I have recently been diagnosed with Cluster Headaches and have been prescribed injections of Imitrex to treat them. I've recently come to realize that I also suffer from depression; but the insert in the Imitrex package said that it can't be taken with SSRIs or other types of antidepressants. The Cluster Headaches are so painful, that I don't want to stop taking the Imitrex; as it has provided great relief. On the other hand, my quality of life is declining due to the depression. I feel like I am in a "catch 22." Is there anything that I can do?
Thanks, Cluster Sufferer
Dear Cluster Sufferer;
Actually, the insert doesn't say that Imitrex can't be taken with SSRIs or other types of antidepressants. In the patient section, under questions to ask yourself before taking it, it mentions antidepressants, but doesn't say not to use Imitrex with them. In the full prescribing information it says:
Serotonin Syndrome: The development of a potentially life-threatening serotonin syndrome may occur with triptans, including treatment with IMITREX, particularly during combined use with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). If concomitant treatment with sumatriptan and an SSRI (e.g., fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, escitalopram) or SNRI (e.g., venlafaxine, duloxetine) is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases. Serotonin syndrome symptoms may include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination), and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).
This is something to discuss with your own doctor, but many people take both triptans such as Imitrex and antidepressants. It's important to note the potential symptoms to report to your doctor so you can report them if they occur, but serotonin syndrome is rare. You can read more about it in _Antidepressants, Triptans, and Serotonin Syndrome _.
John Claude Krusz and Teri Robert
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© Teri Robert and J.C. Krusz, 2010.
Last updated January 8, 2010.