Triptan HA Title

Overview

Imitrex (sumatriptan) is rarely associated with a variety neurological adverse effects, including 'disturbance of emotion'. The prescribing information for Imitrex lists the incidence rate of this side effect at less than 1%.

Associated adverse neurological effects of Imitrex include (<0.1-1% incidence rate):

  • Anxiety
  • Agitation
  • Confusion
  • Depression
  • Difficulty concentrating
  • Euphoria
  • Aggressiveness
  • Apathy
  • Detachment
  • Personality change

Imitrex, a drug in the 'Triptan' class, works stimulating specific serotonin receptors in the body. The serotonin effects are thought to be what could potentially cause the neurological adverse effects described above.

It isn't known whether or not any single  'Triptan' medication has a higher incidence rate of neurological side effects than another.

It is important to discuss the side effects you are experiencing with your doctor and decide on the appropriate action, whether it be trying a different 'Triptan' or discontinuing the medication altogether.


About 'Triptans'

All 'Triptans' (including Imitrex) are indicated for the acute treatment of moderate to severe migraine headache. Minor differences exist between them in regard to:

  • Duration of action
  • Onset of action
  • Efficacy
  • Safety
  • Tolerability

The exact mechanism of action of 'Triptan' medications aren't known and multiple pharmacological actions have been suggested to be important for anti-migraine effects, including:

  • Stimulating 5-HT1D serotonin receptors, inhibiting both dural vasodilation and inflammation.
  • Stimulating 5-HT1B serotonin receptors, inhibiting trigeminal nuclei cell nociceptive neurotransmission.
  • Vasoconstriction of painfully dilated intracranial vessels.

Imitrex is the only 'Triptan' available for subcutaneous injection, which studies have shown has a faster onset of action and is more effective than other formulations. It is, however, associated with a greater risk of side effects

'Triptan' medications should be used as soon as symptoms of migraine occur (within 4 hours of the onset of symptoms but preferably within 1 hour) for greatest efficacy.


Imitrex Side Effects

Imitrex Structure

The most commonly reported side effects of Imitrex are:

  • Paresthesias (i.e. tingling)
  • "Warm sensations" (i.e. flushing)
  • Dizziness
  • Somnolence (i.e. sleepiness)
  • Chest discomfort

Other reported side effects include:

  • Dysgeusia (i.e. altered taste)
  • Headache
  • Nausea
  • Dry mouth
  • Runny nose
  • Changes in emotions
  • Rebound headaches (from overuse)
  • Changes in heart rhythm
  • Chest pains
  • Lightheadedness

In regard to 'rebound headaches', they have been reported when the use of a 'Triptan', such as Imitrex, has exceeded 10 days per month. They are characterized by a significant increase in headache frequency.

If rebound headaches occur with Imitrex, withdrawal treatment of associated symptoms is typically necessary.

Summary

'Changes in emotion' is a listed side effect off all 'Triptan' medications, including Imitrex (sumatriptan).

References
  1. Imitrex Prescribing Information. GSK
  2. Where do triptans act in the treatment of migraine? PubMed
  3. Sumatriptan inhibits neurogenic vasodilation of dural blood vessels in the anaesthetized rat--intravital microscope studies. PubMed
  4. Triptans disrupt brain networks and promote stress-induced CSD-like responses in cortical and subcortical areas. PubMed
  5. Imitrex Prescribing Information. DailyMed
  6. Increased susceptibility to cortical spreading depression in an animal model of medication-overuse headache. PubMed
  7. Recurrent depression after sumatriptan administration for treatment of migraine. PubMed