with 5-second holds. JME 1 Cervical rotation restores segmental mobility at the joints that refer pain into headache through the trigeminocervical nucleus. Ten repetitions per direction. JME 15 Cervical lateral flexion addresses side-bending restriction that sustains neck-driven headache. Ten repetitions per side. JME 16 Cervical flexion and extension restore sagittal mobility restricted by suboccipital guarding. Eight slow repetitions. JME 2 Cervical retraction reinforces a neutral head position that reduces the postural strain feeding headache. Ten repetitions per set. JME 150 Thoracic rotation restores mid-back motion needed for full cervical range and relaxed upright posture. Eight repetitions per direction. JME 227 Overhead reach opens the thoracic spine and reduces the compensatory upper cervical extension that drives headache. Ten repetitions with controlled tempo. Start your 3-day free trial for joint-specific mobility programming that addresses the cervical and autonomic contributors to post-traumatic headache. Common Mistakes Abandoning the whole triptan class after one triptan fails Taking the triptan too late in the attack, reducing its effect Using an oral tablet when early vomiting calls for a nasal spray or injection Exceeding safe triptan days and causing medication overuse headache Using triptans for tension-type or cervicogenic headache they do not treat Progression A clinician confirms the migraine phenotype, screens cardiovascular risk, and matches a first triptan and formulation to the attack pattern, taken early. Response is reviewed over several attacks, and different triptans or formulations are tried if needed, since individual response varies. Use is capped to prevent overuse, preventive treatment is added when attacks are frequent, and general trigger management supports acute treatment. What are triptans and what headaches do they treat? Triptans are migraine-specific medications that act on serotonin receptors to abort a migraine attack by targeting its trigeminovascular mechanism. They treat the migraine phenotype of post-traumatic headache, which is common after concussion, but they do not treat tension-type or cervicogenic headache, so an accurate diagnosis matters. Why did one triptan work for me but another did not? People respond to triptans individually because of differences in brain chemistry, receptor sensitivity, and drug metabolism, so a triptan that aborts one person's attacks may do little for another's. Triptans also differ in speed, duration, and formulation. Failing one triptan does not mean the class will not work. How many triptans should I try before giving up? The evidence supports trying at least two or three different triptans, and different formulations, before concluding the class is ineffective, because individual response varies and a second or third agent often succeeds where the first failed. A clinician guides this structured trial rather than stopping after one disappointment. Which triptan form is best if I vomit during attacks? Attacks with early nausea or vomiting suit non-oral routes such as nasal sprays or injections, which are absorbed without relying on the stomach and act faster. An oral tablet may be vomited or absorbed too slowly. Matching the formulation to the attack, especially its speed and nausea, improves response. Can I use triptans as often as I need them? No. Triptan use is limited to about ten treatment days per month to avoid medication overuse headache, which sustains a daily headache. Frequent need signals that preventive treatment should be added. A clinician also screens cardiovascular risk, since triptans constrict blood vessels and are avoided in certain conditions. Red Flags Requiring Urgent Evaluation The following warrant same-day emergency evaluation rather than routine care. Sudden severe headache that peaks within seconds to minutes Headache with fever, neck stiffness, or rash New weakness, numbness, slurred speech, or facial droop New vision loss, double vision, or a persistent visual change Progressive worsening headache over days to weeks Headache with confusion, drowsiness, or repeated vomiting Headache that is worse lying down, wakes the person, or worsens with straining Sudden severe neck pain with neurological symptoms, suggesting arterial dissection These features can indicate a dangerous cause and take priority over any headache-specific diagnosis. Absence of red flags supports outpatient evaluation and management. Tracking Triggers and Patterns With a Headache Diary A headache diary is one of the most useful tools for post-traumatic headache. Recording the timing, location, quality, and severity of each headache, along with sleep, meals, hydration, menstrual cycle, weather, activity, and medication use, reveals the patterns and triggers that guide treatment. Over a few weeks, a diary shows whether headaches cluster around specific triggers, whether medication use is creeping toward overuse, and which phenotype dominates. Bringing this record to a clinician sharpens the diagnosis and the plan far more than memory alone. Medication Overuse Headache Frequent use of acute headache medication can produce medication overuse headache, where the treatment itself sustains a daily or near-daily headache. This is common after concussion, when frequent pain drives frequent medication use. As a general guide, using simple analgesics on 15 or more days per month, or triptans, combination analgesics, or opioids on 10 or more days per month, raises the risk. Preventive treatment and careful limits on acute medication, guided by a clinician, break the cycle. Why Location and Triggers Matter for Diagnosis Post-traumatic headache is not one condition. Its location, timing, quality, and triggers point toward specific phenotypes, migraine, tension-type, cervicogenic, or a trigeminal autonomic cephalalgia, and each has different treatment. Where the pain sits, what sets it off, and how it behaves are diagnostic clues, not incidental details. A precise diagnosis by a physician, neurologist, or headache specialist, using the criteria of the International Classification of Headache Disorders, directs the person to the treatment most likely to work and avoids prolonged trial and error. A cervical contribution is common across phenotypes and responds to physical therapy alongside medical care. References Ashina, H., et al. (2019). Post-traumatic headache: epidemiology and pathophysiological insights. Nature Reviews Neurology, 15(10), 607-617. PubMed Headache Classification Committee of the International Headache Society (IHS). (2018). The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38(1), 1-211. PubMed Patricios, J. S., et al. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695-711. PubMed