Sumatriptan (Imitrex) with Celexa increases the risk of which serious condition?

• A. Serotonin syndrome
• B. Hypertension
• C. NMS
• D. Torsades de Pointes

Answer: (A)

Combining a triptan with an SSRI raises the risk of serotonin syndrome, a potentially life-threatening state from too much serotonin activity in the brain and body. Sumatriptan stimulates serotonin receptors (5-HT1B/1D) to help relieve migraines, while Celexa increases serotonin levels by blocking reuptake. When used together, they can push serotonergic signaling beyond safe limits, leading to mental status changes (agitation, confusion), autonomic instability (fever, sweating, rapid heart rate, blood pressure changes), and neuromuscular abnormalities (tremor, myoclonus, hyperreflexia). This combination is classic for triggering serotonin syndrome.

Other options don’t fit as well. NMS is linked to dopamine-blocking antipsychotics, not serotonergic drug combinations. Torsades de Pointes is a QT-prolongation–related arrhythmia, not the primary risk with this drug pairing. Hypertension can occur with sumatriptan alone due to vasoconstriction, but the question centers on a drug interaction that specifically elevates serotonergic toxicity.