Can Imitrex (sumatriptan) cause serotonin syndrome?

Medically reviewed by Kristianne Hannemann, PharmD. Last updated on June 30, 2024.

Official Answer by Drugs.com

While serotonin syndrome can occur from taking Imitrex (sumatriptan) by itself, the risk is higher if you take it with other medications that can affect serotonin. Serotonin is a chemical in the brain that affects mood and behavior. Too much serotonin activity in the brain can lead to toxicity and serious side effects.

You should stop taking Imitrex and get medical attention right away if you believe you have symptoms of serotonin syndrome.

What are the symptoms of serotonin syndrome?

Symptoms of serotonin syndrome usually occur within minutes or hours of taking a new or higher dose of a medication that can affect serotonin levels. You may experience mild symptoms, or they could become life-threatening.

If you have serotonin syndrome, you may experience some of the following symptoms:

Agitation
Diarrhea
Fever
Rapid heartbeat
Hallucinations
High blood pressure
Nausea or vomiting
Confusion
Muscle spasms
Shivering
Trouble walking

These are not all possible signs and symptoms of serotonin syndrome. If you think you are experiencing serotonin syndrome, get medical help right away.

What medications can raise the risk of serotonin syndrome?

Medications that have been associated with serotonin syndrome, especially when combined, include:

Dextromethorphan
Opioids
Lithium
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
St. John’s wort
Triptans
Tricyclic Antidepressants (TCAs)
Monoamine oxidase inhibitors (MAOIs)

Other medications may cause serotonin syndrome, and the list above is not all-inclusive. Check with your healthcare provider each time you start a new medication. They can review your individual risk for serotonin syndrome with you.

How common is serotonin syndrome from Imitrex?

Serotonin syndrome while taking Imitrex is rare, especially if you are not taking other medications that affect serotonin. There currently is not enough information to know how common serotonin syndrome is from taking Imitrex (a triptan) alone or combined with other serotonergic medications. The information available is based on case reports.

Each year, it is estimated that about 5 to 7 cases of serotonin syndrome associated with triptan therapy are reported to the FDA. This includes patients taking a triptan alone and in combination with other medications that affect serotonin.

As of 2010, the FDA has identified 11 cases of serotonin syndrome in patients taking a triptan medication by itself.

One study looked at health records of about 19,000 patients who were prescribed triptans and an SSRI or SNRI antidepressant. Researchers found that serotonin syndrome was suspected in 17 patients, and only 2 patients had definite serotonin syndrome. Keep in mind that the more medications you take that affect serotonin, the higher your risk gets for serotonin syndrome.

References

Evans, R., et. al. (2010). The FDA alert on serotonin syndrome with use of triptans combined with selective serotonin reuptake inhibitors or selective serotonin-norepinephrine reuptake inhibitors: American Headache Society position paper. DOI: https://doi.org/10.1111/j.1526-4610.2010.01691.x

Imitrex tablet [package insert]. (Revised Feb 2024). Accessed 06/28/2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=584abe73-8290-4484-ff8e-5890831c095e

MedlinePlus. (2022). Serotonin Syndrome. Accessed 06/30/2024 at https://medlineplus.gov/ency/article/007272.htm

Orlova, Y., et. al. (2018). Association of Coprescription of Triptan Antimigraine Drugs and Selective Serotonin Reuptake Inhibitor or Selective Norepinephrine Reuptake Inhibitor Antidepressants With Serotonin Syndrome. DOI: https://doi.org/10.1001/jamaneurol.2017.5144

Shaprio, R. (2020). Serotonin Syndrome with Triptans: Facts vs. Fear. Accessed 06/30/2024 at https://americanheadachesociety.org/wp-content/uploads/2020/09/AHS-Fact-Sheet_Serotonin-Syndrome-Triptans.pdf

What drugs can cause serotonin syndrome?

Serotonin syndrome is a potentially life-threatening condition caused by an excess of serotonin in the body, usually triggered by medications or drugs that increase serotonin activity. It most commonly occurs when certain antidepressants, migraine medications, opioids, or illicit drugs are taken alone in high doses or, more often, in combination. Common drug classes that can cause serotonin syndrome include selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and opioids like tramadol.

How often can you take Imitrex (sumatriptan)?

How often you can take Imitrex (sumatriptan) depends on which form you are taking. Imitrex comes as a tablet, nasal spray, and injection. Each form of Imitrex has its own specific dosing recommendations. Do not take more Imitrex than what’s prescribed to you, since taking too much can lead to serious side effects. Continue reading

Ubrelvy vs Imitrex (sumatriptan): How do they compare?

Ubrelvy and Imitrex are both oral tablets used to treat migraine, but there are differences in the way they work. Ubrelvy prevents a protein called CGRP thought to play a role in migraine attacks from binding to its receptor and Imitrex is thought to bind to serotonin 5‑HT1B/1D receptors, and inhibit pro-inflammatory substances Although no head-to-head comparison trials compare Ubrelvy to Imitrex, indirect evidence suggests that overall, Ubrelvy is no more effective, and may be inferior to Imitrex at relieving migraine in adults who are able to tolerate triptans. For those adults with moderate-to-severe migraine attacks that cannot tolerate triptans or who have found them ineffective, Ubrelvy is beneficial for treating migraines compared to no treatment. Ubrelvy is associated with fewer side effects than Imitrex, but is more expensive, costing almost twice as much. Continue reading

Can Imitrex (sumatriptan) cause serotonin syndrome?

What are the symptoms of serotonin syndrome?

What medications can raise the risk of serotonin syndrome?

How common is serotonin syndrome from Imitrex?

Read next

What drugs can cause serotonin syndrome?

How often can you take Imitrex (sumatriptan)?

Ubrelvy vs Imitrex (sumatriptan): How do they compare?

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