Is chest pain after sumatriptan oesophageal in origin?
3-5% of patients taking the 5HT1D agonist sumatriptan for migraine have chest discomfort, suggesting a cardiac origin. We have investigated an alternative explanation of an oesophageal cause in 24 volunteers after the subcutaneous administration of a supratherapeutic dose of sumatriptan (16 mg) or placebo in a randomised, double-blind crossover study. Sumatriptan did not alter the electrocardiogram but increased the amplitude (p < 0.001) and duration (p < 0.001) of oesophageal contractions without affecting velocity of propagation. Clinically abnormal motility was also increased (p = 0.001), and was more common in the 5 subjects with chest pain after sumatriptan. The effect of sumatriptan on oesophageal function provides an alternative explanation for the chest symptoms.
Houghton
L A
LA
Department of Medicine, University Hospital of South Manchester, UK.
Foster
J M
JM
Whorwell
P J
PJ
Morris
J
J
Fowler
P
P
D000328:Adult; D002637:Chest Pain / Q000139:chemically induced*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects; D015154:Esophageal Motility Disorders / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008365:Manometry; D018170:Sumatriptan / Q000008:administration & dosage / Q000009:adverse effects*
D018170:Sumatriptan