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        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> Imigran and Prozac
        
(Message started by: JoeKen on Feb 8^th, 2004, 7:29am)

Title: Imigran and Prozac
Post by JoeKen on Feb 8^th, 2004, 7:29am

:) I would greatly appreciate hearing of anyone else's experience or medical knowledge on the intereaction, (if that is the right word), between Imigran and Prozac.
I am an episodic CH sufferer due to go into cycle in the next week or so. Currently I manage my CH by taking 25 or 50 mg of Sumatriptan, dependant on severity, in tablet form. I realise that I get away lightly compared with most sufferers.
Three weeks ago my GP put me on 20 mg daily of Fluoxetine (Prozac) to counter anxiety/depression. Since this time I have needed to take a 25 mg tablet of Imigran on 2 seperate ocassions, and I was unpleasantly surprised by the reaction that followed.I felt much more 'woozey' and light headed and uncomfortable, but it did clear the CH in much less than the usual time. The overall effect was possibly as if I had exceeded the dose. The thought occurred to me that, as both drugs target receptors in the brain, I believe, may be they were interacting and having an additive effect.
My GP says that it is OK to take Imigran and Prozac together, and a couple of web sites that I have consulted appear to confirm this, but as I shortly expect to need to take further, more frequent combinations, when my cycle really 'kicks in', I would be grateful to read of anyone else's experiences or knowledge of taking these two drugs together.
Thanks for taking the time to consider this.
JoeKen

Title: Re: Imigran and Prozac
Post by t_h_b on Feb 8^th, 2004, 9:41am

JoeKen, you may be getting an "overdose" of seratonin:

Drugs that increase serotonin include antidepressants such as Prozac (fluoxetine), Zoloft (sertraline), Luvox (fluvoxamine), Celexa (citalopram), Paxil (paroxetine), and Effexor (venlafaxine) and medicines for migraines such as including Imitrex* (sumatriptan), Zomig (zolmitriptan) and Migranal (dihydroergotamine).

above from (http://www.drugstore.com/qxa1043_333181_sespider-are_there_any_drug_interactions_with_meridia.htm)

As an aside, here's what seratonin and some other neurotransmitters look like when crystallized and photomicrographed under polarized light:

http://www.microscopy.fsu.edu/micro/gallery/neurotrans/neurotrans.html

*Imigran is sumatriptan, called Imitrex in the US

Title: Re: Imigran and Prozac
Post by JoeKen on Feb 8^th, 2004, 10:48am

:)To t_h_b,
Many thanks for your response - you seem to know a bit about this subject, so can I ask you, if I am 'overdosing on Seratonin', is it dangerous or merely disconcerting?
JoeKen.

Title: Re: Imigran and Prozac
Post by t_h_b on Feb 8^th, 2004, 4:22pm

You can take both of them but you need to be careful. You're probably just a little high but there is such a (rare) condition known as "Serotonin Syndrome". If you're going to take both drugs you should learn the symptoms to play it safe. The immediate treatment is to stop using the medications. Severe cases in which the person kept taking the drugs have lead to death.

Serotonin syndrome is characterized by changes in mental status, agitation, tremor and shivering.

More symptoms:

http://www.aic.cuhk.edu.hk/web8/serotonin%20syndrome.htm

Serotonin syndrome is caused by drug induced excess of intrasynaptic 5-hydroxytryptamine.

http://www.biopsychiatry.com/ssyn.htm

http://www.priory.com/psych/seurotosyn.htm

http://headaches.about.com/cs/asktheclinian/f/ser_syn_f.htm

http://members.aol.com/atracyphd/syndrome.htm

You can find dozens of other good articles with Google or Dogpile.

Most of the medications we take to fight CH can have side effects and unintended consequences. That's why it's important to discuss your medications with a knowledgeable physician and pharmacist. You should also make sure that all of your physicians and pharmacists know all of the medications you're on, especially when starting new prescriptions.

Title: Re: Imigran and Prozac
Post by JoeKen on Feb 9^th, 2004, 5:47am

To t_h_b,
Thanks for your reply, I don't think that I currently have the option to stop taking the Prozac - the state that I was in prior to taking it was horrendous and it is helping me greatly, with noticeable improvement every day. I guess that I shall have to reduce the 25 mg of Imitran down to half a tablet (12.5 mg) to minimise the adverse effects, particularly as the CH cleared up so quickly when taking 25 mg.
Thanks again.
JoeKen.

Title: Re: Imigran and Prozac
Post by t_h_b on Feb 9^th, 2004, 7:09am

JoeKen,

It's okay to break the tablets and you could even get 100mg tablets and split them into pieces. (Especially if you're paying for them out-of-pocket--the 100mg shouldn't cost much more than the smaller doses). With the 25mg tabs, you could take 3/4 of a tablet if 1/2 is too little and a whole one too much.

None of these meds are are much fun.

Good luck with adjusting your Imitrex dosage to minimize the side effects.

Title: Re: Imigran and Prozac
Post by JoeKen on Feb 15^th, 2004, 2:53pm

:)
To t_h_b,
Sorry for the delay in responding - I wasn't sure that you would reply. Since I last posted I have twice had to take Imigran in the afternoon after taking Prozac in the morning. On both ocassions I took a quarter of a 50 mg Imigran tablet and on both ocassions it lifted the headache, the first time completely, after 1.5 hours and the second time, today, after a little more than 2 hours the CH is so far in the background I can live with it OK. On both ocassions I had no noticeable side effects except that I felt really well, (high??) after the first ocassion - probably the serotonin?.
Anyway, if this reaction, (or lack of), continues I guess that I will just have to keep doing it again to manage the CH.
Thanks for your concern.
JoeKen

Title: Re: Imigran and Prozac
Post by fred33 on Feb 18^th, 2004, 4:34pm

Hello, I'm not a doctor, but I can tell you that I have done the mix many times without problem. [smiley=gossip.gif]
I regularly take MAOI (old strong antidepressants) along with two mood stabilizers, after having tried most of the newer antidepressants (because of bipolar illness:-/).
Note that MAOI (actually large amounts of moclobemide) act like a "soft" prophylactic drug for me.
I regularly take Relpax® (eletriptan) without any unwanted effect.
I even took Imitrex® injections at times for really awfull migraines along with most antidepressants (pharmacocinetikal interactions cannot be excluded).
I think that the serotonin-syndrome is only a theoretical risk with this mix...

Good luck.

Title: Re: Imigran and Prozac
Post by JoeKen on Feb 20^th, 2004, 9:29am

:)
To fred33,
Thanks for your input. Last evening, Thursday, I took another 12.5 mg of Imigran for CH after taking 20 mg Prozac in the morning, and again I got an unwelcome reaction. I began to feel ' woozey', particularly when I moved my head, and I felt slightly nauseous. I had a poor nights sleep, waking more frequently than normal, and the 'woozey' and nauseous feelings are still with me, around 24 hours after taking the Imigran.
I have an appointment with my GP on Wednesday next week and I plan to discuss this with him, but as he has already confirmed that I can take these two medications at the same time I am not sure how he will respond.
My fears were raised slightly when I collected the Prozac from the pharmacy, (the same pharmacy from where I get my Imigran), and they handed me a note saying that "Rare reports of weakness, hyper-reflexia, in coordination with Imigran and SSRIs", and advising me to contact my GP if I have problems.
Once again, thanks for your input.
JoeKen.