Medication Side Effects
in [Bipolar]
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From: Markey on 12 Apr 2006 13:10 Does anyone know of where you could find the side effects of the "cocktail" of medications you take? Like the side effects of taking Lithium, Depakote, Lamectal and Seroquel together? I know there are sites that will give you the side effects of one medication. Are there any that will give you the side effects of more than one medication? Mark
From: m_kelbell on 13 Apr 2006 07:45 "Markey" <TodayNov13(a)aol.com> wrote in message news:1144861826.037128.143310(a)i40g2000cwc.googlegroups.com... > Does anyone know of where you could find the side effects of the > "cocktail" of medications you take? > > Like the side effects of taking Lithium, Depakote, Lamectal and > Seroquel together? > > I know there are sites that will give you the side effects of one > medication. Are there any that will give you the side effects of more > than one medication? > > Mark > > Probably not. What your really looking for are called 'drug interactions'. But by carefully reading about drug interactions on the detailed drug information sites (the one's that give as much info as the PDR) on all the drugs you're taking, you can probably come to some conclusions about possible problems. Then talk to your p-doc about what you've learned. Some pharmacists (the degreed ones, not pharm techs) are also very knowledgeable about interactions and may be able to answer your questions. (Are you actually taking lithium, depakote, lamectal and seroquel together? I sure hope not - as these 3 of these are mood stabilizers, and Seroquel although an antipsychotic can also act as a mood stabilizer for BP patients. On all 4 drugs, you would probably be so zonked you couldn't tell which way was up. I can't think of any circumstances where you would need more than 2 mood stabilizers together!!! Ask your doctor what's going on if he has you on all these. Get a 2nd opinion!!!) -- maryjane
From: Snell on 13 Apr 2006 19:16 Begging your pardon, Maryjane, but I only agree with some of what you say, and I think Markey should hear other opinions, too. I have an extra source of information about psychopharmacological practice because my Dad is a neuropsychiatrist. Obviously, he has nothing to do with my care, but he and I discuss his "interesting" cases, including the medication management issues. 1. I don't think that there's anything wrong, a priori, with taking lithium, Depakote, Lamictal and Seroquel together. There are synergistic effects among the drugs. In my case, for example, Lamictal and Depakote are maintenance medications, but I take the Seroquel as needed if I'm having a "black mania" or a really bad anxiety blow-out. 2. Further, when you say "...as 3 of these are mood stabilizers[.]" Well, no--Lamictal has significant antidepressant activity, and is now being prescribed as monotherapy for depression without manic features. Neither Lamictal NOR Depakote is technically, originally, a "mood stabilizer"--they both started their careers as antiseizure meds. I think making an oversimplification in classification can sometimes confuse issues, rather than elucidating them. 3. IMO, it's not a good idea to question the pharmacological regimen of another person unless you know that person very, very well. Even if you were a doctor, you haven't seen this patient (Markey); you don't know his/her medical, familial, and psychosocial history; you don't know about other conditions he may have that might be causing him to take "all 4 drugs". Maybe if one of those four (4) pillars is removed, his treatment collapses. You don't know. Sorry if that seemed like a "blast," but though your opinion is clear and well-written, I don't agree. Markey--as for telling which drugs is doing which--I can usually tell, just from paying really close attention to how I feel. One way to learn how each drug affects you is to take (with pdoc supervision of course) a "holiday" from a drug. If you discontinued the Depakote, for example, how might you feel different? This can lead to some hypothesis about how it makes you feel when you do take it. I don't throw my hat in with the "all polypharmacy is bad" and "one should take as few drugs as possible" crowd. I think that *adequate and sufficient treatment* should be the goal. So the real question for Markey: Are you getting adequate and sufficient treatment? Are you able to manage the side effects of that treatment? Best, Snell
From: m_kelbell on 14 Apr 2006 06:15 Dear Snell & Markey, Your probably right. I overreacted to that med combination. I'm certainly not a doctor or pharmacist. But having had some bad personal experiences with drug interactions & side effects, I'm very hot on being an informed patient. When ever anyone has questions about drug interactions and mentions 4 drugs, I tend to suspect they may be having some side effects. The main point I should have made is this - when in doubt first ask the prescribing doctor. He/She's the one who really needs to know about any problems. But I am a strong believer in being a well informed 'mental health consumer' (that's what they're calling us mentally ill folks here in Texas now!) - read up the med facts in the box insert, check the internet drug info pages (esp. the ones by the drug company), and check with others here about what side