Should triptans be taken with certain antidepressants?

09/03/2009

Should triptans be taken with certain antidepressants?

In 2006, the FDA put out a warning about triptan medications (Imitrex, Maxalt, Relpax and other migraine-specific medications) being taken with SSRI's (antidepressants such as Prozac, Lexapro, Celexa, Zoloft). The concern was that the combination would cause an unusual but dangerous set of symptoms called Serotonin Syndrome. This syndrome involves autonomic changes in the body and can cause confusion, seizures, blood pressure problems, dilated pupils, and other symptoms. It can be life threatening. As a result, pharmacies have been warning numerous patients and doctors about this issue and it has been causing significant fear among migraine patients and their doctors.

In an excellent talk, Dr. Stuart Tepper (a well-known migraine researcher) puts these concerns to rest. Indeed, by his analysis, those patients who were on the combination of SSRI and triptan had a lower incidence of Serotonin Syndrome than those who were on an SSRI alone. He also points out that, based on the ways these drugs work (their mechanisms of action), no fear of the combination should have been a concern for the FDA.

The bottom line? While SSRI's can rarely cause Serotonine Syndrome, there is no increased risk in taking an SSRI and a triptan medication.

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