What are the health risks associated with taking migraine medicines and antidepressants at the same time?

Answer From Narayan Kissoon, MD

Reports have suggested that combining migraine medicines called triptans with certain antidepressants could increase the chances of developing a condition called serotonin syndrome. Serotonin syndrome can cause changes to your mental state and other symptoms.

The antidepressants that can cause this condition include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). But the risk of developing serotonin syndrome from taking these medicines with triptans appears to be very low.

Serotonin syndrome occurs when your body has too much serotonin. Serotonin is a chemical found in your nervous system. Several medicines and medicine combinations may cause this to occur.

SSRIs and SNRIs raise serotonin levels. Triptans interact directly with some serotonin receptors in the brain. In theory, taking these medicines together could cause much higher levels of serotonin and more stimulation of serotonin receptors than if you took only one of the medicines.

But serotonin syndrome appears to be rare among people taking triptans with SSRIs or SNRIs. The medicines have safely been used together for many years. Anxiety and depression are common in people with migraines and each condition needs to be treated appropriately. However, keep in mind that the risk of serotonin syndrome increases when more than one SSRI or SNRI medicine is used. Risk also increases with higher doses of SSRIs and SNRIs.

Some other medicines to treat or prevent migraines also can stimulate serotonin receptors or increase levels of serotonin. They include some opioids and anticonvulsants. Always review the medicines you currently take with your health care provider. This is especially important before you begin a new medicine to be sure your medicines are safe to use together.

Anyone who takes migraine medicines and antidepressants should be aware of the potential of developing serotonin syndrome.

Symptoms may occur within minutes to hours of taking the medicines. They may include:

  • Nausea, vomiting and diarrhea.
  • Fever.
  • Increased heart rate.
  • Changes in blood pressure.
  • Overactive reflexes.
  • Tremor.
  • Extreme agitation or restlessness.
  • Seeing things that aren't there, known as hallucinations.
  • Loss of coordination.
  • Skin flushing.
  • Shivering.
  • Confusion.
  • Seizures.
  • Coma.

If you experience symptoms of serotonin syndrome, seek immediate medical attention. Left untreated, serotonin syndrome may be fatal.

There also may be a risk of taking other antidepressants and migraine medicines. Antidepressants known as monoamine oxidase inhibitors (MAOIs) can cause an increase in the level of triptans in your blood. MAOIs also can slow the breakdown of serotonin.

Tell your health care provider if you're taking migraine medicines and antidepressants. And be sure to contact your provider if you notice any changes in your health. Don't stop or change the dosages of any of your medicines on your own.


Narayan Kissoon, MD

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

April 13, 2023 See more Expert Answers

See also

  1. Acupuncture
  2. Antidepressant withdrawal: Is there such a thing?
  3. Antidepressants and alcohol: What's the concern?
  4. Antidepressants and weight gain: What causes it?
  5. Antidepressants: Can they stop working?
  6. Antidepressants: Side effects
  7. Antidepressants: Selecting one that's right for you
  8. Antidepressants: Which cause the fewest sexual side effects?
  9. Antiphospholipid syndrome
  10. Atypical antidepressants
  11. Biofeedback
  12. Botox injections
  13. Chiropractic adjustment
  14. Chronic daily headaches
  15. Clinical depression: What does that mean?
  16. CT scan
  17. Depression and anxiety: Can I have both?
  18. Depression, anxiety and exercise
  19. What is depression? A Mayo Clinic expert explains.
  20. Depression: Diagnosis is key
  21. Depression in women: Understanding the gender gap
  22. Depression (major depressive disorder)
  23. Depression: Provide support, encouragement
  24. Depression: Supporting a family member or friend
  25. Diarrhea
  26. Headache
  27. Headaches 101: Know your type
  28. Headaches and hormones
  29. Headaches in children
  30. Headaches: Treatment depends on your diagnosis and symptoms
  31. Lumbar puncture (spinal tap)
  32. Male depression: Understanding the issues
  33. Managing Headaches
  34. MAOIs and diet: Is it necessary to restrict tyramine?
  35. Marijuana and depression
  36. Massage therapy
  37. Mayo Clinic Minute: Prevent migraines with magnetic stimulation
  38. Mayo Clinic Minute Weathering migraines
  39. Migraine
  40. What is a migraine? A Mayo Clinic expert explains
  41. Migraine FAQs
  42. Migraine treatment: Can antidepressants help?
  43. Infographic: Migraine Treatments: Botox & Nerve Blocking
  44. Migraines and gastrointestinal problems: Is there a link?
  45. Migraines and Vertigo
  46. Migraines: Are they triggered by weather changes?
  47. Alleviating migraine pain
  48. Monoamine oxidase inhibitors (MAOIs)
  49. MRI
  50. Natural remedies for depression: Are they effective?
  51. Nausea and vomiting
  52. Nervous breakdown: What does it mean?
  53. Nighttime headaches: Relief
  54. Occipital nerve stimulation: Effective migraine treatment?
  55. Ocular migraine: When to seek help
  56. Pain and depression: Is there a link?
  57. Pain Management
  58. Prednisone risks, benefits
  59. Prednisone withdrawal: Why taper down slowly?
  60. Relaxation techniques
  61. Seeing inside the heart with MRI
  62. Selective serotonin reuptake inhibitors (SSRIs)
  63. Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  64. Sleep tips
  65. Stop your next migraine before it starts
  66. Stress and headaches: Stop the cycle
  67. Symptom Checker
  68. Treatment-resistant depression
  69. Tricyclic antidepressants and tetracyclic antidepressants
  70. Migraine aura
  71. MRI
  72. Vitamin B-12 and depression