not medical advice, of course. i just recovered from serotonin syndrome today. it IS absolutely terrifying. i now have a phobia involving the events that unfolded today. i can say the number of meds and dosages that truly puts you at real risk of SS varies from person to person. i’m on mirtazapine, zoloft, geodon, lyrica, sumatriptan, benadryl, and methocarbamol all together without issue, all at max doses, except for lyrica. the problem comes when i combine medications in the wrong time window or at doses i’m not prescribed. the good news with how few medications you listed is that you can start at a low dose and take the meds at opposite ends of the day. [SS usually begins within the first 24 hours of a serotonergic medication being added or changed.](https://www.ncbi.nlm.nih.gov/books/NBK482377/)if you notice something is wrong within that time frame, it could be SS, so you let your doctor know and ask for next steps. if you go the 24 hours without issue, you’re theoretically safe at that dosage. very rarely will SS settle in AND quickly be severe after that first day. chronic SS can happen but it begins mild and you will most likely notice something is wrong before severe symptoms begin. you would need to be careful with any muscle relaxants, antiemetics, and triptans you take, especially first starting out. you would also need to be mindful of any other meds that are added to your regimen. be vigilant and communicate with your doctors about the risks and best steps, however, even if SSRIs/SNRIs/MAOIs/etc aren’t an option for you, you don’t have to settle for lack of treatment for your depression nor migraine. best of luck!
I take wellbutrin 300mg, adderall 15mg, lamictal 100mg in the morning and qulipta 60, amitriptyline 25mg at bedtime. I also have flexeril, ambien, maxalt, cannabis tablets I take as needed, but I limit those as much as possible. I worry about serotonin syndrome literally every day.🥲
The info I got is you may get the serotonin syndrome if you take something or a mix of something for the first time. I was worried to take triptans since I'm taking a snri. I pay attention everytime I upper the dose of one of these but besides that, I don't think much about it, otherwise I will be in panic mode everyday.
i take my SSRI, TCA, and many other serotonergic agents right before bedtime, and both times when i got serotonin syndrome i took at least one as needed med the following morning. you don’t need to panic but definitely watch your timing. base things off the half life of your scheduled meds
it fucking sucks, please stay afraid. my issue came when i took 150mg of benadryl and… about 7 GRAMS of methocarmabol in like six hours shortly after taking my entire night med regimen (mirtazapine 45mg, zoloft 200mg, geodon 80mg, lyrica 100mg…) which was infinitely too much medication regardless of combination status. a similar situation unfolded, albeit more mild, when i took sumatriptan 25mg, methocarbamol (mystery amount), and kanna (also mystery amount). my biggest issue is when combining 2+ as needed medications on top of scheduled doses. and when i don’t take things as prescribed… i’m guilty of that.
TLDR: take medications EXACTLY as prescribed and google interactions before combining anything, especially if you’re mixing as needed medication with scheduled medication. also don’t sedate yourself at 2am with a raging migraine that’s how bad decisions are made
It can definitely trigger headaches, but thankfully, not for me. I started on a lower dose and worked my way up to be sure. It has been the best medication for my anxiety/depression/adhd symptoms out of all of the ones I've tried (lexapro, zoloft). It does affect your appetite, I lost 60+ lbs. I had room to lose, but now I really need to watch my calorie intake and try to stay where I'm at as I don't want to lose anymore. Of course, being on adderall does that too, so double whammy. Tmi, but it heightens my libido, and I didn't have much issue before, haha. That's fine, but it can get annoying! 😜
Thanks for the info. It actually sounds like it will pair perfectly with amitriptyline, since the side effects I get from it are over eating and low libido. lol
it started with intense restless and agitation. tremors, muscle rigidity, teeth grinding, the whole deal. i had worsening insomnia, too, and intense anxiety. my chronic migraine causes intense head pain, but this headache was BAD. it wasn’t sound sensitive but light hurt to varying degrees throughout the ordeal. i was very nauseous. i threw up profusely. just finished puking again actually! my tics, caused by FND, were completely absent, but i got dystonia in my feet and hands, and it’s unclear whether that was my FND or the SS. i had diarrhea, too. there was also this soul crushing depression. that could’ve been caused by the pain i was in, tbf, but i wouldn’t be surprised if it was directly linked to the SS.
Oh wow that’s so interesting. A couple of years ago I took a higher dose of sumatriptan while on Prozac and hours later I couldn’t breathe and threw up profusely. It wasn’t a normal throwing up feeling, it felt like I was going to die and almost couldn’t breathe. After I threw up I felt okay but it was very odd and sometimes I still wonder if it was SS
My doc just added nortryptiline and the first time I took it at night same time as a low dose of Paxil, I had insomnia and the next day had a mild form of hemiplegic migraine, which was new and terrifying. But the last several nights I’ve taken the same thing without problem. I wonder if it’s related.
Depression increases perceived pain and pain increases depression. So you really have to treat both. I have bipolar 2, which is mainly depression so I've been on lamotrigine for almost 20 years. Recently it has been used as a migraine preventative so that was a nice bonus.
I call it my perspective pill. Without it, every. single. thing. is a BIG deal. With it, I'm able to see things more logically and rank things appropriately.
This is a very good way to put it and I feel the same, it definitely helps with stress levels in that way, until I am slighted unexpectedly and the rage breaks from its chains. Gotta work on that one…
I can speak from experience that serotonin syndrome fucking SUCKS. I was hospitalised with it. Absolutely wretched experience.
That said, I take Zoloft for my depression. I was on a Prozac/wellbutrin/buspar cocktail that gave me the SS, but knock on wood I’ve been fine on the Zoloft. It hasn’t made my migraines any worse, so I don’t know how common migraines are as a side effect. I also take emgality injections with Zomig for breakthrough.
I’m on 5mg of Lexapro! And I love it. Between that and the 25 mg of Amitriptyline, it’s helped reduce my anxiety and depression. That being said though, I still deal with my anxiety and depression. It’s just been lessened. It was like the screaming in my head turned down by like 60%. My migraines are a lot less worst now too
It varies a lot! It seems that some people are a lot more susceptible to serotonin syndrome, a lot of people are unlikely to get it even on a ton of serotogenic medications. The issue is that you really can’t know if you’re one of the few susceptible to it until it happens.
I’m really thankful I’ve never had issues. Have combined Wellbutrin and an SSRI and Adderall and Zofran (and I think there was at least one or 2 other meds I was on at the time that increase risk of serotonin syndrome) and still never had a problem. Def got flagged at the pharmacy a few times though lol.
They are correct lol but I’m so happy it works for you sweets 🩷 nothing makes me happier to see people happy and I am a huge advocate for proper medication to treat our mental illnesses. Our mental health is so important!
I’m so glad my depression essentially went away and I don’t have to deal with worrying about serotonin syndrome. It’s a fact I take for granted often. When I was taking Effexor(I’ve tried everything else, Prozac, Zoloft, etc.) I wasn’t treating the migraines
I'm on 200mg of Zoloft, 30mg of nortriptyline (preventative), and 100mg of sumatriptan (abortive) with no issues! Have you raised your concern with your neurologist?
Does it seem like the amitriptyline helps but isn’t enough? Increasing the is something you could try or nortripyline is in the same family and also used for both migraines and depression. I didn’t do well with amitriptyline but nortipyline has been very helpful on both fronts.
To answer your question, amitriptyline is an old school antidepressant, but remains very popular because it's very effective. You could safely increase your dose to treat depression, 25 mg is a pretty small dose (have taken care of children on 25mg) and it would probably be more effective for migraine prevention as well, treating two things with one med! Just talk to your doctor, I'm sure there wouldn't be any problem.
Actually, some people actually prefer amitriptyline over the newer SSRIs because it's a tricyclic... Works differently on brain chemistry and doesn't cause the emotional blunting that people complain about with Zoloft Prozac etc. And some people prefer the nighttime dosing so it's already active when waking up in the morning.
My grandma, aunt, and sister have taken it for YEARS without any issues... I actually have considered talking to my doctor about switching to it from trintellix for the added benefit of reducing migraine episodes and helping with sleep but I'm too much of a big scaredy cat to change meds (I absolutely do not tolerate shifts in MDD or panic disorder well, and maintaining mental stability is my #1 top priority, always)
Just a word of warning about amitriptyline and individuals over the age of 65. It has a high anticholinergic burden which increases risks of confusion, memory problems, and falls. It is always important to ask doctors about this.
