The use of serotonin-enhancing drugs -- including some newer antidepressants, antimigraine agents, decongestants, diet pills, and amphetamines -- can trigger strokes due to narrowing of cerebral blood vessels.

According to a study published in the Jan. 8, 2002 issue of Neurology, the scientific journal of the American Academy of Neurology, the use of multiple serotonergic drugs can cause sudden, severe headaches, seizures and stroke, particularly when combined with other vasoactive drugs.

The authors cautioned about the use of these drugs, particularly with patients who complain of severe or sudden headaches or other symptoms.

"We would stress the importance of asking these patients about use of such medications," said study author A. B. Singhal, M.D. of the Massachusetts General Hospital Department of Neurology.

Often, these patients are treated with drugs, which may be either causing the problem in the first place or have the potential for making things worse.

Instead of giving them additional medications, they "may be best served by noninvasive evaluation of cerebral arteries for vasoconstriction, after conditions like brain hemorrhage have been excluded," suggested Dr. Singhal. "If vasoconstriction is suspected, serotonergic agents should be discontinued."

SOURCE: Neurology, Jan. 8, 2002.