Migraine Medications
Juggling Drug Combos

Migraine medications, when mixed with other drugs, don't always give expected results. Anxiety disorder medicine is no exception. Over-the-counter remedies, either. Effects can be non-existent. Too strong. Or, poisonous.

What are your options?

Show and Tell

Know exactly what's in your medicine cabinet.

Tricky mixes for migraine medications

Over-the-counter medication can be sneaky. They appear harmless. But, can seriously mess with your medication for anxiety disorder, migraine or depression.

Watch out for...

  • Cough medicines. 
  • Anti-nausea remedies.
  • Antibiotics. 


  • Pain relievers.
  • Antacids.
  • Hay fever medicine.
  • Anti-fungal remedies.

Keep packages and pill containers with labels listing ingredients.

Show and tell your doctor, pharmacist, or psychopharmacologist. Get the best advice on do's and don'ts. Then, ask what to expect when 'rules are broken'. You could be in for a rude awakening.

Migraine Medications

They aim to prevent – hold off, or stop migraines cold...abort them.

Preventive - prophylactic – medication

They shave off how often, how hard, and how long, migraines last. The severe, repeated ones. More than 2 migraines a month is good reason to move into preventive medicine. And,  helpful when you want to beat depression to control ocd.

Several look familiar, too, as treatment for anxiety disorder:

Tricyclic antidepressants

  • Elavil
  • Endept
  • Tryptanol
  • Laroxyl


  • Manerix
  • Nardil
  • Parnate

As well as the SNRI, Effexor.


  • Topamax
  • Depacon
  • Valproate
  • Neurontin

...can reduce attacks, length and intensity of pain. Lamictal, for migraine with aura.


  • Tenormin
  • Toprol XL
  • Lopressor  

A calcium channel blocker, Verapamil, under brands of Calan, Verelan or Isoptin, can also give migraine relief.

Abortive Migraine Medication

... can be prescribed or bought over the counter. Its purpose is to stop migraine in its tracks. And, most effective, when taken at the first sign of pain.

Unwanted bleeding, overdoses, and overuse, are possibilities. And, risky to ignore.


Are prescribed. Not all mix well with anxiety disorders medication. Even depression medication. So, go over this with your doctor before you decide. It's important.

Others are Amerge, Frova, Maxalt, Imitrex and Zomig.


This medication stimulates serotonin. Not a good thing when mixed with TCA's, MAOI's, SSRI's, or SNRI's. They boost serotonin, too.

Ergot examples...

  • Migergot
  • Cafergot

Keep in mind,...

Ergots, now, aren't as popular as triptans. But, an ergot derivative, D.H.E. 45, injected, can work. With less side effects to boot. Migranal Nasal Spray is another option.

Over The Counter Medication

...can abort migraines. There are non-narcotic pain killers such as...

  • Ibuprofen.
  • Naproxen sodium.
  • Aspirin. 

1000 mg of Aspirin could knock out a migraine. But, be a recipe for ulcers, gastrointestinal bleeding. Taken with some tricyclic antidepressants or SSRI's, increases risk of bleeding.

Others contain acetaminophen - APAP.

  • Tylenol
  • Acephen
  • Vitapap 

...are examples. They're okay for mild migraines. But, don't have the punch to knock out severe attacks. Taking more than what's recommended, in one shot, won't help either.

Narcotic pain relievers, such as codeine, can be migraine busters. But, there's always the danger of dependency. Or, drug tolerance. And, having even more headaches.


Caffeine is in many migraine medications. Yes, it boosts the pain-killing effect. But, it's a stimulant. And, triggers an already over-active fight flight or freeze response in anxiety disorders. This spells trouble.


Caffeine is almost non-existent in your diet.

New Approach to Stop Pain

One more thing...

Research has gone on for a very long time to find a way to block migraine pain. Stop the headache before it explodes. Science may be at the cusp of making available medicine do this very thing.

Calcitonin gene-related peptide - CGRP - a neurotransmitter, is found at a high level in the blood of migraine-sufferers. Drugs are now in development as migraine-fighters. Targeting specifically CGRP to tone down its over-activity, what causes the pain.

This could be, in the very near future, a godsend for so many who haven't had much success with other treatments.

Drug Interaction

Combining medications can help you thrive. Or, poison. One drug can lessen the effect of the other. Or, make it super strong.

Some migraine medications clash with anxiety disorder drugs. Others don't.

  • Relpax, Axert, Amerge and Forva get along with MAOI's. 


  • MAOI's Marplan, Nardil or Parnate, aren't a good mix with triptans Maxalt, Imitrex, and Zomig. 
  • Prodrin (acetaminophen, caffeine, and isometheptene) is an enemy for any MAOI.

An ergot combined with Prozac or Luvox, is highly toxic. Or, the channel blocker Verapmil, with Xanax.

  • The SSRI Luvox, keeps migraine medication Axert or Relpax from working properly. 
  • Dilantin and Provigil increase the effects of triptans Axert and Relpax. 

So does...

  • Inderal on triptan, Maxalt. Cutting Maxalt's dosage in half, helps.

Here's what else...

Imitrex, a triptan, stimulates serotonin. Combine this with other drugs doing the same, and results can be serotonin syndrome. A potential killer.   

Migraine medications, mixed with other drugs, is tricky business. And, THE time to get advice for do's and don'ts from your psychopharmacologist, pharmacist or doctor. You won't regret it.

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