PEBC Free Practice Question of the Week 
Updated: Jul 20, 2020
DN is a 25 year old female who has been diagnosed with anxiety disorder. Her current medications include sertraline 50 mg po every morning and bupropion XL 300 mg po at noon. The family doctor of DN wants to add sumatriptan for her migraines. What most importantly should the pharmacist counsel on?
a) QT prolongation b) Serotonin syndrome c) Myocardial infarction d) Hyperkalemia
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The answer is (B).
Sertraline is a selective serotonin reuptake inhibitor, whereas sumatriptan is a sertonin receptor agonist. Both of these agents work on the serotonin system, a drug interaction which can increase the risk of sertonin syndrome.
Serotonin syndrome is a rare but fatal reaction which is characterized by 3 sets of symptoms: cognitive (confusion), autonomic (tachycardia) and somatic (tremor).
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