Stroke 'link' to combining medicines

When a stroke occurs part of the brain is severely damaged

Patients who combine common medications could be at increased risk of developing a stroke, new research suggests.

People taking "serotonin enhancing" drugs including newer anti-depressants, anti-migraine agents, decongestants, diet pills, amphetamines and the illegal drug "ecstasy" are at risk.

Research was carried out in the US on a small study group who complained of sudden "explosive" headaches.

Two out of the three patients had suffered a stroke, according to the study published in the scientific journal of the American Academy of Neurology.

The research also stresses the need for doctors to check whether patients suffering from severe headaches, have narrowing of the blood vessels in the brain, before administering any drugs.

Treatment of headaches usually involves prescribing serotonin enhancing drugs - those which boost the chemicals inside the brain responsible for carrying out communication in the brain and the body.

If the blood vessels have constricted then this type of drugs should be avoided.

The first patient in the study, a 46-year-old woman, took a common cold remedy for two days on top of her medication for migraine, depression and asthma.

The second patient, a 45-year-old woman, took a similar cold remedy on top of drugs for migraine, depression and obesity.

Drug checks

Both experienced sudden severe headaches and strokes.

The third patient, a 34-year-old man experienced a severe "explosive" headache and was treated with sumatriptan - a serotonin enhancer - which increased the intensity of the headache.

Tests showed reversible damage to parts of his brain, but no stroke had occurred.

The report's author Dr Aneesh Singhal said it was essential for doctors to check on the medication of patients experiencing severe headaches, but who may be suffering from migraines, depression or obesity.

He said: "We would stress the importance of asking these patients about use of such medications."

He suggested patients who present with sudden-onset headaches "may be best served by non-invasive evaluation of cerebral arteries for vasoconstriction, after conditions like brain haemorrhage have been excluded".

He said: "If vasoconstriction is suspected, serotonergic agents should be discontinued."

Professor Charles Warlow from the Association of British Neurologists declined to comment on the findings, saying they were inconclusive.