05/21/07 #5 - Doctor says no Imigran (Imitrex) with sertraline (Zoloft)?

Health Professional

Full Question:

I have suffered very severe migraines since I was about 4 years old, and I am now 26. I have tried many different prescription drugs, and found that Imigran Nasal spray did the best job for me, as I constantly vomit not long after I get an aura. However, I have been put on Sertraline (Zoloft) 150mg (antidepressant) and I can no longer have Imigran, and my GP has given me Clotam 200mg. How effective is Clotam in easing migraines? I am very worried that the next one I have will not be eased by this drug, and therefore I will be suffering for at least 3 - 4 days. My migraines are that bad I feel suicidal when I have them as I could not describe to you how bad the pain is. Also, my GP has given me Clotam in tablet form. How long does it take to be absorbed into my stomach as I vomit pretty quickly. I thought maybe taking Stemetil immediately with the Clotam may stop me vomiting and let the tablet absorb. Can you give me some advice? Steph.


Dear Steph;

The best advice we can offer is to sit down and discuss this with your GP again or consult a Migraine specialist. Caution should be exercised when using antidepressants and triptans because of a rare potential issue with serotonin syndrome. Patients should be aware of the symptoms of this condition so they can report them to their doctors if they occur, but in general, antidepressants and triptans are very frequently used together. You can read more about this issue in Antidepressants, Triptans, and Serotonin Syndrome.

When patients cannot take triptans due to heart disease or other issues, NSAID's, which is what Clotam is, are often prescribed, often in combination with an antinausea med such as Stemetil. How effective the Clotam is varies from person to person, and you raise a good point about the issue with oral medications for Migraineurs who vomit quickly.

Please take the information on serotonin syndrome with you and discuss this with your doctor.

Good luck,
John Claude Krusz and Teri Robert

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