The FDA ( Food and Drug Administration ) announced important new information on possible risks associated with the combined use of triptans and certain types of antidepressant medicines.
The antidepressant medicines of concern are selective serotonin reuptake inhibitors ( SSRIs ) and selective serotonin/norepinephrine reuptake inhibitors ( SNRIs ).
Triptans, also known as 5-hydroxytryptamine receptor agonists, are drugs used to treat migraine headaches.

A life-threatening condition called serotonin syndrome may occur when triptans are used together with a SSRI or a SNRI.

Serotonin syndrome occurs when the body has too much serotonin, a chemical found in the nervous system.
Serotonin syndrome symptoms may include: restlessness, hallucinations, loss of coordination, fast heart beat, rapid changes in blood pressure, increased body temperature, overactive reflexes, nausea, vomiting, and diarrhea.
Serotonin syndrome may be more likely to occur when starting or increasing the dose of a triptan, SSRI or SNRI.

The FDA has determined that serotonin syndrome occurs with combined use of triptans and a SSRI or SNRI through reports describing serotonin syndrome in people taking these medications together. Each of these types of medicine increases serotonin levels on its own, as well.

Physicians prescribing a triptan, SSRI or SNRI should:

keep in mind that triptans are often used intermittently and that either the triptan, SSRI or SNRI may be prescribed by a different physician

weigh the potential risk of serotonin syndrome with the expected benefit of using a triptan with a SSRI or SNRI

discuss the possibility of serotonin syndrome with patients if a triptan and a SSRI or SNRI will be used together

follow patients closely if a triptan and a SSRI or SNRI are used together, particularly during treatment initiation, with dose increases, or with the addition of another serotonergic medication

instruct patients who take a triptan and a SSRI or SNRI together to seek medical attention immediately if they experience the symptoms of serotonin syndrome.

List of drug names:

SSRIs and a Combination: Celexa ( Citalopram ), Luvox ( Fluvoxamine ), Lexapro ( Escitalopram ), Paxil ( Paroxetine ), Prozac ( Fluoxetine ), Symbyax ( Olanzapine/Fluoxetine ), Zoloft ( Sertraline );

SNRIs: Cymbalta ( Duloxetine ), Effexor ( Venlafaxine );

Triptans: Amerge ( Naratriptan ), Axert ( Almotriptan ), Frova ( Frovatriptan ), Imitrex ( Sumatriptan ), Maxalt and Maxalt-MLT ( Rizatriptan ), Relpax ( Eletriptan ), Zomig and Zomig ZMT( Zolmitriptan )

Source: FDA, 2006


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