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  • Depression

Antidepressants & Migraines – A Potentially Dangerous Drug Combination

Under: Depression, Migraine & Headache


Taking antidepressants, like Pristiq, along with certain migraine medications can lead to dangerous and even life-threatening side-effects. Many people who suffer from depression also suffer from migraine headaches. Unfortunately, the mechanism of action of many antidepressants is to increase serotonin (a feel-good neurotransmitter) levels in the brain. Triptan drugs like Imitrex, which are used to reduce or end the pain of a migraine attack also work by stimulating serotonin receptors.

This combination of antidepressants and triptan migraine drugs can lead to too much serotonin in the brain. This is not a good thing and can result in a potentially life-threatening condition known as “serotonin syndrome.”

Though not approved for migraine prevention by the FDA, some physicians recommend antidepressants like Pristiq, for this purpose. There is very little data supporting this recommendation and not insignificant risk if they are also used with the triptan drugs like Imitrex or Zomig.

In some people, just the use of triptans alone can result in unhealthy levels of serotonin, leading to serotonin syndrome. This risk increases substantially if these people are also taking an antidepressant like Pristiq or any other of several antidepressants known either as SSRI (selective serotonin reuptake inhibitors) or SNRI (serotonin-noradrenaline reuptake inhibitors).

The symptoms of “serotonin syndrome” are:

  • Rapid heart rate and high blood pressure
  • Agitation or restlessness
  • Confusion
  • Dilated pupils
  • Loss of muscle control or twitching muscles
  • Heavy sweating
  • Diarrhea
  • Headache
  • Goosebumps
  • Shivering

woman with head pain


In severe cases of serotonin syndrome life-threatening symptoms can occur:

  • High Fever
  • Seizures
  • Irregular heartbeat
  • Unconsciousness

If you and your physician decide to use this combination of drugs, you must be monitored very closely for any of these signs and symptoms of serotonin syndrome.

If your migraines are bad enough, your physician may decide to stop the antidepressant so that you can use the triptan drugs with less risk (though as mentioned above, they alone, in some users can cause serotonin syndrome).

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