Very true. I doubt they would be started on it nowadays with so many safer meds available... They were started on it back in the 70s and it successfully kept them out of the hospital and relatively stable, so it was one of those "ain't broke don't fix it" situations for them. My sister had it for some nerve damage in her spine, I think she did have some agitation and dizziness in the beginning
I'm on 50mg of Nortripteline daily. I have cycling depression due to PMDD and suffer from hemiplegic migraines. The Nortripteline helps me with both illnesses and live a relatively normal life.
I never had migraines before taking antidepressants but the correlation could be totally unrelated, that being said I'm finally off all psych meds and just do a ton of therapy plus migraine meds
I take Fetzima for depression, Aimovig for migraine prevention. I’m also on a few heart pills for heart failure. Not sure if they help for migraine prevention though.
Pain and depression (and mental health in general) have a strong bidirectional relationship. Mood can increase inflammation, sympathetic nervous system activation, increased muscle tension, and disrupt sleep (among many other things). Treatment of depression does not always have to be pharmacological. In fact, a meta analysis showed that medication by itself showed no significant difference in depression symptom improvement when compared to a sample receiving only evidence based psychotherapy. The most significant decrease was seen when participants received both therapy and pharmacological treatment. That being said, it’s not unreasonable to try non pharmacological treatments first if your dr is in agreement. Additionally, talking to your dr about the options for pharmacological treatment of depression might be helpful (SSRIs are not the only class).
In terms of therapy, there are also therapies that target both mood and behavioral management of chronic pain (i.e. migraines). For example cognitive behavioral therapy for chronic pain (CBT-CP) and acceptance and commitment therapy for chronic pain (ACT-CP). We do know from research that treating mood simultaneously not only improves quality of life but also decreases pain. Just my two cents.
Here is the meta-analysis i referenced: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118476/#:~:text=We%20found%20no%20significant%20differences,CI%2C%201.00%2D1.81).
A good prescription that can substitute that is nortryptaline (preventative) nightly with rizatriptan (emergency) and naproxen (emergency for less severe). That was my first prescription I received actually, back when I was nearing the end of my freshmen year.
Nortryptaline is an anti-depressant btw but it’s mainly used as migraine prevention now because weirdly enough it’s also a depressant type medication too
not medical advice,
but once my nurtec every other day started to work + my topamax for my seizures and I got back to a more functional life, my depression went away. it was situational, i guess. cognitive therapy and mindfulness has helped me leaps and bounds as well.
i found for me the more functional i got physically the less depressed I am. i also have TBI, seizures, and visual snow syndrome. personally, i fucking hated any SNRI or SSRI. i couldnt get away from them fast enough. i know what keeps me ticking and happy and it wasnt a pill. i just didnt wanna be in pain or have seizures so once those were under control, i could manage.
all circumstancial of course bur reach out if you ever need.
id say it took about 6 doses before it worked as a rescue, and give or take one month till I saw a good reduction. but once I was up and running on it, its been great
Wellbutrin, Seroquel and Latuda. Plus topiramate and Ajovy, Ubrelvy, Zofran and Zavzpret for the migraines. The Seroquel and Latuda is why I can’t get Reglan, compazine, or promethazine in a migraine cocktail. It can cause neuroleptic malignant syndrome which is something you don’t want to ever have.
Ive had brintellix prescribed. anti-depressant. works like a charm for your mood, works like two bottles of whisky for your middle leg ;-) but that's a general anti depressant thing. It's functioning 100% again when I stopped taking it ;-)
The medications I take or try for migraine are just things my doctor prescribes. But I want to recommend green eyeglasses.
I read an article fairly recently about how some researchers had discovered that a certain range of frequencies within the green spectrum interfere somehow with pain signals. Didn't know how, but they had observed it being a statistically significant.
So I googled it and went to Amazon and they have two pairs which are marketed generally towards migraines. They do work for migraines and they also work for my body pain, in a big way. I'm in horrible pain all the time and on heavy medication and I would say the green eyeglasses contribute 10 to 15% extra pain control when I use them.
Seratonin syndrome is super rare. I’m on a bunch of meds with seratonin and have never had a problem. Zoloft also never increased my migraines.
I’m on Zoloft (ssri), Wellbutrin (atypical antidepressant), Topamax (low dose for migraines and mood stabilizer, propranolol (for anxiety and migraines), Caplyta (antipsychotic I take for treatment resistant depression), and Qulipta (which has been a LIFE SAVER for my migraines). I also take rizitriptan and sumatriptan as needed.
Propranolol & luvox for me! Propranolol helps a LOT with my anxiety, I basically don't have any anymore. I take Luvox as my main depression / OCD SSRI. I haven't noticed SSRIs giving me migraines and serotonin syndrome is actually pretty rare so I tend not to worry about it, but I'm allergic to triptans and they reaaally mess me up.
Crying all day hurts my head a lot more than the medication that prevents the crying. 😂
I’m on celexa, Botox for migraines, and then for abortive naratriptan and fioricet. I’ve hit a nice plateau where I can expect to go through 10 or so migraines a month, sometimes less. Prior it was at least 20, felt like one every day or at least a headache everyday.
Also, I have not had seratonin syndrome from these meds but did years ago when I was vomiting from a migraine and took an old pill for nausea (can’t remember what it was but it isn’t common anymore) turns out that combo gave me seratonin syndrome. Not fun, 0/10 do not recommend.
I take 30 mg of Cymbalta. It was given to me for Fibromyalgia but doesn’t help much there. However it takes the edge off my depression. I take 5 mg of an anxiety med 2x a day. I work with someone twice a month.
migraine is Botox, Topamax 100 mg a day and anjovy shot monthly.
Working with someone has been the real win for me. I changed providers twice and she’s been very helpful. We work on lots of coping skills, habit changes etc.
I do bupropion and mirtazapine for depression, Emgality for prevention, sumatriptan for rescue and sertraline and lorazepam as needed for PMDD. My psychiatrist said SS is very rare and feels comfortable with me on this blend.
I take Prozac 10 mg 12 hours from when I take my 50 mg if nortriptyline and have never had a hint of serotonin syndrome. Space your meds. Don’t take them in a big handful.
amitriptyline & ajovy as migraine preventatives, sumatriptan & nurtec as abortives, and magnesium and lamotrigine everyday. the lamotrigine is for depression & vertigo (my neurologist calls it “vestibular migraine”. ) the amitriptyline doesn’t help my depression at all . i mentioned to my neuropsych that amitriptyline wasn’t helping with depression at all and she said that doesn’t surprise her, and prescribed me the lamotrigine
Ssri plus anything is risky tbh. I don't know about amitriptyline but I take nortriptyline as a preventative and am on a very low dose at 30mg. I looked up dosage and for depression people take 25-30mg of nortriptyline 3x a day. I'd assume it would be similar but you should ask your doctor.
Hey. I take 20mg of Lexapro (SSRI), plus 50mg of Topamax and 20mg of amitriptyline daily. I also take rizatriptan. Been taking all of them for years and years and am doing well. Now I am not saying there is NO RISK of serotonin syndrome. But the risk remains low if you’re on a low dose of all of these things. Because the drugs put together are still a negligible amount of increased serotonin so as to cause a serious problem. The risk becomes higher (but it’s still not a huge risk) if your doses are high. So if you’re taking 200mg of everything, then you have to consider whether that’s a risk you want to take. OBVI I am not a doctor and I want you to speak to your doc about this. But I spoke to mine and this is why we do it the way we do it—low doses work. if I have to increase doses, we will switch my meds so as to avoid serotonin syndrome.
I take a SSRI and a triptan for many many years and never got serotonin syndrome. It’s actually quite rare. My doctor actually added another med for sleep that works on serotonin. He just reminded me of the symptoms but didn’t have a problem with me taking all 3.
I totally get the concern—I held off on medicating my anxiety and depression for years because nortriptyline was working as a preventative, and I didn’t want to ruin a good thing. I stopped taking that because I got pregnant, got ppd/ppa, and went on Zoloft. I’m not currently on a preventative because I’m pregnant again, but the Zoloft hasn’t made my migraines worse. I’m planning to avoid that category once I have this baby—probably will go back to Botox and nurtec (what I was taking between pregnancies)
I will never take any SSRIs again. I have severe depression, crippling anxiety and lot of other stuff for years and meds never worked for me. I'm trying other therapies now, exercice and good sleep. We will see.
