Migraine Treatments & Bipolar
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Q:  Migraine Treatments & Bipolar


I was wondering if you had come across any research involving the use of seratonin altering drugs in therapies for illnesses such as migraine, bringing on bi-polar disorder or making it manifest itself in an individual that was perhaps genetically predisposed to the disease in the first place?


Dear Patricia -- 
I presume you mean medications like the "triptans" -- sumatriptan (Imitrex) and the like.  Let's see:  since I haven't heard of this, we start with a PUB MED search...

Searching "sumatriptan bipolar disorder" yields only some interesting research using the serotonergic agent as a "probe" into the serotonergic aspects of the illness, some of which are presumed to be shared with the way migraines are caused as well (what's that? not clear, that's what they're studying). 

Searching "migraine treatment bipolar", still not much to go on to answer your question.  One report on patients with bipolar disorder found that nearly half the women (44%) had migraines.  In the entire group, 27% of them used triptans.  So, if there was a really clear reaction, e.g. a negative one such as you ask about, there are a lot of people out there using triptans in bipolar disorder.  Therefore we might reason that if such a reaction occurs, it is uncommon or subtle -- but it would be much better to reach this conclusion through more deliberate research.  As you may know, even the antidepressants are being examined for the possibility that they might cause a serious reaction (namely, make people suicidal) and though you'd think that would be pretty easy to spot (big reaction, huge numbers of individuals using the medications), it remains unclear if such a reaction exists.  So, the point of that was, it may be a long time before we could tell you "no, no problem"; but at present, there is little evidence, at least that I know of or could find with a brief search, linking triptans and worsening of an underlying bipolar tendency. 

However, I could easily be missing some such evidence, so if somebody wants to enlighten me (evidence , not anecdote), write please. 

Dr. Phelps

Published November, 2004


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