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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by cubbybear on January 29, 2005, at 5:58:12
I just got out of the hospital (here in Thailand) for treatment of a bacterial infection and painful shoulder injury. I am presently taking MAOI Parnate, and I even gave a copy of the warnings and precautions in the Thai language to the hospital to insert in my file when I was admitted. I received Amoxycillin for the infection, Neurontin for the pain, plus Xanax for sedation,all of which are OK with the Parnate.
One evening I found a pill in the cup that didn't look familiar. It was "Ultracet." I was able to borrow a copy of the Thai version of PDS and saw that this med contains Tramodol, which is VERY risky with any MAOI. The next night, I found a tiny pill that turned out to be Nortriptyline, a TCA anti-depressant, which is ordinarily totally contraindicated with MAOIs. Obviously, somebody on the staff fully screwed up.
In all fairness, I realize that here in Thailand, where MAOIs are not even available,doctors know next to zero about them, and mistakes are more likely than in an English-speaking country where these drugs are more well known.
But, we MAOI users can't ever be TOO careful.
If ever given a pill in any hospital, we must ask exactly what it is and what it's for. We must determine somehow on the spot, from a reliable source like the PDR or conversation with the hospital pharmacist, if there are any contraindications. Don't let any nurse bully you either.
Had I not checked these meds out, the tiny Nortryptiline pill could have given me a lot more life-threatening headache than I had had to begin with, and the same goes for the Ultracet.
cubbybear
Posted by alienatari on January 29, 2005, at 6:25:28
In reply to Don't Swallow ANYTHING you're not sure about!, posted by cubbybear on January 29, 2005, at 5:58:12
Gosh thats terrible, Thank God you were alright and didnt take the pills.
Im on Parnate myself, if I ever have to go to hospital I will make sure to double (tripple!!!) check my medication.
That really is awful.
Take care
Chris.
Posted by KaraS on January 29, 2005, at 19:54:29
In reply to Don't Swallow ANYTHING you're not sure about!, posted by cubbybear on January 29, 2005, at 5:58:12
You really have had a lot going on your life lately. It's a good thing you're so educated and proactive. I hope you're finding that the Parnate is still working for you and that you were just going through a rough patch.
Take care,
Kara
Posted by gardenergirl on January 29, 2005, at 20:51:34
In reply to Re: Don't Swallow ANYTHING you're not sure about! » cubbybear, posted by KaraS on January 29, 2005, at 19:54:29
Very good advice. I would even go so far as to suggest that everyone do this, MAOI user or not. My uncle was given another patient's IV antibiotics while in the hospital recently. This was a large and well-respected hospital in the States, so language barrier was not a problem. Carelessness is.
And if you are going to be incapacitated, it would be good to have someone with you to do this for you. You can't be too careful.
gg
Posted by Maxime on January 29, 2005, at 22:40:25
In reply to Re: Don't Swallow ANYTHING you're not sure about!, posted by alienatari on January 29, 2005, at 6:25:28
You ALWAYS have to careful. I was on Parnate and was prescribed Lamictal and the pharmacist misread it and I received a trycyclic antidepresant called Sumontil. If you have ever been on Lamictal you will know that you have to raise the dose gradually. By the time I was at 150mg I was having awful side effects. I had read the bottle but I figured Sumontil was a generic version ... I didn't know that one didn't exist.
I finally looked up Lamictal and it wasn't what I was taking!
And no, I was not able to sue. But now if I start a new med I check on the Internet to make sure they look the same.
Maxime
Posted by cubbybear on January 30, 2005, at 3:51:58
In reply to Re: Don't Swallow ANYTHING you're not sure about! » cubbybear, posted by KaraS on January 29, 2005, at 19:54:29
> You really have had a lot going on your life lately. It's a good thing you're so educated and proactive. I hope you're finding that the Parnate is still working for you and that you were just going through a rough patch.
>
> Take care,
> KaraYes, you're very observant and empathetic. January has been the worst month I've had in years. And now that I'm back home from the hospital, infection is cleared and shoulder injury is slowly healing, I'm back to having to deal with the demons of anxiety, which never left the innermost recesses of my mind in the first place. I upped my dose of Parate from 30 to 40 mg. two weeks ago and my gut feeling is that it's probably doing its job and helping to prevent me from being a total basket case otherwise. But it's very hard to accept the fact,despite what several doctors and people on this board have said, that anxiety can break through at times. Maybe I've just been lucky not to have had any ongoing anxiety issues for so long. The underlying concern about my mother ('s health) is probably the root problem.
I switched to a new psychiatrist at the local Bangkok Hospital here and my initial impressions are positive. He is no benzophobe and did not hesitate to write prescriptions for Xanax and Klonopin for me. I'm going to speak to him about altering the whole dosing schedule--I prefer to keep the Xanax in abeyance and use during better times, just for transient insomnia. I'd rather use the Klonopin for more extended relief during the day and to help me sleep. I tend to be hard on myself and UNDERUSE the benzos as prescribed, because I'm afraid about getting habituated and then having to wean myself off in the long process. But I guess that these awful times dictate that I have to take the benzos more frequently. Also praying that the increased Parnate dose will be manifest in feeling much better before long. Sorry for the long reply; it's Sunday here, and Sundays always make me feel worse.
Posted by KaraS on January 30, 2005, at 13:50:14
In reply to Re: Don't Swallow ANYTHING you're not sure about! » KaraS, posted by cubbybear on January 30, 2005, at 3:51:58
> > You really have had a lot going on your life lately. It's a good thing you're so educated and proactive. I hope you're finding that the Parnate is still working for you and that you were just going through a rough patch.
> >
> > Take care,
> > Kara
>
> Yes, you're very observant and empathetic. January has been the worst month I've had in years. And now that I'm back home from the hospital, infection is cleared and shoulder injury is slowly healing, I'm back to having to deal with the demons of anxiety, which never left the innermost recesses of my mind in the first place. I upped my dose of Parate from 30 to 40 mg. two weeks ago and my gut feeling is that it's probably doing its job and helping to prevent me from being a total basket case otherwise. But it's very hard to accept the fact,despite what several doctors and people on this board have said, that anxiety can break through at times. Maybe I've just been lucky not to have had any ongoing anxiety issues for so long. The underlying concern about my mother ('s health) is probably the root problem.
>
> I switched to a new psychiatrist at the local Bangkok Hospital here and my initial impressions are positive. He is no benzophobe and did not hesitate to write prescriptions for Xanax and Klonopin for me. I'm going to speak to him about altering the whole dosing schedule--I prefer to keep the Xanax in abeyance and use during better times, just for transient insomnia. I'd rather use the Klonopin for more extended relief during the day and to help me sleep. I tend to be hard on myself and UNDERUSE the benzos as prescribed, because I'm afraid about getting habituated and then having to wean myself off in the long process. But I guess that these awful times dictate that I have to take the benzos more frequently. Also praying that the increased Parnate dose will be manifest in feeling much better before long. Sorry for the long reply; it's Sunday here, and Sundays always make me feel worse.
>
>Cubbybear,
Not a problem. I asked because I wanted to know how you were doing. I understand completely your reticence to take benzos regularly - but sometimes you just have to. It's kind of amazing that you found a good psychiatrist in Bangkok when so many can't seem to find a good one here in the states.Anyway, my thoughts are with you. Please keep us posted on your progress.
Kara
This is the end of the thread.
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