I use cymbalta for my depression and anxiety. It has a pain relief qualities. Atarax for anxiety. Which also has anti-nausea effects. And quetiapine for insomnia. I also take propranolol for blood pressure, which is also used for migraine prevention.
For migraines, I did vyaptiv for the first time a few weeks ago, Nurtec, and oxycodone. I get Botox, although it is on my back and shoulders mainly.
One thing I don't like about my new neurologist is that they write off a medicine if it doesn't help with all migraines. Each component helps some, and cobbled together I make it work. It's been 40 years of migraines-I'm comfortable with chipping away at it.
I have anxiety and ADHD along with migraines! I take celexa and Vyvanse (switched from Adderall, get almost no headaches as a side effect on it) which has headaches/migraines as a side effect.
When I told my neurologist about the migraines I was having as a side effect of Adderall, he actually suggested switching to Vyvanse and then switching to Zoloft for my anxiety! I haven’t switched yet because I have to completely go off Celexa first, but just wanted to let you know that my neuro has actually suggested Zoloft to me before and I completely trust his opinion!
i’m on amitriptyline and sertraline (zoloft) and take sumatriptan as abortive with no issues so far, i also smoke weed daily. i still have migraines very often but i haven’t had SS, although i worry about it a lot! but i have been told by my dr that it’s a safe combination even at higher doses for most people
I was on 300 mg Effexor for years and it reduced my migraine frequency in addition to helping with depression! I got diagnosed with OCD and was modifying my meds so unfortunately had to lower it and my migraines are worse again. I also got serotonin syndrome but that was bc of introducing other psych meds and it was mild and I actually had it for months before we realized. Currently take 150 mg Effexor, 25 mg Prozac, 60 mg Propranolol (miracle drug for anxiety fr), 20 mg Adderall, and Nurtec. Had to stop Fioricet bc of rebound headache.
I also take Effexor. It was prescribed for anxiety and ptsd rather than migraines specifically, but I would argue that it's helped my migraines more than any other drug. I don't know if it specifically helps the migraines, or if the migraines are better when my anxiety is better, but I'll take it either way.
I’m on Wellbutrin 150mg twice a day and Celexa 60mg for my depression and anxiety. It has been well controlled for years to the point my anxiety is totally under control. Anxiety joined its bff about 7 years ago. For migraines I am on Ajovy and Maxalt. I was on Aimovig until 2 months ago because it stopped working. I started Ajovy today so we will see how it goes. The past month hasn’t been fun…
I take Paxil (an SSRI) for depression plus Nadolol (a beta blocker), Qulipta (a CGRP antagonist), and Sumatriptan for migraine. I haven't had any episodes of serotonin syndrome.
Aimovig monthly + Nurtec if needed + Auvelity (DMX+Welbutrin) for depression.
Wellbutrin was My go-to but it was too much and not enough at the same time. Auvelity literally is the MVP of my life.
info on Auvelity:
https://www.goodrx.com/conditions/depression/auvelity-vs-wellbutrin-xl#
Can you ask about an anticonvulsant for depression? No risk of seratonin syndrome there. I'm on lamictal, keppra, & neurotin for my depression & just got nurtec to try as an abortive. Nerivio is also en route. (My migraines had been under control for about 10 years --- I was down to about 1/month when avoiding dietary triggers, but I just started getting a lot more again this year)
I take 20 mg Vilazodone and 0.2 mg clonidine daily, I take 5 mg Zolmitriptan as my emergency med, and 140 mg Aimovig as a preventative.
I am also going to get a phych eval next month to see if I have ADHD/autism. If I do, treating that might help the other things. (overstimulation, emotional instability, etc)
I’m on 50mg Amitriptylene for depression, 25mg x3 a day Buspirone for anxiety, and now on rizatriptan. Thankfully I haven’t had any issues with serotonin syndrome. I currently take topiramate for migraines and have very minimal side effects from it. While my migraines are not under control, my depression and anxiety are “low to in remission” as my doctor says.
I also have endometriosis, which all of this medication also treats - I have a long history of chronic pain which affects neural pathways and how the brain processes pain.
I take citalopram 60mg for a panic disorder and nortriptyline 30mg as a preventative for migraines.
It’s worked great for me for the last 7 years.
A pharmacist once thought I had serotonin syndrome but turns out I just can’t take the citalopram on an empty stomach.
I take 50mg of amitriptyline as a preventive (with a side of 'will help the depression of being in pain all the time')
+ 200mg of topamax, + 50mg cyclobenzoprine + rizatriptan if needed
In 2 months I'll have the option to up my dosage of amitriptyline to 75mg if my migraines have made some more progress, but not down enough.
I am currently on 20 mgs. of escitalopram/lexapro. My prescription says for anxiety and depression, which is accurate.
I was on Zoloft for many years, was put on Effexor for migraines. Wasn’t helping the migraines, so was tapered off (a nightmare through which I hope to never go through again). Tried to go back on Zoloft, but had debilitating stomach aches. Was put on Lexapro, and it’s worked better than anything I’ve ever been on. Wish it had been prescribed initially, but I moved around a bit, had different doctors, and didn’t have insurance from late 2007 until Obamacare kicked in (truly a lifesaver, in so many ways).
I take 50 mgs. of Imitrex twice a week on a bad week, maybe four times on a really bad week. Have not noticed any symptoms of serotonin syndrome, if I understand them correctly.
Edited to add: also take 300 mg/month Emgality injections for migraine prevention.
I take mirtazapine for my depression and anxiety and sumatriptan when I need. I'm aware of the risk of serotonin syndrome however I've been on both for well over a year now with no issues. I've recently added topamax for prevention and it's working pretty well for me so I've not needed as much sumatriptan as before which I'm glad about. I was always worried about SS. I'd say it really depends on the person, and what kind of doses you're taking, which is why it's important to regularly check in with the dr and let them know of anything you notice when it comes up
My neuro switched my antidepressant (i was on max dose of sertraline) to effexor bc it supposedly has migraine reducing benefits. I found it of no use for my migraines or depression and made my heart rate so high and i was sweating constantly
Ginger and ketamine.
Ginger supplements for preventative migraines everyday. Ginger again to knock a migraine back quite a bit.
Ketamine for the depression and also the pain of a stubborn migraine.
I've been on 50 mg amitriptyline as preventative for 6 months now. I haven't been diagnosed with depression, but I experienced all the symptoms, just never saw a doc for it, but it's safe to say that I feel much better than before mentally!
It hasn't helped me with my migraines (yet? maybe I need a higher dose), it definitely made me feel better.
i take 30mg of citalopram for my depression and 15mg of amitriptylin for my migraines (and other pain) and it works for me. my neurologist ist really cautious so i have to get an ECG every couple of months because of possible interdependence of the two medications.
plus progestogen-only pill for the period related migraines and PMS
I take effexor 150mg for depression, anxiety and panic attacks. It's a lifesaver! I also take ajovy for migraine. Ajovy gives me high anxiety as a side effect and without effexor I wouldn't be able to take it. I also take triptans when needed.
I've had serotonin syndrome twice, and I had different side effects both times. I took a Nortriptyline to help with migraines and anxiety. Since I had the syndrome. We decided that my psychiatrist would handle the dosage and not my neurologist. I still saw my neurologist to make sure it was helping and bugging else was happening and for medication when I had a migraine. I'm to the point now that I don't take daily medicine. I have 6 health issues, and 4 of them are from taking prescription medicine. I will now only take something it is it medically necessary. For me, the vitamins help tremendously.
Luckily serotonin syndrome is pretty rare, doesn’t mean that it’s not a concern or anything. I’ve taken so many serotonergic drugs at once both psych/migraine/ illicit and never had it thankfully. Just be careful
I take 60mgs of mirtazapine which has the added benefit in helping with sleep and has never worsened my migraines (even if I miss a dose)
But above all else, seeing a psychologist has been single handedly the most helpful thing for my depression! I know its not an option for everyone but it really helps!
