Amitryptline and Prozac together?

2021.10.27 21:57 brinkdew Amitryptline and Prozac together?

Hi. 41 Female, hospitalized with intractable migraine. Ready to do whatever I’m told to get rid of this thing.
Drugs: Propranolol 60mg XR Cetirizine 10mg Adderall 15mg XR Magnesium Ox 500 mg twice daily B Vitamins Fluoxetine 10mg (kept low because according to genesight test I don’t process it quickly.)
So a 12-day prednisone taper failed to stop the migraine. I got a few hours of relief at a time from Benadryl/Reglan by IV, (3 times this month) but this came with a cost I think. I know I can’t take Benadryl regularly because depression will result. Now that the prednisone is out of my system I’m back to being allowed NSAIDs.
Discharge instructions: Double Prozac to 20mg Add amitryptline 10mg for sleep Add Ativan 0.5 for heart palpitations up to 3 times daily as needed
My blood pressure kept dipping into 80’s/40’s range while I was hospitalized, which was not fun, but bringing it back came with pain and heart palpitations. The dip was blamed on depakote, which they tried me on for the first time ever (on top of propranolol and prednisone and the migraine cocktail)
When healthy, my normal BP has been around 110/70 and resting heart rate in high 90’s.
Question: I’m seeing this big old warning about “serotonin syndrome” on combining Prozac and Amitryptline. Is this just for very high doses or something? How common is it to be prescribed both at once indefinitely?
Also, the propranolol does seem to help me feel better, should I have any concerns about taking Ativan with it?
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