In 2006, 38 cases of serotonin syndrome associated with triptans (Imitrex, Maxalt, etc). Out of them, "27 were in patients taking the headache drugs and antidepressants and 11 in people taking headache drugs alone," said Offie Soldin, an associate professor at Georgetown University Medical Center in Washington who conducted a new study for FDA. This study is the first to use the FDA Adverse Event Reporting System which is a fancy name for a database that monitors all drugs and therapeutic biologic products after they have been FDA-approved.
It's a well known fact that if one is on Valiums or Prozacs or whatever similar drugs that are out there that play a number on one's serotonin level, one should be careful with triptans. There even was an FDA warning about it in 2006. At least it's supposed to be. Many a doctor prescribe both antidepressants and triptans to migraine patients without as much as butting an eyelash.
That particular nuisance aside, this is the first time someone publicized the cases of serotonin syndrome from triptans alone. "In the 11 reports of serotonin syndrome, five patients were hospitalized and two cases were classified as life threatening," said study.
Considering the origins of the triptans as LSD derivatives, that comes as small surprise. It is, however, a good reminder to us all that triptans are a serious medicine that's has to be taken carefully and if there's any notable after-effects, one has to pay close attention to them. Here's a short primer on what to be on look-out for:
Mild symptoms of serotonin syndrome include Mild symptoms may only consist of tachycardia, and shivering, diaphoresis (sweating commonly associated with shock), mydriasis (dilated pupils), myoclonus (intermittent tremor or twitching), as well as overactive or overresponsive reflexes. In addition moderate intoxication includes abnormalities such as hyperactive bowel sounds, hypertension and hyperthermia; a temperature as high as 40 °C (104 °F) is common in moderate intoxication. The overactive reflexes and clonus in moderate cases may be greater in the lower limbs than in the upper limbs. Mental status changes include hypervigilance and agitation.
Severe symptoms include severe hypertension and tachycardia that may lead to shock. Severe case often have agitated delirium as well as muscular rigidity and high muscular tension. Temperature may rise to above 41.1 °C (105.98 °F) in life-threatening cases. Other abnormalities include metabolic acidosis, rhabdomyolysis, seizures, renal failure, and disseminated intravascular coagulation.
(source: wikipedia.com, serotonin syndrome, symptoms)
So, not to OD on LSD, do watch out for the above-mentioned abnormalities, my gentle readers.
link: Migraine Medicines May Cause Potentially Deadly Brain Syndrome