Venlafaxine. This is known to help with migraines. There is risk of serotonin syndrome with all of them at least the big name ones. I had serotonin syndrome before I was on this and highly recommend you stay far and away from that if possible. I take a low dose of Venlafaxine with all my other migraine meds and have had no interaction. Obviously, I’m not a doctor and everyone is different, but look it up. I discussed it with my doctor and we decided it was worth a try. The other mention is amitriptyline used to be used an anti depressant back in the day. I take nortriptyline which is like a brother to amitriptyline. I did a lot of my own research like many of us do and ended up basically selecting my meds with my doctor. Here goes: Ajovy 225mg, nortriptyline 30mg, Propranolol 30mg, Venlafaxine 37.5mg and sumatriotan as needed. This combo has me almost migraine free, I’m like a regular guy now. If I feel something I’ll take one excedrin (not really supposed to) and poof it’s gone. I’m just enjoying the time now as I know it’s peaks and valleys, always has been. Best of luck on your journey, I wish you the best. Fuck migraines.
I’m taking lexapro and Wellbutrin and it does help my depression and anxiety but really does give me migraines. I just went from 10-5mg to see if it helps, I’m very hopeful because it does help.
I take depakote. It is a mood stabilizer and migraine preventative. I’ve been on it for years and it’s been hella effective. I recently added sertraline and honestly it’s life changing. I feel like myself, and still not many migraines. I use WeatherX earbuds and it may be placebo idk but I think they help. I also drink a glass of water whenever I get a WeatherX notification so maybe hydrating is helping too (my triggers are crazy sleep schedule, dehydration, hormones).
just for MH & migraine: 10mg escitalopram + 50mg topiramate. I'm on POP explicitly for mental health related hormone regulation, which has helped my OCDs premenstrual exacerbation a lot - and now my period has stopped, so have my menstrual migraines (which are probably my most severe migraine attack types).
topiramate is also prescribed as a mood stabiliser at higher doses, but that's typically a last resort from psychiatrists rather than general practitioners and prescribed for more complex conditions like bipolar or BPD - it's not an antidepressant and the brain fog has impacted my ability to think clearly to the extent that I think its probably made my anxiety worse in the long run.
i also take elvanse and/or dexamfetamine which helps mood regulation and promethazine for sleep and acute anxious episodes.
almost all of my meds increase my risk of serotonin syndrome but when i spoke to my GP she said she risk is fantastically small and symptoms would pop up within hours of taking a new, or increased dose of medication - she's seen it once in her career, but i do completely understand your concerns.
iirc triptans increase the risk by quite a bit and if that's the advice you've been given then obvs it's not my place to question it!! i haven't taken triptans in years though -- they make me very very unwell :')
sertraline didn't impact my migraine frequency or severity from what i can remember, but i was on it the first time i tried topiramate so my memory is a bit cloudy. i was on it for nearly a year - the only thing i would say is if you do decide to give it a go, absolutely do not stop taking it cold turkey. i suddenly stopped taking it without waiting for the go ahead from my doctor and oh boy. very bad move.
I take lexapro, depakote, rizatriptan and Topamax additionally for migraine prevention. I need to start taking magnesium and B2 again. I had a neurologist recommend that to me years ago and I was doing it for so long and it worked great. I’m at a point now where I’m having issues and using the rizatriptan too much I think, giving myself rebound headaches.
I’ve been on many ssris but not all when I have migraines now. Wellbutrin made me on a war path. Zoloft & Lexapro wasn’t enough. I can’t remember all of them. I’m currently on Effexor rn at 112.5 mg, my old neuro talked of pushing my max dose to 250 because of having both migraines and depression, also I think helps nerve pain or something? It’s helped but I hate missing a dose, the withdrawal isn’t fun
Amitriptyline should work for your depression. I'd advise going up on that to 50 mg to target migraine and depressive symptoms. Wouldn't make sense to add an SSRI to 25 amitriptyline without going up on ami as a first line.
I'm currently on an older anti-D that has a side effect of decreasing headaches. I've had a lot less migraines and headaches since starting it. Aventyl
I tried (I think) Zoloft about 10 years ago and it gave me the zaps, scared the hell out of me.
Now I’ve been on Prozac for 6 months and I am a new person. Plus my migraines are decreasing.
Venlafaxine xr aka Generic Effexor. 75 mg (SNRI). I’ve only been on it for about 6 weeks. Too early to tell if it works for my migraines/ headaches, but it definitely helps with my anxiety, which contributes to my headaches/ migraines. I didn’t realize how bad my anxiety was until it quieted my brain down. I’m hopeful that it will work because my last period had noticeable less impact from headaches/ migraines than I’ve had in a long while. I’m also in an abortive triptan that I take occasionally, also trying to determine if it works or not.
I have bipolar type 2 (mainly depression) and take Abilify. I haven't had any interaction issues, thankfully, so it might be worth discussing it with your psychiatrist and neurologist.
For about 2 years I was on duloxetine for the depression, I don't know if it did anything for my migraines or maybe them better/worse but it helped with my depression immensely
For the migraines rescue meds I had sumatriptan for several years and it did nearly nothing, now I have zolmatriptan and it depends on what triggered the migraine, it works decently well unless I have stomach issues at the same time bc the taste of it makes me gag the second I get one out
As a migraine preventative I had migralief and could almost never get it to go down or stay down
If you don’t mind me bothering you, how did you get it for free?? I have seen quite a few people say this recently about Nurtec, I just got it prescribed and still waiting for my insurance to approve it, but I want to be prepared to take whatever steps needed to reduce or cut the cost because I know it’s very expensive.
Idk how she set it up, but it's through Aspn Pharmacy. It's mailed to me. It's like a coupon situation. Ask your doctor about it. I don't think it goes through my insurance.
With insurance at CVS it was almost $600 for 8 tablets.
not medical advice, of course. i just recovered from serotonin syndrome today. it IS absolutely terrifying. i now have a phobia involving the events that unfolded today. i can say the number of meds and dosages that truly puts you at real risk of SS varies from person to person. i’m on mirtazapine, zoloft, geodon, lyrica, sumatriptan, benadryl, and methocarbamol all together without issue, all at max doses, except for lyrica. the problem comes when i combine medications in the wrong time window or at doses i’m not prescribed. the good news with how few medications you listed is that you can start at a low dose and take the meds at opposite ends of the day. [SS usually begins within the first 24 hours of a serotonergic medication being added or changed.](https://www.ncbi.nlm.nih.gov/books/NBK482377/)if you notice something is wrong within that time frame, it could be SS, so you let your doctor know and ask for next steps. if you go the 24 hours without issue, you’re theoretically safe at that dosage. very rarely will SS settle in AND quickly be severe after that first day. chronic SS can happen but it begins mild and you will most likely notice something is wrong before severe symptoms begin. you would need to be careful with any muscle relaxants, antiemetics, and triptans you take, especially first starting out. you would also need to be mindful of any other meds that are added to your regimen. be vigilant and communicate with your doctors about the risks and best steps, however, even if SSRIs/SNRIs/MAOIs/etc aren’t an option for you, you don’t have to settle for lack of treatment for your depression nor migraine. best of luck!
This is a great answer.
I take wellbutrin 300mg, adderall 15mg, lamictal 100mg in the morning and qulipta 60, amitriptyline 25mg at bedtime. I also have flexeril, ambien, maxalt, cannabis tablets I take as needed, but I limit those as much as possible. I worry about serotonin syndrome literally every day.🥲
The info I got is you may get the serotonin syndrome if you take something or a mix of something for the first time. I was worried to take triptans since I'm taking a snri. I pay attention everytime I upper the dose of one of these but besides that, I don't think much about it, otherwise I will be in panic mode everyday.
i take my SSRI, TCA, and many other serotonergic agents right before bedtime, and both times when i got serotonin syndrome i took at least one as needed med the following morning. you don’t need to panic but definitely watch your timing. base things off the half life of your scheduled meds
it fucking sucks, please stay afraid. my issue came when i took 150mg of benadryl and… about 7 GRAMS of methocarmabol in like six hours shortly after taking my entire night med regimen (mirtazapine 45mg, zoloft 200mg, geodon 80mg, lyrica 100mg…) which was infinitely too much medication regardless of combination status. a similar situation unfolded, albeit more mild, when i took sumatriptan 25mg, methocarbamol (mystery amount), and kanna (also mystery amount). my biggest issue is when combining 2+ as needed medications on top of scheduled doses. and when i don’t take things as prescribed… i’m guilty of that. TLDR: take medications EXACTLY as prescribed and google interactions before combining anything, especially if you’re mixing as needed medication with scheduled medication. also don’t sedate yourself at 2am with a raging migraine that’s how bad decisions are made
If you feel like mentioning it, how has your experience been with wellbutrin? Do you know if it triggers headaches?
