Paxil - Migraine Medicines
serotonin syndrome
The FDA warns that combining selective serotonin reuptake inhibitors (SSRI), like Paxil, and migraine medicines -- called triptans -- could lead to a potentially fatal combination.
The life-threatening combination may lead to serotonin syndrome. This syndrome occurs when the body has too much serotonin, a chemical located in the nervous system. Symptoms of this Paxil side effect include:
Symptoms of Serotonin Syndrome
- Restlessness
- Hallucinations
- Loss of coordination
- Fast heart beat
- Rapid changes in blood pressure
- Increased body temperature
- Overactive reflexes
- Nausea
- Vomiting
- Diarrhea
Both Paxil and triptans individually increase levels of serotonin. Combined, the drugs may cause Serotonin Syndrome.
The FDA recommends that physicians prescribing either Paxil or a triptan should:
- Keep in mind that triptans are often used intermittently and that either the triptan, SSRI or SNRI may be prescribed by a different physician
- Weigh the potential risk of serotonin syndrome with the expected benefit of using a triptan with an SSRI or SNRI
- Discuss the possibility of serotonin syndrome with patients if a triptan and an SSRI or SNRI will be used together
- Follow patients closely if a triptan and an SSRI or SNRI are used together, particularly during treatment initiation, with dose increases, or with the addition of another serotonergic medication
- Instruct patients who take a triptan and an SSRI or SNRI together to seek medical attention immediately if they experience the symptoms of serotonin syndrome (described above).
- The FDA has requested that all manufacturers of triptans, SSRIs and SNRIs update their prescribing information to warn of the possibility of serotonin syndrome when triptans and SSRIs or SNRIs are taken together.
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