Sumatriptan

In this section
Does it work?
What is it?
How can it help?
Why should it work?
Can it be harmful?
What's the evidence?

Does it work?

Yes. Sumatriptan will probably help if you have a migraine attack. Even if your attack is very bad, sumatriptan should make the pain more bearable. It works whether you take it as a pill, an injection under your skin, or a nasal spray.

Sumatriptan makes some people's migraines go away completely. It can also help with other symptoms of a migraine, including nausea, vomiting and being unable to bear light or sound.

However, some research has found that sumatriptan may not work any better for migraine than aspirin.¹

What is it?

Sumatriptan is a type of drug known as a triptan. It works in a similar way to a chemical in your brain called serotonin. Like serotonin, sumatriptan makes the blood vessels in your brain narrower. And this can stop the pain of an attack, at least partly.

Sumatriptan was the first triptan to be developed to treat migraine.

There are different ways to take sumatriptan. You may:

• Inject it under your skin
• Take it as a tablet
• Spray it into your nose and breathe it in.

You can buy sumatriptan tablets yourself from a pharmacy. The brand name is Imigran Recovery.

How can it help?

Sumatripan works well for migraine. It usually works within one hour or two hours.^{2 3 4}

• About 6 in 10 to 7 in 10 people with migraine feel better after taking sumatriptan .^{2 3}
• It will probably make your migraine attack either disappear completely or become mild and more bearable.
• Injections, pills and nasal spray all work equally well.³
• Sumatriptan may also help with other symptoms of an attack, including nausea and vomiting, and being extra-sensitive to light or sound.⁵ It is likely to help you get back to your usual routine.
• Injected sumatriptan can help people who have frequent migraine attacks. A study of 246 patients who had one to six attacks per month found that using injected sumatriptan made nearly 8 in every 10 attacks better. It made the pain go away completely or almost completely.⁴

A study looking at all the triptans available at the time (in 2007) found that they all helped to get rid of the pain within two hours, or make it much milder, compared to a dummy drug (a placebo). But only sumatriptan and rizatriptan worked better than a placebo drug within half an hour.⁶

Why should it work?

Like other triptans, sumatriptan acts like a chemical in your brain called serotonin. It binds to your cells at specific sites called serotonin receptors, rather like a key being put into a lock.

Sumatriptan helps to treat migraine in these ways.

• When you have a migraine attack, the blood vessels in your brain open up (dilate). This means there is more blood flowing through them. Researchers think this is what causes the pain of migraine attacks. Sumatriptan corrects the changes in blood flow and makes your blood vessels narrower.
• It also blocks the release of chemicals that carry pain messages between different parts of your brain.

These effects work together to help you feel better.

Can it be harmful?

Like all triptan drugs, sumatriptan can have side effects, although they are usually mild and do not last long.²

• The most common side effects are pins and needles and feelings of warmth in different parts of the body.
• This medicine can also make you feel dizzy or flushed or get neck pain and stiffness.
• You can get more worrying side effects like feeling confused and drowsy but these are less common.
• Some people get chest pain or tightness but this is not very common.

But it's not clear from the research what proportion of people get side effects. Different studies say different things.

The research we looked at found the following.

• About 6 in 10 to 7 in 10 people who used injected sumatriptan got side effects. About 3 in 10 people taking a dummy treatment (a placebo) also got side effects.³
• All doses of sumatriptan increase the risk of side effects. But the higher the dose, the higher the risk.²
• With sumatriptan doses of 50 mg and 100 mg, there is a risk of more serious side effects, such as chest symptoms and symptoms affecting your nervous system (drowsiness, for example).²

If you have heart disease, you should not take this medicine. It can make your blood vessels narrower and your heart disease worse. If you have risk factors for heart disease, like high blood pressure, your doctor might want you to take some heart tests before using this medicine to see if it is safe for you.⁷

You should also not take sumatriptan at the same time as ergotamine, which is another type of drug used to treat migraine.⁷

Triptans and antidepressants

If you take sumatriptan (or any other triptan) together with one of the groups of medicines called selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-noradrenaline reuptake inhibitors (SNRIs), there's a chance you could get a condition called serotonin syndrome.⁸ SSRIs and SNRIs are types of antidepressants. They are treatments for depression and some other mental health problems. SNRIs are sometimes called selective serotonin-norepinephrine reuptake inhibitors.

Serotonin syndrome happens when you get too much serotonin in your body. It can be fatal. All SSRIs and SNRIs increase the amount of serotonin in the body. Names (and brand names) of SSRIs and SNRIs include:

• citalopram (Cipramil)
• duloxetine (Cymbalta)
• escitalopram (Cipralex)
• fluovoxamine (Faverin)
• fluoxetine (Prozac)
• paroxetine (Seroxat)
• sertraline (Lustral)
• venlafaxine (Effexor).

The symptoms of serotonin syndrome are:

• Feeling restless
• Rapid changes in blood pressure (you may not notice anything when this happens)
• A rise in your body temperature
• Feeling jittery
• Feeling like you might be sick
• Vomiting
• Diarrhoea.

The chances of getting serotonin syndrome are highest when you start treatment with one of these medicines in addition to one you're already taking, or the dose of one of them is increased.

If you get any of the above symptoms you should see your doctor or go to an emergency department straight away.

What's the evidence?

What's the evidence for sumatriptan?