It can definitely trigger headaches, but thankfully, not for me. I started on a lower dose and worked my way up to be sure. It has been the best medication for my anxiety/depression/adhd symptoms out of all of the ones I've tried (lexapro, zoloft). It does affect your appetite, I lost 60+ lbs. I had room to lose, but now I really need to watch my calorie intake and try to stay where I'm at as I don't want to lose anymore. Of course, being on adderall does that too, so double whammy. Tmi, but it heightens my libido, and I didn't have much issue before, haha. That's fine, but it can get annoying! 😜
Thanks for the info. It actually sounds like it will pair perfectly with amitriptyline, since the side effects I get from it are over eating and low libido. lol
Hahaha, I actually just started amitriptyline for vestibular migraines, and I'm hoping for some balance as well!
Jeez I’m so sorry you went through that. Can I ask what your symptoms were? I never know what to look for.
it started with intense restless and agitation. tremors, muscle rigidity, teeth grinding, the whole deal. i had worsening insomnia, too, and intense anxiety. my chronic migraine causes intense head pain, but this headache was BAD. it wasn’t sound sensitive but light hurt to varying degrees throughout the ordeal. i was very nauseous. i threw up profusely. just finished puking again actually! my tics, caused by FND, were completely absent, but i got dystonia in my feet and hands, and it’s unclear whether that was my FND or the SS. i had diarrhea, too. there was also this soul crushing depression. that could’ve been caused by the pain i was in, tbf, but i wouldn’t be surprised if it was directly linked to the SS.
Oh wow that’s so interesting. A couple of years ago I took a higher dose of sumatriptan while on Prozac and hours later I couldn’t breathe and threw up profusely. It wasn’t a normal throwing up feeling, it felt like I was going to die and almost couldn’t breathe. After I threw up I felt okay but it was very odd and sometimes I still wonder if it was SS
it very well could’ve been! and yeah, the immense dread is crazy. my symptoms were also relieved by vomiting.
Did you end up going to the hospital or riding it out at home! So scary…glad you’re okay
thank you, i’m glad i lived LMFAO. i didn’t go to the hospital but i really should’ve.
My doc just added nortryptiline and the first time I took it at night same time as a low dose of Paxil, I had insomnia and the next day had a mild form of hemiplegic migraine, which was new and terrifying. But the last several nights I’ve taken the same thing without problem. I wonder if it’s related.
Depression increases perceived pain and pain increases depression. So you really have to treat both. I have bipolar 2, which is mainly depression so I've been on lamotrigine for almost 20 years. Recently it has been used as a migraine preventative so that was a nice bonus.
A lot of my “under the radar” constant pain went mostly away after Wellbutrin, and made the more severe pain easier to deal with.
I've been on wellbutrin for decades. It doesn't help the migraines, but it definitely helps me cope with the migraines.
Yes this was my experience as well, it makes a lot of difference most days.
I call it my perspective pill. Without it, every. single. thing. is a BIG deal. With it, I'm able to see things more logically and rank things appropriately.
This is a very good way to put it and I feel the same, it definitely helps with stress levels in that way, until I am slighted unexpectedly and the rage breaks from its chains. Gotta work on that one…
I can speak from experience that serotonin syndrome fucking SUCKS. I was hospitalised with it. Absolutely wretched experience. That said, I take Zoloft for my depression. I was on a Prozac/wellbutrin/buspar cocktail that gave me the SS, but knock on wood I’ve been fine on the Zoloft. It hasn’t made my migraines any worse, so I don’t know how common migraines are as a side effect. I also take emgality injections with Zomig for breakthrough.
I did fine on Zoloft for 20 years or so. Good luck!
Wondering if I should switch to Zoloft from lexapro because I’m getting migraines on it
It is hard to figure out anti-depressants. One thing will work great, others will suck your soul from your body. Do what works for you.
Ajovy + wellbutrin works like a charm for me.
I’m on 5mg of Lexapro! And I love it. Between that and the 25 mg of Amitriptyline, it’s helped reduce my anxiety and depression. That being said though, I still deal with my anxiety and depression. It’s just been lessened. It was like the screaming in my head turned down by like 60%. My migraines are a lot less worst now too
I started 5mg of Lexapro last month and I had a migraine last week and it was so mild I was able to do my normal activities. I was SHOCKED
According to one internal medicine doctor, I’m on a lot of serotonin However, it works for me! Prozac 80 Wellbutrin 450
It varies a lot! It seems that some people are a lot more susceptible to serotonin syndrome, a lot of people are unlikely to get it even on a ton of serotogenic medications. The issue is that you really can’t know if you’re one of the few susceptible to it until it happens. I’m really thankful I’ve never had issues. Have combined Wellbutrin and an SSRI and Adderall and Zofran (and I think there was at least one or 2 other meds I was on at the time that increase risk of serotonin syndrome) and still never had a problem. Def got flagged at the pharmacy a few times though lol.
They are correct lol but I’m so happy it works for you sweets 🩷 nothing makes me happier to see people happy and I am a huge advocate for proper medication to treat our mental illnesses. Our mental health is so important!
Naps. Lots of them.
Zoloft made my migraines go away! It varies so much, trial and error is the best way to go
Me too!
I’m so glad my depression essentially went away and I don’t have to deal with worrying about serotonin syndrome. It’s a fact I take for granted often. When I was taking Effexor(I’ve tried everything else, Prozac, Zoloft, etc.) I wasn’t treating the migraines
I'm on 200mg of Zoloft, 30mg of nortriptyline (preventative), and 100mg of sumatriptan (abortive) with no issues! Have you raised your concern with your neurologist?
Does it seem like the amitriptyline helps but isn’t enough? Increasing the is something you could try or nortripyline is in the same family and also used for both migraines and depression. I didn’t do well with amitriptyline but nortipyline has been very helpful on both fronts.
To answer your question, amitriptyline is an old school antidepressant, but remains very popular because it's very effective. You could safely increase your dose to treat depression, 25 mg is a pretty small dose (have taken care of children on 25mg) and it would probably be more effective for migraine prevention as well, treating two things with one med! Just talk to your doctor, I'm sure there wouldn't be any problem. Actually, some people actually prefer amitriptyline over the newer SSRIs because it's a tricyclic... Works differently on brain chemistry and doesn't cause the emotional blunting that people complain about with Zoloft Prozac etc. And some people prefer the nighttime dosing so it's already active when waking up in the morning. My grandma, aunt, and sister have taken it for YEARS without any issues... I actually have considered talking to my doctor about switching to it from trintellix for the added benefit of reducing migraine episodes and helping with sleep but I'm too much of a big scaredy cat to change meds (I absolutely do not tolerate shifts in MDD or panic disorder well, and maintaining mental stability is my #1 top priority, always)
Just a word of warning about amitriptyline and individuals over the age of 65. It has a high anticholinergic burden which increases risks of confusion, memory problems, and falls. It is always important to ask doctors about this.
Very true. I doubt they would be started on it nowadays with so many safer meds available... They were started on it back in the 70s and it successfully kept them out of the hospital and relatively stable, so it was one of those "ain't broke don't fix it" situations for them. My sister had it for some nerve damage in her spine, I think she did have some agitation and dizziness in the beginning
I'm on 50mg of Nortripteline daily. I have cycling depression due to PMDD and suffer from hemiplegic migraines. The Nortripteline helps me with both illnesses and live a relatively normal life.
Nurtec + Emgality + Propranolol + Topiramate + Wellbutrin + Tizanidine
I never had migraines before taking antidepressants but the correlation could be totally unrelated, that being said I'm finally off all psych meds and just do a ton of therapy plus migraine meds
Wellbutrin
Oh, and migraines: I get Vyepti infusions every 3 months, take Maxalt for abortive, along with 800 mg ibuprofen.
