Abnormal dreams and night terrors with atogepant: A case series.
Jason To, Heather Cournoyer, Amanda G. Kennedy, Adam S Sprouse-Blum, J. MacDougall
American Journal of Health-System Pharmacy July 13, 2026 DOI: 10.1093/ajhp/zxag213 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 4 |
| Population | Patients with migraine treated at a tertiary headache clinic |
| Intervention | Atogepant |
| Key findings | Four patients with migraine developed vivid abnormal dreams, nightmares, or night terrors after starting atogepant; symptoms were bothersome, often led to discontinuation, and generally resolved after stopping the drug, though one patient improved while continuing therapy. The authors argue that timing and causality assessment, despite confounders, support a possible association, consistent with FDA Adverse Event Reporting System pharmacovigilance signals, and propose that abnormal dreams and night terrors may be an underrecognized, potentially reversible adverse effect of atogepant. |
Abstract
Purpose: To describe a potential emerging neuropsychiatric adverse effect, abnormal dreams or night terrors, associated with atogepant (a calcitonin gene-related peptide receptor antagonist) observed in 4 patients treated at a tertiary headache clinic, and to place these observations in the context of existing postmarketing pharmacovigilance signals. SUMMARY Four patients with migraine developed vivid abnormal dreams, nightmares, or night terrors after starting atogepant for migraine prevention. Symptoms were bothersome, often led to atogepant discontinuation, and generally resolved after stopping use of the drug; one patient improved despite continuing therapy. Although confounders existed, timing and causality assessment supported a possible association, consistent with US Food and Drug Administration Adverse Event Reporting System pharmacovigilance signals.
Conclusion: Abnormal dreams and night terrors may represent an underrecognized adverse effect of atogepant. Based on this case series, the effect appears potentially reversible with discontinuation and may diminish over time in some patients who continue therapy. For patients who are taking atogepant and report sleep disturbances and dream-related symptoms, a possible correlation with atogepant should be considered. During follow-up, proactively asking about sleep disturbances and dream-related symptoms should be considered.