effects they may have experienced. Knowledge is Power!! In Texas we only get to see the MHMR community health clinic p-doc's once every 3 months. But I learned my lesson the hard way - if I'm having problems and suspect its one of my med's I pester pester pester the nurse and doctor at MHMR till I get an answer - no more suffering 3 months for me!!! After all its your body and your mind here being effected - not the p-doc's!! -- maryjane ** (But you also need to give the drugs time to work. Your doctor should tell you when is earliest time you can expect the drug to help, and also how long to give the drug a fair trial (4 weeks, 6 wks, 2 months, etc.) Unfortunately, with some meds you will experience the difficult side effects before you get to the good results.) "Snell" <ripleysnell(a)gmail.com> wrote in message news:1144970186.743730.85540(a)i39g2000cwa.googlegroups.com... > Begging your pardon, Maryjane, but I only agree with some of what you > say, and I think Markey should hear other opinions, too. > > I have an extra source of information about psychopharmacological > practice because my Dad is a neuropsychiatrist. Obviously, he has > nothing to do with my care, but he and I discuss his "interesting" > cases, including the medication management issues. > > 1. I don't think that there's anything wrong, a priori, with taking > lithium, Depakote, Lamictal and Seroquel together. There are > synergistic effects among the drugs. In my case, for example, Lamictal > and Depakote are maintenance medications, but I take the Seroquel as > needed if I'm having a "black mania" or a really bad anxiety blow-out. > > > 2. Further, when you say "...as 3 of these are mood stabilizers[.]" > Well, no--Lamictal has significant antidepressant activity, and is now > being prescribed as monotherapy for depression without manic features. > Neither Lamictal NOR Depakote is technically, originally, a "mood > stabilizer"--they both started their careers as antiseizure meds. I > think making an oversimplification in classification can sometimes > confuse issues, rather than elucidating them. > > 3. IMO, it's not a good idea to question the pharmacological regimen > of another person unless you know that person very, very well. Even if > you were a doctor, you haven't seen this patient (Markey); you don't > know his/her medical, familial, and psychosocial history; you don't > know about other conditions he may have that might be causing him to > take "all 4 drugs". Maybe if one of those four (4) pillars is removed, > his treatment collapses. You don't know. > > Sorry if that seemed like a "blast," but though your opinion is clear > and well-written, I don't agree. > > Markey--as for telling which drugs is doing which--I can usually tell, > just from paying really close attention to how I feel. One way to > learn how each drug affects you is to take (with pdoc supervision of > course) a "holiday" from a drug. If you discontinued the Depakote, for > example, how might you feel different? This can lead to some > hypothesis about how it makes you feel when you do take it. > > I don't throw my hat in with the "all polypharmacy is bad" and "one > should take as few drugs as possible" crowd. I think that *adequate > and sufficient treatment* should be the goal. > > So the real question for Markey: Are you getting adequate and > sufficient treatment? Are you able to manage the side effects of that > treatment? > > Best, > Snell > >
From: Cybil Cyclone on 14 Apr 2006 08:21
Well, it looks as though one may have to be careful with answers which are only opinions and we should know that when we post or reply to posts. As far as Snell's comments go, each patient has a right to privacy and you discussing patient's and medication with your father does not make sense to me. That confidentiality that we deserve and have rights to is discussed over dinner? I'm not trying to cause trouble; but these are support discussion groups and every one of us has a right to our opinions without someone jumping out about them. I agree with m-jane and her answer. I agree because I am a disabled and retired nurse. I have some knowledge and OPINIONS about psychotropic drugs and I am going to answer with my opinion. Lactimal and Depakote are not antidepressants. They are specifically for mood stabilizing and most people take one or the other. I, for one, was weaned from depakote to lactimal decreasing doses of depakote with increasing doses of lactimal. Now, I am strictly on lactimal. I would question my doctor if he kept me on depakote and lactimal together, especially adding lithium. Lithium works as a mood stabilizer. It has antidepressant qualities but is used mainly to alleviate mania. Most take a anti-depressant with lithium, depakote, or lactimal. Seroquel is a rather new drug and is used as an anti-depressant and also as an anti-psychotic. It is used to help other drugs but I know people that take that alone. Not knowing the dx or tx plan, it's hard to say anything of concrete value. Most bi-polars take an anti-depressant with a mood stabilizer. There may be some good reason. I still would question that to a doctor or call a pharmacist (one that works behind a store desk). I think Markey ought to know that he is taking a cocktail concoction. I would definitely get with a psychiatrist ASAP. Just my opinion, Take care, Cybil |