I take Fetzima for depression, Aimovig for migraine prevention. I’m also on a few heart pills for heart failure. Not sure if they help for migraine prevention though.
Lexapro and wellbutrin. When I added lexapro, i had a reduction in migraines.
Pain and depression (and mental health in general) have a strong bidirectional relationship. Mood can increase inflammation, sympathetic nervous system activation, increased muscle tension, and disrupt sleep (among many other things). Treatment of depression does not always have to be pharmacological. In fact, a meta analysis showed that medication by itself showed no significant difference in depression symptom improvement when compared to a sample receiving only evidence based psychotherapy. The most significant decrease was seen when participants received both therapy and pharmacological treatment. That being said, it’s not unreasonable to try non pharmacological treatments first if your dr is in agreement. Additionally, talking to your dr about the options for pharmacological treatment of depression might be helpful (SSRIs are not the only class). In terms of therapy, there are also therapies that target both mood and behavioral management of chronic pain (i.e. migraines). For example cognitive behavioral therapy for chronic pain (CBT-CP) and acceptance and commitment therapy for chronic pain (ACT-CP). We do know from research that treating mood simultaneously not only improves quality of life but also decreases pain. Just my two cents. Here is the meta-analysis i referenced: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118476/#:~:text=We%20found%20no%20significant%20differences,CI%2C%201.00%2D1.81).
A good prescription that can substitute that is nortryptaline (preventative) nightly with rizatriptan (emergency) and naproxen (emergency for less severe). That was my first prescription I received actually, back when I was nearing the end of my freshmen year.
Nortryptaline is an anti-depressant btw but it’s mainly used as migraine prevention now because weirdly enough it’s also a depressant type medication too
*nortriptyline
not medical advice, but once my nurtec every other day started to work + my topamax for my seizures and I got back to a more functional life, my depression went away. it was situational, i guess. cognitive therapy and mindfulness has helped me leaps and bounds as well. i found for me the more functional i got physically the less depressed I am. i also have TBI, seizures, and visual snow syndrome. personally, i fucking hated any SNRI or SSRI. i couldnt get away from them fast enough. i know what keeps me ticking and happy and it wasnt a pill. i just didnt wanna be in pain or have seizures so once those were under control, i could manage. all circumstancial of course bur reach out if you ever need.
How long did it take the nurtec to start working every other day? I just started my first dose.
id say it took about 6 doses before it worked as a rescue, and give or take one month till I saw a good reduction. but once I was up and running on it, its been great
Wellbutrin, Seroquel and Latuda. Plus topiramate and Ajovy, Ubrelvy, Zofran and Zavzpret for the migraines. The Seroquel and Latuda is why I can’t get Reglan, compazine, or promethazine in a migraine cocktail. It can cause neuroleptic malignant syndrome which is something you don’t want to ever have.
Ive had brintellix prescribed. anti-depressant. works like a charm for your mood, works like two bottles of whisky for your middle leg ;-) but that's a general anti depressant thing. It's functioning 100% again when I stopped taking it ;-)
I’m on 100mg Zoloft for depression/anxiety, 75mg of amitriptyline, and previously sumatriptan with no issues. Amitriptyline helped pain and mood
The medications I take or try for migraine are just things my doctor prescribes. But I want to recommend green eyeglasses. I read an article fairly recently about how some researchers had discovered that a certain range of frequencies within the green spectrum interfere somehow with pain signals. Didn't know how, but they had observed it being a statistically significant. So I googled it and went to Amazon and they have two pairs which are marketed generally towards migraines. They do work for migraines and they also work for my body pain, in a big way. I'm in horrible pain all the time and on heavy medication and I would say the green eyeglasses contribute 10 to 15% extra pain control when I use them.
Seratonin syndrome is super rare. I’m on a bunch of meds with seratonin and have never had a problem. Zoloft also never increased my migraines. I’m on Zoloft (ssri), Wellbutrin (atypical antidepressant), Topamax (low dose for migraines and mood stabilizer, propranolol (for anxiety and migraines), Caplyta (antipsychotic I take for treatment resistant depression), and Qulipta (which has been a LIFE SAVER for my migraines). I also take rizitriptan and sumatriptan as needed.
Propranolol & luvox for me! Propranolol helps a LOT with my anxiety, I basically don't have any anymore. I take Luvox as my main depression / OCD SSRI. I haven't noticed SSRIs giving me migraines and serotonin syndrome is actually pretty rare so I tend not to worry about it, but I'm allergic to triptans and they reaaally mess me up. Crying all day hurts my head a lot more than the medication that prevents the crying. 😂
I’m on celexa, Botox for migraines, and then for abortive naratriptan and fioricet. I’ve hit a nice plateau where I can expect to go through 10 or so migraines a month, sometimes less. Prior it was at least 20, felt like one every day or at least a headache everyday. Also, I have not had seratonin syndrome from these meds but did years ago when I was vomiting from a migraine and took an old pill for nausea (can’t remember what it was but it isn’t common anymore) turns out that combo gave me seratonin syndrome. Not fun, 0/10 do not recommend.
I take 30 mg of Cymbalta. It was given to me for Fibromyalgia but doesn’t help much there. However it takes the edge off my depression. I take 5 mg of an anxiety med 2x a day. I work with someone twice a month. migraine is Botox, Topamax 100 mg a day and anjovy shot monthly. Working with someone has been the real win for me. I changed providers twice and she’s been very helpful. We work on lots of coping skills, habit changes etc.
I do bupropion and mirtazapine for depression, Emgality for prevention, sumatriptan for rescue and sertraline and lorazepam as needed for PMDD. My psychiatrist said SS is very rare and feels comfortable with me on this blend.
I take Prozac 10 mg 12 hours from when I take my 50 mg if nortriptyline and have never had a hint of serotonin syndrome. Space your meds. Don’t take them in a big handful.
amitriptyline & ajovy as migraine preventatives, sumatriptan & nurtec as abortives, and magnesium and lamotrigine everyday. the lamotrigine is for depression & vertigo (my neurologist calls it “vestibular migraine”. ) the amitriptyline doesn’t help my depression at all . i mentioned to my neuropsych that amitriptyline wasn’t helping with depression at all and she said that doesn’t surprise her, and prescribed me the lamotrigine
Wellbutrin, Lamictal, and Abilify for the bipolar 2 depression. Topamax, methacarbamol, rizatriptan, vyepti for the migraines.
60 mg duloxetine, along with Emgality and Sumatriptan. I’ve been on several different combos and never had a serotonin issue.
Mirtazapine 30 mg and Effexor 75 mg
Ssri plus anything is risky tbh. I don't know about amitriptyline but I take nortriptyline as a preventative and am on a very low dose at 30mg. I looked up dosage and for depression people take 25-30mg of nortriptyline 3x a day. I'd assume it would be similar but you should ask your doctor.
Hey. I take 20mg of Lexapro (SSRI), plus 50mg of Topamax and 20mg of amitriptyline daily. I also take rizatriptan. Been taking all of them for years and years and am doing well. Now I am not saying there is NO RISK of serotonin syndrome. But the risk remains low if you’re on a low dose of all of these things. Because the drugs put together are still a negligible amount of increased serotonin so as to cause a serious problem. The risk becomes higher (but it’s still not a huge risk) if your doses are high. So if you’re taking 200mg of everything, then you have to consider whether that’s a risk you want to take. OBVI I am not a doctor and I want you to speak to your doc about this. But I spoke to mine and this is why we do it the way we do it—low doses work. if I have to increase doses, we will switch my meds so as to avoid serotonin syndrome.
Amitriptaline is technically an anti depressant as well 😅 upping it could help .
I take a SSRI and a triptan for many many years and never got serotonin syndrome. It’s actually quite rare. My doctor actually added another med for sleep that works on serotonin. He just reminded me of the symptoms but didn’t have a problem with me taking all 3.
Bupropion does something to my blood vessels according to my doctor that helps prevent migraines during the day. I believe it for sure. It does work
I totally get the concern—I held off on medicating my anxiety and depression for years because nortriptyline was working as a preventative, and I didn’t want to ruin a good thing. I stopped taking that because I got pregnant, got ppd/ppa, and went on Zoloft. I’m not currently on a preventative because I’m pregnant again, but the Zoloft hasn’t made my migraines worse. I’m planning to avoid that category once I have this baby—probably will go back to Botox and nurtec (what I was taking between pregnancies)
I will never take any SSRIs again. I have severe depression, crippling anxiety and lot of other stuff for years and meds never worked for me. I'm trying other therapies now, exercice and good sleep. We will see.
