Clusterheadaches.com Message Board


    
      
        Clusterheadaches.com Message Board
        (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi)
      

        New Message Board Archives >> 2007 General Board Posts >> If You Take Triptans And Cymbalta - READ THIS!
        
(Message started by: B14CK5H33P on Oct 23^rd, 2007, 3:09pm)

Title: If You Take Triptans And Cymbalta - READ THIS!
Post by B14CK5H33P on Oct 23^rd, 2007, 3:09pm

I'm only posting this because I know I am not the only CHead who have mixed the two.

My doc put me on Cymbalta earlier this year, as it helps cope with pain. What I went through shortly after starting the med, I did not associate with it - I just figured I was due for another insomnia cycle more wicked than ever (and knew better than to post here during that time period.)

I had a 16 day period with a whopping total of 15 hours of sleep! One of my neighbors said everyday I came out with the dog I looked worse and worse. I had to "DROP OFF" the Cymbalta, as the insurance wouldn't cover it, and dropping off an anti-depressant without tapering is not a fun rollercoaster to be on - trust me.

Anyway, every commercial for the next fad drug always has the warnings at the end. They had a commercial for cymbalta and at the end it said "Those taking certain migraine medicines may want to talk to their doctor about a potentially fatal condition."
So I googled triptan + Cymbalta and found this nifty info out (I had the symptoms asterisked) :

FDA Alert and Related Information
SSRIs/SNRI/Triptan and Serotonin Syndrome (7/2006)
A life-threatening condition called serotonin syndrome (serious changes in how your brain, muscles and digestive system work due to high levels of serotonin in the body) can happen when medicines called selective serotonin reuptake inhibitors (SSRIs), such as Cymbalta, and medicines used to treat migraine headaches known as 5-hydroxytryptamine receptor agonists (triptans), are used together. Signs and symptoms of serotonin syndrome include the following:
*restlessness
*diarrhea
*hallucinations
coma
*loss of coordination
*nausea
fast heart beat
*vomiting
*increased body temperature
*fast changes in blood pressure
*overactive reflexes

Serotonin syndrome may be more likely to occur when starting or increasing the dose of an SSRI or a triptan. This information comes from reports sent to FDA and knowledge of how these medicines work. If you take migraine headache medicines, ask your healthcare professional if your medicine is a triptan.

Before you take Cymbalta and a triptan together, talk to your healthcare professional. If you must take these medicines together, be aware of the possibility of serotonin syndrome, and get medical care right away if you think serotonin syndrome is happening to you.

This is where I found out the above info.
http://www.fda.gov/cder/drug/infopage/duloxetine/default.htm

Also, my doc couldn't write me a script for o2, so I went to another doc at the suggestion of a good friend, and got an o2 tank bigger than god (though it is near empty already and I needs a refill.) Someone mentioned suing my doc, since this is the 2nd drug interaction in 2 years (the last one producing seizures) but am in no position to be 'blacklisted' so I am just thanking my lucky stars I am still alive and found a new GP and a new neuro (my old neuro is just that - old and incompetent.)

So, I know everyone is different, but if you have these symptoms at all, it might me a good thing to stop the cymbalta or the triptans.

The Guinea Pig,
Carl D

Title: Re: If You Take Triptans And Cymbalta - READ THIS!
Post by Rosybabe on Oct 23^rd, 2007, 3:27pm

Carl sounds like a very dangerous combo, good thing you are not taking both now, take care and get your o2 refill as soon as possible, you don't want the beast to find you with an empty tank ;).

Hugs

Rosy.

Title: Re: If You Take Triptans And Cymbalta - READ THIS!
Post by B14CK5H33P on Oct 23^rd, 2007, 3:32pm

on 10/23/07 at 15:27:57, Rosybabe wrote:

Yuppers, getting a refill and a portable tank for when I plan to be gone for more than a couple of hours.

I'm just glad the o2 is WORKING 90 percent of the time.

Title: Re: If You Take Triptans And Cymbalta - READ THIS!
Post by Rosybabe on Oct 23^rd, 2007, 4:00pm

on 10/23/07 at 15:32:15, B14CK5H33P wrote:

I'm just glad the o2 is WORKING 90 percent of the time.

