Being part of a family with a high penetrance for both depression/anxiety and migraines, I can’t tell you how many times I’ve asked docs and pharmacists whether it is safe to take a “triptan” class migraine drug (e.g. Imitrex, Zomig) while taking maintenance doses of a SSRI or SNRI class antidepressant (e.g. Prozac, Lexapro, Effexor).
Well, the US Food and Drug Administration today released a warning on the potential for interaction between these two classes of agents. This risks are real, although very, very low for a condition called “serotonin syndrome.”
The FDA statement would scare the bejeezus out of anyone who lacks medical or pharmaceutical training, especially because they fail to put the severity of risk into proper persepective.
For this information, I had to turn to yet another of my favorite Wall Street Journal sci/med writers, Jennifer Corbett Dooren for the scoop:
“The FDA said it’s reviewed 27 reports of the syndrome, the symptoms of which can include restlessness, hallucinations, loss of coordination, fast heartbeat, rapid changes in blood pressure, increased body temperature nausea, vomiting and diarrhea. Of the 27 reports, 13 patients were hospitalized and two cases were considered life-threatening. An FDA spokesperson did not immediately know the time period over which the cases were reported.”
That’s 27 cases out of tens of millions of doses of each drug class taken each year. For the record, I can count several dozen cases in my own family where drugs from both classes have been taken, with little more than a stiff neck resulting.
I am indeed concerned about the cases that were life-threatening, but I also hold that it was irresponsible of the FDA to release this information without putting the real risks… the very, very, very low risks, into proper perspective.
Bottom line: Look to the bottom of the FDA press release for the drug names. Do not stop taking your antidepressant, but DO contact your physician if you need to take one of the migraine drugs listed.