Posted by Donna Louise on May 12, 2006, at 6:18:16
In reply to Re: Triptans and MAOIs » Donna Louise, posted by ed_uk on May 11, 2006, at 14:52:03
> Hi
>
> >ok, so if it is ok to take Axert as it does not enter the brain, does it follow that it is ok to imitrex also since it does not enter the brain either?
>
> Sumatriptan (Imitrex) is predominantly metabolised by MAO, so it might not be the best choice. Still, in one study, no unusual side effects occured when sumatriptan was combined with an MAOI, despite the increased blood levels of sumatriptan. If you do decide to take sumatriptan with an MAOI, you should take a low dose eg. 25mg. The manufacturer of sumatriptan states that it is contra-indicated with MAOIs. It seems that they are attempting to protect themselves from litigation if a patient claimed that a serious interaction occured.
>
> >I also noticed on your original list of triptans ok to take was eletriptan but now you say it enters the brain more quickly than the other.
>
> MAOIs do not effect the metabolism of eletriptan. I suggested that almotriptan might be a safer choice than eletriptan because almotriptan does not readily cross the blood-brain barrier. Some doctors have suggested that combining triptans with MAOIs might cause the serotonin syndrome. There is no evidence that this actually occurs however. Unfortunately, few people have taken the MAOI/triptan combination so there is little reliable evidence.
>
> >Can I assume that I can't take that one either even though it is on the ok to take list?
>
> Difficult to say. I wouldn't recommend it personally.
>
> Which triptans do you have at home?
>
> EdThe only one I have is Maxalt. It works really well for me but after having read some literature, I see it is probably the most likely one of them to give me trouble. I did some reading on the Axert and as you say, it apparantly is not contraindicated, that it only raises MAOI levels 27% and that no dosage adjustment would be necessary. As you say, alot of the elimination is via the PCY450 enzyme (or whatever those letter are..can't remember right at the moment). At any rate, I am going to ask my pdoc for some this afternoon. She is willing but careful dr. and I appreciate that. Some regular dr.'s I have talked to lately regarding other stuff (a neurosurgeon and family dr.) all seem to be shaming me for taking an MAOI. The ignorance is maddening to me, and I am sure my irritation is evident. I hate feeling like I know more than dr.'s about some things. Under the irritation is fear which is a good thing too I guess, makes me a very proactive patient and I don't care if they like it or not. excuse me, I am getting off an a rant, wrong board.
Hey, but back on the subject, I so appreciate you and other babblers that make my able to be proactive and get what I need to make this rocky road a littel smoother.Donna
poster:Donna Louise
thread:641231
URL: http://www.dr-bob.org/babble/20060510/msgs/642917.html