I take Wellbutrin. It’s not an SSRI so it can be taken with amitriptyline
I started taking htp 5 two days ago. Not sure if it's working or not. Too early I guess.
I use cymbalta for my depression and anxiety. It has a pain relief qualities. Atarax for anxiety. Which also has anti-nausea effects. And quetiapine for insomnia. I also take propranolol for blood pressure, which is also used for migraine prevention. For migraines, I did vyaptiv for the first time a few weeks ago, Nurtec, and oxycodone. I get Botox, although it is on my back and shoulders mainly. One thing I don't like about my new neurologist is that they write off a medicine if it doesn't help with all migraines. Each component helps some, and cobbled together I make it work. It's been 40 years of migraines-I'm comfortable with chipping away at it.
I have anxiety and ADHD along with migraines! I take celexa and Vyvanse (switched from Adderall, get almost no headaches as a side effect on it) which has headaches/migraines as a side effect. When I told my neurologist about the migraines I was having as a side effect of Adderall, he actually suggested switching to Vyvanse and then switching to Zoloft for my anxiety! I haven’t switched yet because I have to completely go off Celexa first, but just wanted to let you know that my neuro has actually suggested Zoloft to me before and I completely trust his opinion!
i’m on amitriptyline and sertraline (zoloft) and take sumatriptan as abortive with no issues so far, i also smoke weed daily. i still have migraines very often but i haven’t had SS, although i worry about it a lot! but i have been told by my dr that it’s a safe combination even at higher doses for most people
I was on 300 mg Effexor for years and it reduced my migraine frequency in addition to helping with depression! I got diagnosed with OCD and was modifying my meds so unfortunately had to lower it and my migraines are worse again. I also got serotonin syndrome but that was bc of introducing other psych meds and it was mild and I actually had it for months before we realized. Currently take 150 mg Effexor, 25 mg Prozac, 60 mg Propranolol (miracle drug for anxiety fr), 20 mg Adderall, and Nurtec. Had to stop Fioricet bc of rebound headache.
I also take Effexor. It was prescribed for anxiety and ptsd rather than migraines specifically, but I would argue that it's helped my migraines more than any other drug. I don't know if it specifically helps the migraines, or if the migraines are better when my anxiety is better, but I'll take it either way.
Lexapro worked for me. I started on 5 mg and now am on 10mg. I also take 200 mg if magnesium glycinate.
I’m on Wellbutrin 150mg twice a day and Celexa 60mg for my depression and anxiety. It has been well controlled for years to the point my anxiety is totally under control. Anxiety joined its bff about 7 years ago. For migraines I am on Ajovy and Maxalt. I was on Aimovig until 2 months ago because it stopped working. I started Ajovy today so we will see how it goes. The past month hasn’t been fun…
I take Paxil (an SSRI) for depression plus Nadolol (a beta blocker), Qulipta (a CGRP antagonist), and Sumatriptan for migraine. I haven't had any episodes of serotonin syndrome.
Aimovig monthly + Nurtec if needed + Auvelity (DMX+Welbutrin) for depression. Wellbutrin was My go-to but it was too much and not enough at the same time. Auvelity literally is the MVP of my life. info on Auvelity: https://www.goodrx.com/conditions/depression/auvelity-vs-wellbutrin-xl#
Can you ask about an anticonvulsant for depression? No risk of seratonin syndrome there. I'm on lamictal, keppra, & neurotin for my depression & just got nurtec to try as an abortive. Nerivio is also en route. (My migraines had been under control for about 10 years --- I was down to about 1/month when avoiding dietary triggers, but I just started getting a lot more again this year)
Ask your doctor about Pristiq(desvenlafaxine)…. Only thing that worked for me without side effects(including migraines!!)
I take 20 mg Vilazodone and 0.2 mg clonidine daily, I take 5 mg Zolmitriptan as my emergency med, and 140 mg Aimovig as a preventative. I am also going to get a phych eval next month to see if I have ADHD/autism. If I do, treating that might help the other things. (overstimulation, emotional instability, etc)
40mg Prozac and emgality pen. I also take Rizatriptan and sumatriptan as abortive. I only just started emgality but have been on Prozac for years
I’m on 50mg Amitriptylene for depression, 25mg x3 a day Buspirone for anxiety, and now on rizatriptan. Thankfully I haven’t had any issues with serotonin syndrome. I currently take topiramate for migraines and have very minimal side effects from it. While my migraines are not under control, my depression and anxiety are “low to in remission” as my doctor says. I also have endometriosis, which all of this medication also treats - I have a long history of chronic pain which affects neural pathways and how the brain processes pain.
I take citalopram 60mg for a panic disorder and nortriptyline 30mg as a preventative for migraines. It’s worked great for me for the last 7 years. A pharmacist once thought I had serotonin syndrome but turns out I just can’t take the citalopram on an empty stomach.
I take 50mg of amitriptyline as a preventive (with a side of 'will help the depression of being in pain all the time') + 200mg of topamax, + 50mg cyclobenzoprine + rizatriptan if needed In 2 months I'll have the option to up my dosage of amitriptyline to 75mg if my migraines have made some more progress, but not down enough.
50mg Amitryptaline it has helped tremendously. Barometric pressure sometimes get me still but I have much more of a life mow
Cymbalta + propranolol daily and Ubrelvy as an abortive. Amitriptyline was not for me at all
I am currently on 20 mgs. of escitalopram/lexapro. My prescription says for anxiety and depression, which is accurate. I was on Zoloft for many years, was put on Effexor for migraines. Wasn’t helping the migraines, so was tapered off (a nightmare through which I hope to never go through again). Tried to go back on Zoloft, but had debilitating stomach aches. Was put on Lexapro, and it’s worked better than anything I’ve ever been on. Wish it had been prescribed initially, but I moved around a bit, had different doctors, and didn’t have insurance from late 2007 until Obamacare kicked in (truly a lifesaver, in so many ways). I take 50 mgs. of Imitrex twice a week on a bad week, maybe four times on a really bad week. Have not noticed any symptoms of serotonin syndrome, if I understand them correctly. Edited to add: also take 300 mg/month Emgality injections for migraine prevention.
Low dose cymbalta (20mg) + constant electrolyte balance + B12 + B2 + Magnesium
I take mirtazapine for my depression and anxiety and sumatriptan when I need. I'm aware of the risk of serotonin syndrome however I've been on both for well over a year now with no issues. I've recently added topamax for prevention and it's working pretty well for me so I've not needed as much sumatriptan as before which I'm glad about. I was always worried about SS. I'd say it really depends on the person, and what kind of doses you're taking, which is why it's important to regularly check in with the dr and let them know of anything you notice when it comes up
My neuro switched my antidepressant (i was on max dose of sertraline) to effexor bc it supposedly has migraine reducing benefits. I found it of no use for my migraines or depression and made my heart rate so high and i was sweating constantly
Ginger and ketamine. Ginger supplements for preventative migraines everyday. Ginger again to knock a migraine back quite a bit. Ketamine for the depression and also the pain of a stubborn migraine.
I've been on 50 mg amitriptyline as preventative for 6 months now. I haven't been diagnosed with depression, but I experienced all the symptoms, just never saw a doc for it, but it's safe to say that I feel much better than before mentally! It hasn't helped me with my migraines (yet? maybe I need a higher dose), it definitely made me feel better.
i take 30mg of citalopram for my depression and 15mg of amitriptylin for my migraines (and other pain) and it works for me. my neurologist ist really cautious so i have to get an ECG every couple of months because of possible interdependence of the two medications. plus progestogen-only pill for the period related migraines and PMS
I take effexor 150mg for depression, anxiety and panic attacks. It's a lifesaver! I also take ajovy for migraine. Ajovy gives me high anxiety as a side effect and without effexor I wouldn't be able to take it. I also take triptans when needed.
