Triptans and SSRIs: Still a Thing?

May 2018

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, Tietjen GE, Lucker C. 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. Orlova Y, Rizzoli P, Loder E. Association of coprescription of triptan antimigraine drugs and selective reuptake inhibitor or selective norepinephrine reuptake inhibitor antidepressants with serotonin syndrome. JAMA Neurol. Doi:10.1001/jamaneurol.2017.5144

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

7. Putnam GP, O’Quinn S, Bolden-Watson CP, Gutterman DL, Fox AW. Migraine polypharmacy and the tolerability of sumatriptan: a large-scale prospective study. Cephalalgia. 1999;19:668-675.

8. Mathew NT, Hettiarachchi J, Alderman J. Tolerability and safety of eletriptan in the treatment of migraine: a comprehensive review. Headache. 2003;43:962-974.

9. Smith DA, Cleary EW, Watkins S, Huffman CS, Polvino WJ. Zolmitriptan (311C90) does not interact with fluoxetine in healthy volunteers. Int J Clin Pharmacol Ther. 1998;36:301-305.

10. Goldberg MR, Lowry RC, Musson DG, Birk KL, Fisher A, De Puy ME, et al. Lack of pharmacokinetic and pharmacodynamic interaction between rizatriptan and paroxetine. J Clin Pharmacol. 1999;39:192-199.