Question 1

are ssris (for depression) safe to use with sumatriptan (for migraine)?

Accepted Answer

Probably: When combining these 2, there's theoretical concern about possible  "serotonin syndrome" of CNS hyperactivity, including altered mental status, restlessness, myoclonus, hyper-reflexia, etc.  Both stimulate 5-ht 1a receptors.  However, these theoretical concerns have not shown up in actual patients. If the patient is well educated, using both can be safe.

Question 2

how do tcas actually work to control 
non-migraine headaches? ssris aren't common for this, so is it the norepinephrine that is the agent helping?

Accepted Answer

Great question: Great question! Norepinephrine is definitely involved in the interpretation of pain signals in various areas of the brain. However, serotonin definitely has a role to play (eg, the triptan drugs for migraine work on a specific subtype of serotonin).  So, in theory, it's thought that these components together synergistically act to alleviate headache.  Hope that helps!

Question 3

i have convulsion an tremor evryday and i think my ssri is causing this i was prescribed depakote for migraine yesterday how can 
i come off ssri safe?

Accepted Answer

You can taper yourself: In order to come off of your antidepressants safely, you need to very slowly taper off of it. I would recommend taking the medication at  3/4 dosage for one week, then at 1/2 dosage for another week, and then finally at 1/4 dosage for another week, at which point you can stop the medication safely. At any point if you start feeling withdrawal symptoms you should bump to next highest dose.

Question 4

can periactin (cyproheptadine hydrochloride) (cyproheptadine) be useful in relieving serotonin induced migraine caused by an ssri? periactin (cyproheptadine hydrochloride) has antiserotonin affinity. head hurts..

Accepted Answer

Might be useful: Although Cyproheptadine is nominally an anti-histamine, it does have seratonin antagonistic effects, and, has been best used as a migraine preventative in years past.  Since it is cheap, could try it, but likely should start low dose and aim for about 4mg every 6 hrs.  May take about two weeks to decide success at the higher dose.

Question 5

why does lexapro (escitalopram) cause more migraines than other ssri's?

Accepted Answer

Hmm...: Am not aware of any studies that support what you say. Where did you read that information? I've not found that true in my experience either with patients on various SSRI's.

Question 6

reducing sertraline 50 to 25 mg slowly after long term use. i've  had 2 migraines in the last 5 days (unusual). ssri withdrawal? recommendations?

Accepted Answer

Try oral magnesium: You may be deficient in  magnesium and even if you are not deficient you may benefit from
adding small increments gradually.Magnesium acts as a vasodilator in 
the brain.

Question 7

i cannot take the tricyclics, atacand, (candesartan) ssris, valproic, propanolol, topomax.  tiptans did not work.  anything else for migraines?

Accepted Answer

Caffeine /chocolate: Should be eliminated for at least a few months to se if they are triggering.

Question 8

can you take wellbutrin and depakote together. i am on wellbutrin for bipolar i disorder and depakote for migraines issue is they are both ssris won't they interact with each other?

Accepted Answer

: Although there are no overt metabolic interactions, there are reports of suicide attempts in bipolar patients, and even increased incidence of diabetes in male patients.  Depakote is NOT an SSRI.

Question 9

regarding the treatment of vestibular migraines; overtime does an ssri become less effective due to tolerance and a switch to a tca become necessary?

Accepted Answer

Use both cautiously.: Vestibular migraines is a variant of migraine in general accompanied b dizziness especially when moving and sometimes voices seem muffled. Ssri's are effective . If the medications are less effective, you may ask your doctor to bump the dosage up  or use a tricyclic in conjunction with the ssri instead of  changing the medication all together.

Question 10

what is migraine?

Accepted Answer

More than a headache: Migraines typically are throbbing headaches that tend to be on one side of the head. They may be accompanied by nausea and vomiting, sensitivity to light and sound. Sometimes, migraines are signaled by an "aura, " which may be a visual symptom such as flashing lights or wavy lines followed by a headache. Numbness, weakness, or difficulty talking may signal more severe problems.

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Doctor answers about:

Ssri for migraine

A member asked:

Are ssris (for depression) safe to use with sumatriptan (for migraine)?

A member asked:

How do tcas actually work to control non-migraine headaches? ssris aren't common for this, so is it the norepinephrine that is the agent helping?

A member asked:

I have convulsion an tremor evryday and i think my ssri is causing this i was prescribed depakote for migraine yesterday how can i come off ssri safe?

A member asked:

Can periactin (cyproheptadine hydrochloride) (cyproheptadine) be useful in relieving serotonin induced migraine caused by an ssri? periactin (cyproheptadine hydrochloride) has antiserotonin affinity. head hurts..

A member asked:

Why does lexapro (escitalopram) cause more migraines than other ssri's?

A member asked:

Reducing sertraline 50 to 25 mg slowly after long term use. i've had 2 migraines in the last 5 days (unusual). ssri withdrawal? recommendations?

A member asked:

I cannot take the tricyclics, atacand, (candesartan) ssris, valproic, propanolol, topomax. tiptans did not work. anything else for migraines?

A member asked:

Can you take wellbutrin and depakote together. i am on wellbutrin for bipolar i disorder and depakote for migraines issue is they are both ssris won't they interact with each other?

A member asked:

Regarding the treatment of vestibular migraines; overtime does an ssri become less effective due to tolerance and a switch to a tca become necessary?

A member asked:

What is migraine?

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