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About Eric Brandt
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I am a practicing pharmacist.On my drug information website, I have answered hundreds of questions to date. The articles posted on my site include Parkinson`s disease. depression, menopause, diabetes, sleep and aging, congestive heart failure, calcium channel blockers, thyroid hormone replacement therapy, ADHD, multiple sclerosis an more.
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I have experience in retail as well as hospital pharmacy pracice. Currently working in a hospital pharmacy. I am experienced in drug information. Over the last 6 years I have developed a successful web site for drug information.
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You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > Maxalt & Lexapro - please help me
Expert: Eric Brandt
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
Hi Christa,
The following is the technical information for Maxalt (Rizatriptan)chemistry.
Rizatriptan is a selective 5-hydroxytryptamine 1BÄ1D (5-HT 1B/1D) receptor agonist. Rizatriptan binds with high affinity to human cloned 5-HT 1B and 5-HT 1D receptors. It has weak affinity for other 5-HT 1 receptor subtypes (5-HT 1A, 5-HT 1E, 5-HT 1F) and the 5-HT 7 receptor, but has no significant activity at 5-HT 2, 5-HT 3, alpha- and beta-adrenergic, dopaminergic, histaminergic, muscarinic or benzodiazepine receptors.
The primary route of rizatriptan metabolism is via oxidative deamination by monoamine oxidase-A (MAO-A) to the indole acetic acid metabolite, which is not active at the 5-HT 1BÄ1D receptor. N-monodesmethyl-rizatriptan, a metabolite with activity similar to that of parent compound at the 5-HT 1B/1D receptor, is formed to a minor degree. Plasma concentrations of N-monodesmethyl-rizatriptan are approximately 14% of those of parent compound, and it is eliminated at a similar rate. Other minor metabolites, the N-oxide, the 6-hydroxy compound, and the sulfate conjugate of the 6-hydroxy metabolite are not active at the 5-HT 1BÄ1D receptor.
You need to check with the lab as they would know if Maxalt (Rizatriptan) can cause false positive for amphetaines.
Thank you for using Allexperts
Sincerely,
Eric Brandt, B.Sc. Pharm
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