Triptans can cause Serotonin Sydrome

Serotonin syndrome is a dangerous condition which occurs when a ptaient taking a medication that boosts serotonin---such as SSRI's like Prozac, Effexor, etc actually is taking too much serotonin for his/her system. Often this occurs when such a med is combined with a pain killer, but it can happen merely from taking the medication itself.

I recently read that triptans combined with Serotonin boosters can also cause the syndrome. I have had this condition many times, and it is like being thrown into the underworld. In its most serious form, all hope is sucked out of you, and with no hope, the urge to kill yourself can be overwhelming. I felt like I was constantly enveloped in a black cloud.

Even after having the condition several times, when it grabs hold of you, you have no ability to think or reason, or to say, "Oh, yeah, I remember what caused this last time. I just need to stop taking the pills." Eventually that did happen and I stopped the med causing the problem, but that was after I had the condition at least 20 times.

Here is part of the article on triptans causing Serotonin Syndrome:

"Physicians should be aware that concomitant use of a triptan and a selective serotonin reuptake inhibitor or a selective serotonin norepinephrine reuptake inhibitor can lead to serotonin syndrome, according to a public health advisory issued by the Food and Drug Administration.

"Triptans, which are 5-hydroxytryptamine receptor agonists used to treat migraine; and SSRIs and SNRIs, used to treat depression and other mood disorders, are serotonergic drugs.

"After receiving reports of serotonin syndrome in patients who have been taking a triptan with an SSRI or SNRI, the FDA requested in July that all manufacturers of these drugs update their prescribing information to include a warning that serotonin syndrome can occur when a triptan is taken with medications in either of these drug classes.

"In addition, patients should be told to seek medical attention immediately if they experience any signs of serotonin syndrome. The symptoms of serotonin syndrome, a potentially fatal condition caused by excessive serotonin, include restlessness, hallucinations, clumsiness, tachycardia, labile blood pressure, hyperthermia, hyperreflexia, nausea, vomiting, and diarrhea."

The New England Journal of Medicine referred to the syndrome as: " a potentially life-threatening condition characterized by a triad of clinical manifestations — changes in mental status, autonomic hyperactivity, and neuromuscular abnormalities."

I am particularly sensitive to taking in any excess serotonin and have had serotonin syndrome more than 20 times---no one seemed to be able to figure it out until I made a list of all the meds that affected me and discovered every single one raised my serotonin.

The symptoms listed are severe, but I became suicidal--sometimes after only one dose of a med like Seroquel.

I had to be hospitalized 3 times when I became so terrified I might possibly kill myself that I was afraid to be alone.

I was taking Serzone under a psychiatrist's care; I saw him 3 times a week for 5 months during which time I continued to tell him I was increasingly suicidal. All he did was keep upping my dose. It is frightening that doctors who are prescribing mind altering drugs do not know that certain ones can cause homicidal or suicidal tendencies.

Oh, and when I was put in the hospital from my reaction to Serzone, I was placed on Effexor, which hit me like a lightening bolt. After one dose, I got on my knees in front of a nurse---while in the lockdown psychiatric unit--and wrapped my arms around her legs and sobbingly begged her to kill me painlessly.

I was sick going into the hospital, but this was a whole new level of crazy, and not one nurse or dr was worried about my sudden non-stop sobbing or the fact that I was hallucinating every scary movie episode I had ever seen on a continuous loop, starting with Snow White.

The same exact scenario had occurred with Prozac a couple of years before this---I complained of being suicidal and the dose was constantly raised by my headache dr. for 6 months.

That dr finally replaced Prozac with yet another SSRI which kept the problem going. I was staying with my parents for the last 3 months of my 6 months on Prozac, again, afraid I was going to kill myself. Day and night I continuously hallucinated stabbing myself in my gut and ribbing my abdomen with a knife until my intestines came spilling out.

Yet my dr STILL did not figure out what was going on. My mtoher happened to be watching one of those TV magazine type shows like 20/20 when a psychiatrist came on and described the best kept secret about SSRI's, large numbers of patients were either killing themselves or attemptimg to kill others while taking them, particularly Prozac.

Serotonin syndrome was not mentioned, and I did not learn about it for about 8 more years. But it can happen to any one of us, particularly ater many many years of testing these meds--and SSRI's are not the only medications that raise serotonin. We gradually become more sensitive to serotonin. If any of you are becoming more and more depressed while taking a new medication, serotonin syndrome may be something you need to consider.

The advisory, including a complete list of the drugs the above article is about, is available at: www.fda.gov/medwatch/safety/2006/safety06. htm#Triptans.
Best to all,
Mishkyn

Sorry to here that you have gone through this Mishkyn.

Thank you for this information. I always instintively knew my depression teetered with the antidepressants and triptans so this is the validation I need.

I've always had my dark foreboding moments in life come and go. I've trained myself over the years to recognize that it can pass and to seek help, but it can go on for days and weeks before you realize how deep you are. There is no way to measure depression like you can with a pain scale. Also too, when a person is new to the depths of depression, it is so easy to get lost in that dark moment and think it is permanent. Plus is can dip deep real fast and there is no warning.

It's good to have family and friends to watch out for you.

Hope you are doing better, ((((Mishkyn)))).

Angela

mishkyn, i had forgotten all about serotonin syndrome. i'm so glad you wrote about it! i had a neuro's assistant (a P.A.) prescribe effexor to me about a month ago, though she knew i was taking almost-daily triptans.

since i am hideously drug-sensitive, i could tell right away that it wasn't going to do anything but make me worse. i was hoping it would let me sleep, since that's my biggest issue. it did help, before triptans, when i took it briefly many years ago. i was so sleepy i couldn't stay awake at all, so abandoned it.

why are WE the ones who have to do all the drug research? this is just wrong. we shouldn't be prescribed things that will kill us.......dianne