Do triptan antimigraine medications interact with SSRI/SNRI antidepressants? What does your decision support system say?

J Manag Care Pharm. 2011 Sep;17(7):547-51. doi: 10.18553/jmcp.2011.17.7.547.

Abstract

Drug risks may be ignored or under appreciated, overemphasized, misinterpreted, or in some cases presented in ways that do not wholly reflect the evidence base and clinical experience. Often the available evidence pertaining to drug interactions is grounded upon theoretical concerns, very small trials, or case reports, and thus it is often very challenging to balance the potential risks and benefits of a particular therapy when drug interactions are present. While prescribers and pharmacists may fail to heed interaction alerts provided by decision support systems, it is also possible that the overstatement of risks can cause providers to avoid utilizing a clinically beneficial therapy. The case of the interaction between triptan antimigraine medications and selective serotonin reuptake inhibitor/selective serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) antidepressants provides an example of how the presentation of drug risk may unduly influence the utilization of drug therapy.

MeSH terms

  • Antidepressive Agents / adverse effects*
  • Antidepressive Agents / therapeutic use
  • Case-Control Studies
  • Depression / drug therapy
  • Drug Interactions*
  • Female
  • Humans
  • Male
  • Migraine Disorders / drug therapy
  • Risk Factors
  • Selective Serotonin Reuptake Inhibitors / adverse effects*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Serotonin Syndrome / chemically induced*
  • Serotonin Syndrome / epidemiology*
  • Serotonin Syndrome / mortality
  • Serotonin Syndrome / pathology
  • Tryptamines / adverse effects*
  • Tryptamines / therapeutic use
  • United States
  • United States Food and Drug Administration

Substances

  • Antidepressive Agents
  • Serotonin Uptake Inhibitors
  • Tryptamines