Concomitant triptan and SSRI or SNRI use: a risk for serotonin syndrome.

OBJECTIVE

To discern the prevalence of concomitant use of a triptan and a selective serotonin reuptake inhibitor (SSRI) or a selective serotonin/norepinephrine reuptake inhibitor (SNRI) in the USA.

BACKGROUND

In July, 2006, the US Food and Drug Administration warned patients and health-care professionals to be aware that use of a triptan in combination with an SSRI or an SNRI may result in a potentially life-threatening problem known as serotonin syndrome.

METHODS

We used weighted data from the US National Ambulatory Medical Care Survey for years 2003 and 2004 to derive national estimates of the number of office-based visits documenting concomitant use of a triptan and an SSRI or an SNRI.

RESULTS

During the time frame 2003-04, an annualized mean of 3,874,367 patients were prescribed a triptan, and 50,402,149 patients were prescribed an SSRI or an SNRI. An annualized mean of 694,276 patients were simultaneously prescribed or continued use of a triptan along with an SSRI or SNRI.

CONCLUSION

Our study documents that 1.3% of patients prescribed a triptan or an SSRI or an SNRI were prescribed the potentially fatal combination. While this is a small fraction overall, the actual number of patients on a nationwide basis is significant (n=694,276).