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Re: Any meds for migraines safe on while on SSRI? » Jax

Posted by yxibow on November 8, 2006, at 13:23:13

In reply to Re: Any meds for migraines safe on while on SSRI? » yxibow, posted by Jax on November 7, 2006, at 23:30:35

> > > Hi there
> > >
> > > I'm currently on 30mg Paxil (tapered down from 60mg) and 1.5mg of Klonopin (down from 3mg). In the last 3 months I've started having migraines for the first time in my life. After many blood tests, my doc and I have concluded that these have been brought on by the tapering of the meds. (Which has taken 6 months). My doc prescribed Imitrex for the migraines and I questioned if they would interact with my meds, to which she assured me they wouldn't. Luckily I mentioned which meds I was on when I went to a different pharmacy (I was short on time before going away to go to my usual) who told me the migraine meds and my current meds would definitely intereract and I should not take them. I asked the pharmacist if there was anything else I could take (prescription wise - OTC stuff just wasn't working) and she couldn't think of anything.
> > >
> > > So - does anyone out there know of a good med to take for migraines while you're on an SSRI?
> > >
> > > Thanks
> > > Jax
> >
> > The tapering of the Paxil may have brought on migraines in someone susceptible to them -- Paxil has been used to treat migraines.
> >
> >
> > From Drugs.com interaction engine
> >
> > paroxetine and sumatriptan (major Drug-Drug)
> >
> > Description:
> >
> > MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and 5-hydroxytryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors.
> >
> >
> > In other words dosage would have to be monitored very closely with major migraine medications (triptans, e.g.) in order to prevent serotonin syndrome. In fact tricyclics are used in migraine therapy.
> >
> >
> >
> > It leaves you with OTC with Excedrin Migraine or any OTC NSAID (ibuprofen, naproxen, acetaminophen, aspirin) combined with a portion of a caffeine tablet. The caffeine constricts blood vessels in the head.
> >
> > This combination is not without concern; theoretically NSAIDs and Paxil can cause internal bleeding though this is most likely due to an accentuation of those susceptible to the dangers of COX-1/COX-2 inhibiting compounds and stomach lining/upset.
> >
> > There also exist esoteric prescription NSAIDs like sulindac and piroxicam and flurbiprofen, but these are generally more for types of arthritis.
> >
> >
> > There are also agents which will mask the pain but not necessarily fully treat the symptoms. Caution should be used with these for habituation and interaction with Klonopin:
> >
> > Fiorinal (C-III) - contains a barbiturate family compound.
> >
> > Micrainin - meprobamate (Miltown) and aspirin
> >
> > Stadol NS (C-IV) (nasal) - butorphanol tartrate nasal spray; narcotic weaker than Fiorinal variants
> >
> > -- Jay
>
> Hi Jay
>
> Thanks for all your helpful info. I tend to have bouts of gastritis (inflamed stomach lining) and bad heart burn which took me years to realise were probably the direct result of the meds I was on. Is it likely a caffeine tablet would get my stomach acting up?
>
> Unfortunately I don't have access to all those wonderful medical suggestions you put down as I live in little ol' NZ (no - that's not a new state, it's the country at the bottom of the world LOL...). It sounds like meds are cheaper here, but alas, a lot more restricted...


Yes, I know NZ can be even stodgier than England on scheduled drugs, though you do have a form of oxycodone.

It is conceivable that caffeine could cause gastritis I suppose by its mechanism or interactions with any anxiety you might have. I was not suggesting a large caffeine tablet, those are way too high for the purpose, just a small dose of caffeine, plus any NSAID that is sold, hopefully ibuprofen or paracetamol. I can't believe PHARMAC has restrictions on either. Is there private pay for over the counter medications ?

-- Jay

 

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