We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

A Surfeit of Serotonin: Sumatriptan and Serotonergic Antidepressants

James F. Knudsen, MD, PhD; Beverly Friedman, MBA, RPh; Min Chen, MS, RPh; Jerome E. Goldwasser, MD
Arch Intern Med. 1999;159(10):1141-1142. doi:.
Text Size: A A A
Published online


In reply

We thank Dr Schwartz for his interest in our recent article1 and for his comments about the serotonin syndrome. In addition, his letter affords us the opportunity to provide some further insights about the concurrent use of sumatriptan and the selective serotonin reuptake inhibitors (SSRIs) in patients with migraine headache.

Schwartz raises an important issue, namely, what is the potential for pharmacodynamic interactions when drugs such as fluoxetine, an SSRI, is coadministered with other drugs known to affect neurotransmission, for example, sumatriptan? Such drugs may alter serotonin neurotransmission by different mechanisms of action. These include inhibition of serotonin reuptake or metabolism, increased synthesis or release, and direct stimulation of serotonin receptors. Sumatriptan, the first of the class of so-called triptans to be marketed, and the "new triptans" such as naratriptan, zolmitriptan, and rizatriptan are included in the last category.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles