Antidepressants and Decongestants
September 30, 2019 10:33 AM   Subscribe

Fellow MeFites on SSRIs: what do you take for a cold?

I've been on citalopram for a few years. It works pretty well for me with minimal side effects. But with cold season coming around, I'm dying for a decongestant.

I don't really get coughs but I get horrible congestion with my colds. Before I was on meds, I took a sinus pill with pseudoephedrine for colds and they worked great. I asked my pharmacist and she said they're contraindicated with SSRIs, as are all other cold medications. She suggested a nasal spray instead, but it did way less for me.

It sucks because this has meant I have to take way more sick days. I used to be able to pop a pill and keep it contained during the day, instead I'm blowing my nose every 2 minutes for half a week.

Is there anything allowed that actually works for congestion?
posted by vanitas to Health & Fitness (13 answers total)
I have been on ssris for ages, prescribed by a doctor who also recommend pseudoephedrine for my sinus issues. I have heard of interaction issues with MAOIs but not SSRIs. I would double check with your doctor.

Personally when I am congested I feel like I'm drowning and not being able to breathe makes my depression and anxiety way worse. I have gotten close to suicidal when it's really bad congestion. It just isn't feasible for me to NOT take decongestants in those cases.
posted by joan_holloway at 10:40 AM on September 30, 2019 [3 favorites]

(NOT your pharmacist) The major issue with SSRIs as I understand it is cold medicines containing dextromethorphan, which can potentially trigger serotonin syndrome. That is a cough suppressant, not a decongestant.
posted by praemunire at 10:42 AM on September 30, 2019 [1 favorite]

This site reports no problem. Since you shouldn't get real medical advice from the web, I'd check with your doctor and a different pharmacist.

When I have a cold, spicy soup, usually Thai or Chinese hot & sour, helps get things clear, briefly, but pseudoephedrine is necessary.
posted by theora55 at 10:44 AM on September 30, 2019 [2 favorites]

I asked my pharmacist and she said they're contraindicated with SSRIs, as are all other cold medications.

Your pharmacist is mistaken. I take 150mg of an SSRI every day and Sudafed almost daily.
posted by DarlingBri at 10:51 AM on September 30, 2019 [5 favorites]

I don't do anything differently than I would without an SSRI; I take cold medicines and decongestants with my citalopram as needed.
posted by Stacey at 10:53 AM on September 30, 2019 [1 favorite]

I take citalopram daily and take sudafed regularly for sinus issues. Never heard of or had an issue.
posted by disaster77 at 11:01 AM on September 30, 2019 [1 favorite]

I'm on escitalopram and I always just take the congestion stuff (like sudafed), and also ibuprofen (another contraindicated medication). My doctor told me that if you're just taking it occasionally it is fine to take this stuff with an ssri.

I think you should check for yourself though.
posted by thereader at 12:29 PM on September 30, 2019

I was told amitriptyline has a major interaction with phenylephrine, which is in most decongestants. I tried Guaifenisen but didn't get any congestion relief. It might work for you, though, my FIL swears by it!
posted by brook horse at 6:16 PM on September 30, 2019

It's the cough suppressant dextromethorphan that's contraindicated (serotonin syndrome). Pseudoephedrine (decon) is fine, as is loratadine (antihistamine). NSAIDs are more "use with caution" - you'd likely have to take quite a bit to have an effect.
Source: Medlineplus and liberal use of claritin-D
posted by ahundredjarsofsky at 3:25 AM on October 1, 2019

A couple of days off. :)
posted by kawelch at 6:19 AM on October 1, 2019

I've been taking SSRIs for about a zillion years. I take pseudoephedrine (Sudafed) with no trouble at all.

Incidentally, nasal sprays like Afrin work only if your nasal passages are super inflamed and blowing doesn't help. In that case, decongestants won't have much effect. Afrin, if you need it, is miracle drug if you're super careful about using it (no more than twice a day, no more than two or three days in a row). No problem with SSRIs either, in my experience.
posted by holborne at 8:54 AM on October 1, 2019

Another SSRI (plus others) user and I've always taken the good Sudafed. No issues for me. My doctor didn't even bat an eye when I asked her.

My PCP prescribed me Flonase, but it isn't doing very much as my allergy season has started ramping up. But that is another option.
posted by kathrynm at 9:13 AM on October 1, 2019

i'm bipolar, so i have to stay away from anything with a "d" in the name. BUT, mucinex is magical,
posted by megan_magnolia at 3:46 AM on October 6, 2019

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