Cold Medicine Interactions With Antidepressants and Bipolar Medication

Woman blowing her nose
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Earlier today your throat started getting sore, your voice roughing up a bit. By noon you were sneezing and you killed more than half your box of tissues. When you go home from work exhausted and achy you discovered you’re running a fever.

Stop! Before taking any over-the-counter cold or flu remedy, you need to be aware of the possible cold medicine interactions with your prescriptions.

Psychiatric Medication Interactions With Cold and Flu Remedies

Pretty much every class of drug used to treat psychiatric conditions—antidepressants, antipsychotics, tranquilizers, anticonvulsants, etc.—has the potential to interact poorly or even dangerously with the common active ingredients in OTC medications, such as pseudoephedrine, diphenhydramine, dextromethorphan or guaifenesin. For example:​

  • MAOI antidepressants should not be taken with any over-the-counter cough or flu medications.
  • The sedating effects of antipsychotics and tranquilizers can be greatly increased when taken in conjunction with most cough medicines.
  • The list of antidepressants that have major interactions with dextromethorphan is extensive.

Should You Stop Psychiatric Prescriptions When You Are Treating a Cold or Flu?

No. Many of these medications have withdrawal effects that can make your illness that much worse (consider SSRI discontinuation syndrome). And when you are already feeling down and sluggish, slipping into depression is a possibility. It isn’t a good idea to push this risk further by stopping your antidepressant.

The most important thing you can do for yourself is to schedule an appointment with your doctor or give your favorite pharmacist a call. Your medical professionals can review your list of prescriptions and recommend safe treatments for your cold or flu.

Also, there are a number of good old "grandma" remedies and non-drug options that can help:

  • The ubiquitous “get plenty of rest.”
  • Drink lots of fluids; consider opting for water or sports drinks that are low in sugar.
  • Avoid public areas and minimize contact with others. When your immune system is compromised with one illness, you don’t want to risk picking up another from someone else. (It’s also not very nice to share your illness with others.)
  • Eat healthy simple foods. (Yep! Grandma’s chicken soup.) You need to keep up your strength, but you don’t want to aggravate a tummy that isn’t feeling well.
  • Hot tea with honey can be soothing.
  • Gargling with warm salt water can decrease swelling and ease the discomfort of a sore throat.
  • A saline nasal spray may help relieve sinus congestion.

So give your doctor a call, take care of yourself, and feel better soon.

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Article Sources
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  1. Ereshefsky L, Jhee S, Grothe D. Antidepressant drug-drug interaction profile update. Drugs R D. 2005;6(6):323-36. doi:10.2165/00126839-200506060-00002

  2. Laban ST, Saadabadi A. Monoamine Oxidase Inhibitors (MAOI). StatPearls Publishing LLC. Updated April 7, 2019.

  3. Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ. 2017;189(21):E747. doi:10.1503/cmaj.160991

  4. Centers for Disease Control and Prevention. Sore Throat. Updated August 30, 2019.

  5. Centers for Disease Control and Prevention (CDC). Treatment: What You Need to Know. Updated April 22, 2019.

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