That is just freaking damn good! :D

Title: Re: If You Take Triptans And Cymbalta - READ THIS!
Post by Ray on Oct 23^rd, 2007, 6:22pm

Hello Carl,

I'm glad to see you posting again. I'm on both Cymbalta and Imitrex. Although others may look up the exact reason and add it to this thread, to the depth of my recollection, they both work at the 5HT receptors to block the reuptake of serotonin. Bottom line, there's more serotonin floating around.

If you take melatonin to help with night time hits, there would be even more serotonin as it is converted to that.

If you take Buspar for anxiety, even more, and so on. (I refused Buspar due to being on Cymbalta and Imitrex). The psychiatrist I have been seeing looked at me like I was NUTZ--Duh, why do you think I was seeing the shrink?

LOL

I guess it is a small, but a potentially fatal risk. The symptoms you listed are good for all of us to know.

I must be lucky, I ain't dead yet.

Ray

Title: Re: If You Take Triptans And Cymbalta - READ THIS!
Post by Annette on Oct 23^rd, 2007, 6:39pm

Hi Carl

We had discussions on this site about serotonin syndrome many times before. Did you miss them?

I was talking about it to Tony last year on chat as well, I thought you were there?

Anyway, the risk is there but it is small, not all people get it , but since it is potentially fatal your doctor should have alerted you to the risk.

I am glad you finally got oxygen and I am glad it works well for you.

Take care and all the best to you Carl

HUGS

Title: Re: If You Take Triptans And Cymbalta - READ THIS!
Post by Karla on Oct 23^rd, 2007, 8:20pm

Yes, I was on both cymbalta and imitrix last year for a very short while. I think it was Melissa that brought the condition to my attention on the boards and I talked to my dr about it and I decided it wasn't worth the risk and went on a different antidepressant as a result. I have been doing fine on it. However, I haven't been using imitrix (or any other abortive) much except for one migraine 9 months ago. I am glad that you are alright Carl!! How scary. I am so glad that you figured out what was going on before it was to late for you. Take care, Karla

Title: Re: If You Take Triptans And Cymbalta - READ THIS!
Post by Lizzie2 on Oct 23^rd, 2007, 9:40pm

Here's a good article on this rare, but potentially fatal interaction: http://www.migrainesurvival.com/Newsletters/NewsletterSpecialBulletinJul06.pdf

I took cymbalta with triptans, and was lucky - but I do know someone who spent several days in the ICU due to serotonin syndrome, although I'm not sure if it was from triptans with antidepressants or not. I know she was bipolar and had severe migraine, but I don't know the meds she was taking.

Ray - I think Buspar is much less of a risk than the SSRIs and SNRIs. I've been researching this. When I got my buspar prescription filled, it didn't list triptans as a precaution or an interaction or anything. It is listed in the linked article as something that can enhance the amount of serotonin available, but not a direct danger like SSRIs and SNRIs. I don't know that it would be good to combine cymbalta, triptans, and buspar, though!

Serotonin syndrome is rare but can be very very serious.... All that being said, these drugs can be combined under careful monitoring by a psychiatrist and/or neurologist. They are not completely contraindicated in all cases, though they may be in people with certain predisposing factors, and of course all patients should be educated on the risks vs. benefits of combining therapies like this.

Here's another article: http://www.uspharmacist.com/oldformat.asp?url=newlook/files/feat/acf2fa6.htm

Title: Re: If You Take Triptans And Cymbalta - READ THIS!
Post by ski2k on Oct 23^rd, 2007, 10:52pm

Wow!! Glad to hear you got it straightened out, and are doing ok.
That explains a bit (for me). I musta missed the other articles people mentioned. I was on zoloft, an SSRI, and when I went to try and get Imitrex for the first time, the pharmacy wouldn't give it to me! All they told me then, is there's an interaction risk with one of your other meds.
I too had to get off my meds due to lack of insurance, and I agree.... getting off an antidepressant rather quickly SUCKS!!

Best of luck, and glad to hear the O2 is working so well!!

Adam