Pharmacy Times – November 2006


Drug Interactions: Insights and Observations


Can Triptans and SSRIs be Used Together?

John R. Horn, PharmD, FCCP, and Philip Hansten, PharmD




1. FDA Public Health Advisory. Combined Use of 5-Hydroxytryptamine Receptor Agonists (Triptans), Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) May Result in Life-threatening Serotonin Syndrome. Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration, July 19, 2006.

2. Hendrix Y, van Zagten MS. Serotonin syndrome as a result of concomitant use of paroxetine and sumatriptan. Ned Tijdschr Geneeskd. 2005;149:888-90.

3. Mathew NT et al. Serotonin syndrome complicating migraine pharmacotherapy. Cephalalgia. 1996;16:323-327.

4. Gardner DM, Lynd LD. Sumatriptan contraindications and the serotonin syndrome. Ann Pharmacother. 1998;32:33-38.

5. Tepper S, Millson D. Safety profile of the triptans. Expert Opin Drug Saf. 2003;2:123-32.

6. Putnam GP et al. Migraine polypharmacy and the tolerability of sumatriptan: a large-scale prospective study. Cephalalgia. 1999;19:668-675.

7. Mathew NT et al. Tolerability and safety of eletriptan in the treatment of migraine: a comprehensive review. Headache. 2003;43:962-974.

8. Smith DA et al. Zolmitriptan (311C90) does not interact with fluoxetine in healthy volunteers. Int J Clin Pharmacol Ther. 1998;36:301-305.

9. Goldberg MR et al. Lack of pharmacokinetic and pharmacodynamic interaction between rizatriptan and paroxetine. J Clin Pharmacol. 1999;39:192-199.