AboutDr Alan Galbraith Expertise I can answer most questions on drugs, both medical and "recreational". Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease.
Organizations Institute of Biology, London.
Publications Principal author of "Fundamentals of Pharmacology" 4th Edition published in November 2003 by Pearson Education, Australia.
Expert: Dr Alan Galbraith Date: 4/19/2008 Subject: Maxalt & Lexapro - please help me
Question Almost Killed me!! Last week I was experiencing severe migraines. I went to the Doctor, and he prescribed both, 10 mg. Maxalt and 10mg. Lexapro for depression. I started taking the medication as prescribed, and became VERY ILL. Worse, I went to a drug screening and was found positive for Amphetamines. I HAVE NOT HAD ANY DRUG OTHER THAN MAXALT AND LEXAPRO IN MY SYSTEM. It is my understanding that the doctor should never have started me on both of these medications together at the same time because it causes Serotonin Syndrome. Again, IT MADE ME VERY SICK! If I am to understand it correctly, Maxalt is a selective 5-Hydroxytryptamine, and one of its components is N-Dimethyl-5. I read somewhere (and can not relocate the link) that Dimethyl metabolizes into Methamphetamine and Amphetamines. Is this correct? And where can I locate the information? Because of this false-positive test, they are threatening to send me away, and possibly take my children from me. Please, I beg you, please help me. Please. Thank you.
Answer Dear Christa
It is possible to prescribe Maxalt with Lexapro as serotonergic syndrome is uncommon with this mixture but you seem to have been one of the unlucky ones in more ways than one.
I have had a look at the structures of Maxalt and would not agree that it could be metabolised to an amphetamine or amphetamine metabolite, therefore I would conclude that you have shown a false positive for amphetamines which are not all that unusual. All I can say is that you ask for a retest. I would find it hard to believe that they would take such drastic action on only one positive analysis.
