Safety of migraine medicines mixed with SSRIs?

Full Question:

My question is about the safety of migraine medicines mixed with SSRIs, and more urgently, how to get my doctors to take my symptoms seriously.

I couldn’t get an appointment with my normal Dr, so I took a sooner one with a different doctor. She prescribed Imitrex for a headache I've been having for about 3 weeks now. My first red flag was when I asked about side effects and all she said was that there were a lot of them. Luckily, I did research on my own, and found out about the risk of serotonin syndrome when mixing Imitrex and SSRIs. Considering I'm taking 3 SSRIs, is it even remotely safe for me to take Imitrex?

Also, when I've gone to walk-in clinics with the same problem, I get treated as if I were looking for a Vicodin fix or something, and don't get taken seriously. How can I get some relief if the doctors see me as some common criminal? Brian.

Answer:

Dear Brian;

First of all, it's hard to understand why three SSRIs. The Vicodin/fix/not being taken seriously is common in ER, or in walk-in clinics. They simply don't know what to do to treat an ongoing headache. It's the wrong venue.

Personally, I have never seen serotonin syndrome in anyone on SSRI and triptan, nor have many headache and Migraine experts when polled on this. That doesn't mean it doesn't exist and is in the package insert, as are many dire warnings. You didn't state if Imitrex helped the Migraine or not; not likely to in a 3 week Migraine duration. My strongest advice is to seek out a Migraine specialist. If you need help locating one, there's a link below to our directory of patient recommended specialists.

Good luck,
John Claude Krusz and Teri Robert

About Ask the Clinician:

Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.

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