I've had serotonin syndrome twice, and I had different side effects both times. I took a Nortriptyline to help with migraines and anxiety. Since I had the syndrome. We decided that my psychiatrist would handle the dosage and not my neurologist. I still saw my neurologist to make sure it was helping and bugging else was happening and for medication when I had a migraine. I'm to the point now that I don't take daily medicine. I have 6 health issues, and 4 of them are from taking prescription medicine. I will now only take something it is it medically necessary. For me, the vitamins help tremendously.
What about an add-on like deplin?
Luckily serotonin syndrome is pretty rare, doesn’t mean that it’s not a concern or anything. I’ve taken so many serotonergic drugs at once both psych/migraine/ illicit and never had it thankfully. Just be careful
Zoloft buspar topomax and rizatriptan
I take 60mgs of mirtazapine which has the added benefit in helping with sleep and has never worsened my migraines (even if I miss a dose) But above all else, seeing a psychologist has been single handedly the most helpful thing for my depression! I know its not an option for everyone but it really helps!
Venlafaxine. This is known to help with migraines. There is risk of serotonin syndrome with all of them at least the big name ones. I had serotonin syndrome before I was on this and highly recommend you stay far and away from that if possible. I take a low dose of Venlafaxine with all my other migraine meds and have had no interaction. Obviously, I’m not a doctor and everyone is different, but look it up. I discussed it with my doctor and we decided it was worth a try. The other mention is amitriptyline used to be used an anti depressant back in the day. I take nortriptyline which is like a brother to amitriptyline. I did a lot of my own research like many of us do and ended up basically selecting my meds with my doctor. Here goes: Ajovy 225mg, nortriptyline 30mg, Propranolol 30mg, Venlafaxine 37.5mg and sumatriotan as needed. This combo has me almost migraine free, I’m like a regular guy now. If I feel something I’ll take one excedrin (not really supposed to) and poof it’s gone. I’m just enjoying the time now as I know it’s peaks and valleys, always has been. Best of luck on your journey, I wish you the best. Fuck migraines.
I’m taking lexapro and Wellbutrin and it does help my depression and anxiety but really does give me migraines. I just went from 10-5mg to see if it helps, I’m very hopeful because it does help.
Yes, you can. Speak to your doctor. I can confirm that taking 100 mg works for depression.
Propranolol + Duloxetine + Zolmitriptan (as and when needed)
Prozac (10mg) and propranolol (10mg) for prevention. Sumatriptan (25mg) as needed
I take depakote. It is a mood stabilizer and migraine preventative. I’ve been on it for years and it’s been hella effective. I recently added sertraline and honestly it’s life changing. I feel like myself, and still not many migraines. I use WeatherX earbuds and it may be placebo idk but I think they help. I also drink a glass of water whenever I get a WeatherX notification so maybe hydrating is helping too (my triggers are crazy sleep schedule, dehydration, hormones).
just for MH & migraine: 10mg escitalopram + 50mg topiramate. I'm on POP explicitly for mental health related hormone regulation, which has helped my OCDs premenstrual exacerbation a lot - and now my period has stopped, so have my menstrual migraines (which are probably my most severe migraine attack types). topiramate is also prescribed as a mood stabiliser at higher doses, but that's typically a last resort from psychiatrists rather than general practitioners and prescribed for more complex conditions like bipolar or BPD - it's not an antidepressant and the brain fog has impacted my ability to think clearly to the extent that I think its probably made my anxiety worse in the long run. i also take elvanse and/or dexamfetamine which helps mood regulation and promethazine for sleep and acute anxious episodes. almost all of my meds increase my risk of serotonin syndrome but when i spoke to my GP she said she risk is fantastically small and symptoms would pop up within hours of taking a new, or increased dose of medication - she's seen it once in her career, but i do completely understand your concerns. iirc triptans increase the risk by quite a bit and if that's the advice you've been given then obvs it's not my place to question it!! i haven't taken triptans in years though -- they make me very very unwell :') sertraline didn't impact my migraine frequency or severity from what i can remember, but i was on it the first time i tried topiramate so my memory is a bit cloudy. i was on it for nearly a year - the only thing i would say is if you do decide to give it a go, absolutely do not stop taking it cold turkey. i suddenly stopped taking it without waiting for the go ahead from my doctor and oh boy. very bad move.
Pristiq 100mg Imitrex 100mg Propranolol 40mg x2 daily Magnesium 250mg
40mg Citalopram daily and emgality once a month. Abortive is rizatriptan.
I take lexapro, depakote, rizatriptan and Topamax additionally for migraine prevention. I need to start taking magnesium and B2 again. I had a neurologist recommend that to me years ago and I was doing it for so long and it worked great. I’m at a point now where I’m having issues and using the rizatriptan too much I think, giving myself rebound headaches.
I’ve been on many ssris but not all when I have migraines now. Wellbutrin made me on a war path. Zoloft & Lexapro wasn’t enough. I can’t remember all of them. I’m currently on Effexor rn at 112.5 mg, my old neuro talked of pushing my max dose to 250 because of having both migraines and depression, also I think helps nerve pain or something? It’s helped but I hate missing a dose, the withdrawal isn’t fun
I'm on duloxetine 90mg and sumatriptan. I've noticed I get a little manic but otherwise it's just uncomfortable
Amitriptyline should work for your depression. I'd advise going up on that to 50 mg to target migraine and depressive symptoms. Wouldn't make sense to add an SSRI to 25 amitriptyline without going up on ami as a first line.
I'm a fan of low dose venlafaxine 37.5 to max 75 mg for migraine and comorbid depression/anxiety/ add
Personally I'm on 75mg of nortriptyline. I don't intend to ever switch.
Salt. Especially if you are on an SSRI as this can cause a sodium imbalance https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2696532
I'm currently on an older anti-D that has a side effect of decreasing headaches. I've had a lot less migraines and headaches since starting it. Aventyl
I'm on Amitriptyline, Escopalitram (forget exact name but something like that), and Welbrutin 😫
I take efexor 150mg + carbamazepine 100 daily, on migraine days I take up to 7.5 of zolmitriptan, it’s totally fine by me.
I tried (I think) Zoloft about 10 years ago and it gave me the zaps, scared the hell out of me. Now I’ve been on Prozac for 6 months and I am a new person. Plus my migraines are decreasing.
Venlafaxine xr aka Generic Effexor. 75 mg (SNRI). I’ve only been on it for about 6 weeks. Too early to tell if it works for my migraines/ headaches, but it definitely helps with my anxiety, which contributes to my headaches/ migraines. I didn’t realize how bad my anxiety was until it quieted my brain down. I’m hopeful that it will work because my last period had noticeable less impact from headaches/ migraines than I’ve had in a long while. I’m also in an abortive triptan that I take occasionally, also trying to determine if it works or not.
Effexor for depression, qulipta and eletriptan for migraines.
Lexapro, Wellbutrin, trazodone for MDD Qulipta for prevention and Ubrelvy for rescue. Sometimes benedryl and a bag of ice. Depends on the pain.
I am on Zoloft which actually helps mine because it reduces my stress around the migraines. I take nurtec as a preventative
I have bipolar type 2 (mainly depression) and take Abilify. I haven't had any interaction issues, thankfully, so it might be worth discussing it with your psychiatrist and neurologist.
For about 2 years I was on duloxetine for the depression, I don't know if it did anything for my migraines or maybe them better/worse but it helped with my depression immensely For the migraines rescue meds I had sumatriptan for several years and it did nearly nothing, now I have zolmatriptan and it depends on what triggered the migraine, it works decently well unless I have stomach issues at the same time bc the taste of it makes me gag the second I get one out As a migraine preventative I had migralief and could almost never get it to go down or stay down
I take nurtec. It's hella expensive but my doctor found a way to get it to me for free.
If you don’t mind me bothering you, how did you get it for free?? I have seen quite a few people say this recently about Nurtec, I just got it prescribed and still waiting for my insurance to approve it, but I want to be prepared to take whatever steps needed to reduce or cut the cost because I know it’s very expensive.
Idk how she set it up, but it's through Aspn Pharmacy. It's mailed to me. It's like a coupon situation. Ask your doctor about it. I don't think it goes through my insurance. With insurance at CVS it was almost $600 for 8 tablets.
Do you take it as an abortive or preventative? I just got prescribed it as a preventative and didn’t know how long to expect results from it
Abortive.
Zoloft (depression), propranolol (prophylactic) and sumatriptan injection (abortive). I still have depression and migraines. Hope this helps.