- With Mayo Clinic neurologist
Jerry W. Swanson, M.D.
read biographyclose windowBiography of
Jerry W. Swanson, M.D.
Jerry W. Swanson, M.D.
Dr. Jerry Swanson is a board-certified neurologist at Mayo Clinic and is a professor of neurology at Mayo Clinic College of Medicine. He has a special interest in headache disorders and medical education.
Dr. Swanson, a Lacon, Ill., native, was appointed to the Mayo Clinic staff in 1982 and works in the Department of Neurology with about 90 other physicians. He formerly chaired the Headache Division in the Neurology Department at Mayo Clinic and works with headache subspecialists around the world. He has published and lectured widely on headache disorders. He also serves as Assistant Dean for Assessment in Mayo Medical School.
"In a manner similar to the printing press, Internet technology enables the unprecedented ability to communicate with the global community about health information," Dr. Swanson says. "There is no doubt that the knowledgeable individual contributes greatly to his or her own health care, and now we can share information much more widely."
"There is much information already available about health care on the Internet. Unfortunately, much of it is not founded on sound principles. It is exciting to be a part of the MayoClinic.com team and contribute to the creation of a reliable and timely health resource."
Dr. Swanson is the neurology editor for "Mayo Clinic Family Health Book" and has reviewed articles for "Mayo Clinic Health Letter" and "Mayo Clinic Women's HealthSource." He is also editor-in-chief of the "Mayo Clinic on Headache" book, published in 2004. In 2008 the magazine "Women's Health" named him one of America's Top Doctors for Women.
Definition (1)
- Ocular migraine: What causes it?
Causes (3)
- Migraine headaches: Are they triggered by weather changes?
- Nighttime headaches: What causes them?
- Nighttime headaches: What causes them?
Treatments and drugs (3)
- Migraine treatment: Can antidepressants help?
- Migraine medications and antidepressants: A risky mix?
- Occipital nerve stimulation: Effective migraine treatment?
Prevention (1)
- Aerobic exercise: What's the best frequency for workouts?
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Question
Migraine medications and antidepressants: A risky mix?
What are the health risks associated with taking migraine medications and antidepressants at the same time?
Answer
from Jerry W. Swanson, M.D.
Research suggests that combining migraine medications called triptans with certain antidepressants — including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) — may increase the risk of a rare but serious condition called serotonin syndrome. Although the risk appears to be quite low, debate continues about the level of risk.
Serotonin syndrome occurs when your body has too much serotonin — a chemical found in your nervous system. Triptans, SSRIs and SNRIs naturally raise serotonin levels on their own. When these medications are taken together, the effect may be more pronounced.
Signs and symptoms of serotonin syndrome occur quickly — within minutes to hours — and may include:
- Nausea, vomiting and diarrhea
- Fever
- Increased heart rate (tachycardia)
- Changes in blood pressure
- Overactive reflexes (hyperreflexia)
- Extreme agitation or restlessness
- Hallucinations
- Loss of coordination
- Seizures
- Coma
With prompt treatment — including stopping any medications that may be increasing your serotonin level — signs and symptoms of serotonin syndrome usually stop within 24 hours. Left untreated, serotonin syndrome may be fatal.
Less seriously, there may be a risk of interactions between other antidepressants and migraine medications. A class of antidepressants known as monoamine oxidase inhibitors (MAOIs) can affect how triptans work — increasing the level of triptans in your blood. And SSRIs and MAOIs should be used sparingly with migraine medications called ergotamines, since these antidepressants can slow down the speed at which ergotamines break down.
If you're taking migraine medications and antidepressants, talk to your doctor — especially if you notice any changes in your health. Don't stop or change the dosages of any of your medications on your own. If you experience signs or symptoms of serotonin syndrome, seek immediate medical attention.
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