triptans and anti-depressants

Please hopefulmigrainer I didn't want to scare you, and I debated on posting, but I felt once the thread was started and I knew the information that I needed to post what I knew. Please as I said in my post talk to your doctor about it, I do know some people who combine them. In the warning it talks about this and says that it can be done and you and your doctor just need to know and be aware and on top of it. Please I'm sorry I don't want to scare or worry you---we are all suffering enough as it is with our medical issues and don't need to worry more about side effects of our medications, I just felt like it needed to be posted once the thread was started....I'm sorry if I contributed anymore to your worry, my intentions were only good, not to scare anyone...

Hi hopefulmigraineur,

I take them together and find that if I take too many triptans that I experience Serotonin Syndrome. It makes me feel sicker than I already feel. I don't usually realize it until I have had a migraine for a week or so as well as symptoms like vertigo, nausea, muscle spasms and other strange symptoms that are worse than normal or don't usually accompany my migraines. Because it creeps on so slightly I only take 2 triptans in a row and then don't take any for a week. That way I know the extra serontonin is out of my system.

The person I gained the most information about this was my pharmacist. I was feeling just terrible and was taking a lot of Amerge (triptan). She covered the symptoms of Serotonin Syndrome which matched the symptoms I was experiencing.

I find if my neurologist or family doctor can't give me an accurate idea about side effects the pharmacist can usually provide better information.

I hope this helps.

Hi,

Both triptans and SSRIs (anti depressants) affect the serontonin level in your brain. I believe triptans are agonists and and anti depressants are reuptake inhibitors. Agonists activate the serotonin neurons and reuptake inhibitors block the serontonin from being reuptaked (2nd half of the reaction leaving more serotonin in your brain to be used). This means that one medication creates more serotonin and another blocks it from being used up, leaving more in your system.

Does this make sense?

Just and FYI -- I went to the pdoc today and she told me (before I could bring it up) that I needed to stop Lexapro because an article was published for psychiatrists about triptans and SSRIs. I'm surprised that the neuro didn't catch this. Anyway, now I'm just taking Wellbutrin which is Dopamine and neophenefrine.

Thanks Nicky.  I take triptans frequently.  The only narcotic that I have ever tried is Vicodin and it never touched my migraine pain.  That's how I know they are migraine - triptans are the only thing that work (when they work).  My psyche had me taking both Wellbutrin and Lexapro.  Now, I will only be taking Wellbutrin.  I feel okay knowing that at least I've already been taking the Wellbutrin but I definitely cannot afford a relapse in my depression.  Many life changes going on now and only a month ago I was in a bad way.  Thanks for your reply.

That's terrible.  I hope that you are okay now.  I don't take Topomax.  I tried it twice.  The second time I tried it reluctantly but went off of it in 1 week.  I have recently been diagnosed "glaucoma suspect."  Topamax can also cause glaucoma.  As far as I'm concerned, it is just far too powerful of a drug. 

dear migraines with nerve pain, I can so relate. I just want to let you know that topamax never really did decrease frequency except perhaps when I had medication induced issues. I think that this neuroepileptic should be used with caution as I have had significant lessening of nerve neck and shoulder pain since titrating off this med. Maybe just a remission but I think perhaps this as neurontin and especially lyrica have no real benefit for myself. In fact lyrica increased frequency and intensity. Depends perhaps on chemistry of your migraines. As for shouting can't one just read from context. I find that the message was non-treathening and perhaps indulge those with typing issues. I hope that I haven't offended anyone when doing this in other situations but find that anyone taking offence is slightly dictatorial. I think considering the greater issue of pain one should be more tolerant of us poor typists.