Brief Answer: serotonin syndrome can occur in some Detailed Answer: HI, thanks for using healthcare magic It is understandable to be concerned. There is a risk of a reaction between imitrex with both the trazodone and paxil, if they are used together. All of these medications can potentially increase the levels of the chemical serotonin. Very high levels of serotonin can cause the serotonin syndrome. This condition is associated with a wide range of possible symptoms including muscle spasms, tremor, dilated pupils, increased heart rate and blood pressure, agitation, increased temperature. If it continues can potentially cause damage to different organs. It is possible that you may not experience this condition particularly since you would not be using the imitrex on a daily basis. It is possible to monitor for any symptoms (tremor, agitation, muscle spasms) and if any are noted the medication can be discontinued and the levels of serotonin would decrease. Medications can also be given to treat any symptoms of serotonin syndrome. I hope this helps, feel free to ask any other questions

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