Antimigraine drugs are medications intended to reduce the effects or intensity of migraine headache. They include drugs for the treatment of acute migraine symptoms as well as drugs for the prevention of migraine attacks.
The antimigraine drug sumatriptan, which is a serotonin-1 agonist, has commonly been associated with chest pain and myocardial infarction presumably due to vasoconstriction of the coronary arteries. Sumatriptan-induced atrial fibrillation is uncommon, but several cases have been reported with positive rechallenge, which means occurrence of an anticipated adverse drug reaction after administering sumatriptan. In vivo sumatriptan causes rapid constriction of dural and meningeal vessels. During migraine attack, it does not modify cerebral blood flow but constricts arteriovenous anastamoses that may be dilated.
This evidence recommends that, with its antimigraine activity, sumatriptan has a direct, dose-related, vasoconstrictor action on certain intracranial blood vessels. However, sumatriptan may act directly on the trigeminal sensory nerve terminals within the cranial blood vessel, thus inhibiting the release of sensory neuropeptides. Myocardial ischemia secondary to coronary vasospasm could be a trigger for atrial fibrillation.99