Are you mixing antidepressants with OTC medicines for cold, flu, and more?

The risk of falling prey to viral respiratory infections is ever present. They range from bothersome sore throats, common colds, and sinusitis to the ongoing resurgence of viruses like respiratory syncytial virus (RSV), influenza, and COVID-19.

The symptoms of upper respiratory tract infections come with different levels of severity. These can include fever, chills, body aches, cough, sore throat, congested or runny nose, ear pain, headaches, and exhaustion. Most people tend to self-medicate with over-the-counter remedies for relief.

Although the evidence varies, guidelines propose that orally taken medications like cough syrups or cold and flu tablets could have a limited but potentially positive impact on managing upper respiratory infection symptoms, especially in adults and children above 12 years old. These may include:

  • Paracetamol (like Panadol) or ibuprofen (like Nurofen) for pain or reduce fever

  • Decongestants like phenylephrine (Chemist’s Own Day + Night Cold & Flu Relief) or pseudoephedrine (like Sudafed) to ease congestion

  • Expectorants (like DURO-TUSS Chesty Cough Liquid Forte) and mucolytics (like CHEMISTS’ OWN Chesty Mucus Cough Liquid) to help thin and clear mucus from upper air passages

  • Manage dry coughs using dextromethorphan (like Robitussin Dry Cough Forte)

  • Manage runny noses or watery eyes with either sedating or non-sedating antihistamines (like Polaramine or Allertine)

But what if you are also on antidepressants?

An examination of over 5,000 inquiries from consumers seeking cough and cold advice through an Australian national medicine call centre unveiled a recurring theme: drug interactions, which comprised 29% of the queries.

Even at our pharmacy, numerous patients buying over-the-counter medications frequently inquire about possible interactions with their current medications. This practice is especially crucial for patients taking antidepressants, who should always consult a pharmacist before self-medicating. 

For instance, if a patient is already on a Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant and then takes an oral decongestant (like pseudoephedrine or phenylephrine), it can lead to symptoms like irritability, insomnia, or drowsiness, as well as potential effects on blood pressure.

What happens when these drugs interact?

Serotonin, a powerful natural chemical in charge of brain and nerve functions, also has the ability to narrow blood vessels. Medicines that impact serotonin levels include antidepressants to decongestants, dextromethorphan, L-tryptophan, antimigraine treatments, and amphetamines.

Pairing medications like antidepressants and decongestants, both of which lead to increased serotonin levels, can result in a range of discomforts. These might include irritability, headaches, sleeplessness, digestive issues like diarrhoea, and changes in blood pressure – often a rise in blood pressureSome individuals may encounter orthostatic hypotension, a drop in blood pressure when standing up, along with dizziness.

When serotonin levels reach extreme highs, severe symptoms like confusion, rigid muscles, fever, seizures, and, in rare cases, even death have been documented. Although these symptoms are less common, if you are taking an SSRI anti-depressant and  experience any of them, it’s important to halt the use of the cold and flu medication immediately and seek medical assistance immediately.

In conclusion

The best way to prevent unwanted drug interactions is by being informed about your medicines whether they are prescriptions, OTC, or supplements.  At Heathershaw’s we take our role in preventing unwanted side effects (both mild and serious) seriously, and are available to provide advice on drug interactions, dosage and much more.  

If you are on antidepressants and require cold and flu treatments or have any questions pertaining to your medication, please do not hesitate to ask our friendly team of expert pharmacists – Jenny, Gavin, Michelle, Maria, Amy or Jill

Opinions or facts expressed within the content have been sourced from various news sources. While every effort has been taken to source them accurately, the pharmacy, its owners, staff or other affiliates do not take any responsibility for errors in these sources. Patients should not rely on the facts or opinions in the content to manage their own health, and should seek the advice of an appropriate medical professional. Further, the opinions or facts in the content do not reflect the opinions and beliefs of the pharmacy, its owners, staff or other affiliates. 

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