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Updates
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Antidepressants and Triptans for Migraine Can Be Dangerous When Taken at the Same Time
August 2006
Separate reports on this Web site analyze prescription drugs used to treat depression and migraine headaches. The drugs we evaluate to treat migraines are called triptans. They include brands such as Axert, Imitrex, Relpax, and Zomig. Among the antidepressants we evaluate are the selective serotonin reuptake inhibitors, or SSRIs for short. The SSRIs are the most commonly prescribed type of antidepressant. Among them are paroxetine (Paxil) sertraline (Zoloft), and fluoxetine (Prozac).
In July, the Food and Drug Administration (FDA) issued a warning that taking both these kinds of drugs - a triptan and an SSRI - at the same time can cause a potentially life threatening problem called "serotonin syndrome."
Each drug acts primarily by boosting the amount of serotonin in the brain. Up to a point this can be good. But if serotonin is increased too much, the side effects are unpleasant and can be dangerous or even life-threatening. These include: restlessness, hallucinations, loss of coordination, fast heartbeat, blood pressure changes, fever, nausea, and diarrhea.
If you take both these kinds of drugs at the same time, you should contact your doctor as soon as possible. Don't stop taking either medicine until you do contact a doctor - if you have not been having problems. It can be dangerous to suddenly stop taking an antidepressant.
However, if you take an antidepressant and then take a triptan when you have a migraine, you may want to hold off on that next triptan dose until you talk to a doctor, especially if you have been having any of the side effects we mention above.
The FDA has asked the makers of both kinds of drugs to update their labels to warn of the possibility of serotonin syndrome.
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