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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Acero on September 10, 2000, at 18:10:33
Hello, I'm an 18 year old male with who has smoked marijuana chronically for the past 3 years. Recently my doctor has prescribed me 50mg of zoloft per day for depression. I want to continue to use marijuana only on weekend for social use (not everyday as in the past) but when i questioned my doctor regarding this he said that the combination will produce liver failure. I'm skeptical to whether or not he's telling the truth. Can anyone here help me out?
Thanks, Steve
Posted by Phil on September 10, 2000, at 18:47:30
In reply to Marijuana + Zoloft = Liver Failure?, posted by Acero on September 10, 2000, at 18:10:33
Acero, That's a new one to me, liver failure? Are you seeing a family doc or a psychiatrists...let me guess...
One question though. If you have used pot chronically for three years, do you feel that you can control it to just weekends? Just wondering.Phil
Posted by Winfield on September 10, 2000, at 20:52:26
In reply to Re: Marijuana + Zoloft = Liver Failure?, posted by Phil on September 10, 2000, at 18:47:30
> Acero, That's a new one to me, liver failure? Are you seeing a family doc or a psychiatrists...let me guess...
> One question though. If you have used pot chronically for three years, do you feel that you can control it to just weekends? Just wondering.
>
> PhilAcero,
If you have smoked for the past three years, how
could one of the safest alternative medicines on
earth cause any problems with your liver. It's
doctors like that, that are causing fear in people.
If anything, the mj will help with the side effects
caused by the harsh chemicals in zoloft.
Then again he is a doctor, but from never having
met him, he may very well be a an anti drug crusader
and was trying to scare you into quitting. I say,
definatley get a second opinion on this one.
Also, I highly doubt that there have been any studies
done on the corellation between the two drugs.
Write back to let mee know how things are going.
Later
Posted by Acero on September 10, 2000, at 22:27:04
In reply to Re: Marijuana + Zoloft = Liver Failure?, posted by Winfield on September 10, 2000, at 20:52:26
> > Acero, That's a new one to me, liver failure? Are you seeing a family doc or a psychiatrists...let me guess...
> > One question though. If you have used pot chronically for three years, do you feel that you can control it to just weekends? Just wondering.
> >
> > Phil
>
> Acero,
> If you have smoked for the past three years, how
> could one of the safest alternative medicines on
> earth cause any problems with your liver. It's
> doctors like that, that are causing fear in people.
> If anything, the mj will help with the side effects
> caused by the harsh chemicals in zoloft.
> Then again he is a doctor, but from never having
> met him, he may very well be a an anti drug crusader
> and was trying to scare you into quitting. I say,
> definatley get a second opinion on this one.
> Also, I highly doubt that there have been any studies
> done on the corellation between the two drugs.
> Write back to let mee know how things are going.
> LaterHi, Thanks for responding. In regards to your questions, I am seeing a psychitrist and he is the one prescribing the medicine. I do feel i can control my marijuana use to once a week because the only reason i turned to chronic use was that i was homeschooled for high school and had nothing to do and alot of free time on my hands. Now i have a much busier life so i don't think i'll have a problem. I do believe this doctor may be trying to use scare tactics on me and i'm skeptical of his knowledge and judegement. During what was no more than a 10 minute evaluation he asked if i felt like people were watching me and i responded with a yes. He immediatley prescribed me risperdal. I was surprised and just sort of accepted it without questioning. When i returned home i look up some info on that and found it was for mental patients and stuff and it totally turns you into this zombie-like state. Also, the dosage he gave me was 5mg for 2 weeks and 10mg after that. I looked it up in "The Essential Guide to Prescription Drugs 1997 edition" and it said doses over 6mg aren't recommended. This really bothered me so i decided not to take the risperdal. Anyway, this decision that he made leaves me wondering if his call on Zoloft and Marijuana causing liver failure is true. There was another thread on this board about zoloft and marijuana and a few people posted saying they do the two drugs daily and are fine. The question of liver failure or anything never came up though. I could see this as a possible side effect if combined with alcohol, but i don't understand why marijuana would have anything to do with the liver.
Thanks,
Steve
Posted by stjames on September 11, 2000, at 1:18:25
In reply to Marijuana + Zoloft = Liver Failure?, posted by Acero on September 10, 2000, at 18:10:33
I think you are wasting money on a doc that has no
problem lying to prove his point. I would question
his judgement and not continue to pay to be lied
to.james
Posted by Cam W. on September 11, 2000, at 7:08:37
In reply to Marijuana + Zoloft = Liver Failure?, posted by Acero on September 10, 2000, at 18:10:33
Acero - We may not be able to tell the truth, but we tell you what current opinion and clinical observations have told us. I haven't heard of any liver damage with any of the SSRIs + marijuana. Ask your doc for his reference on this. I would be very interested in reading on the proposed mechanism of action.
Also, don't look upom Risperdal as an antipsychotic, look at it as a "mood modifier" or "mood stabilizer". It is used in many disorders from depression to OCD. Current opinion is not to use it in doses of greater than 6mg per days, to avoid the possibility of movement disorders (although, I have seen some people use 16mg per day without problems, I have wondered on the logistics of this). Doses of Risperdal should be started low (eg 0.5-1mg daily) and increased slowly, unless there is a need to increase the dose faster for it's sedative properties. Are you sure he started you on 5mg and not 0.5mg daily? Janssen does not make a 5mg tablet.
Hope this helps - Cam
Posted by noa on September 14, 2000, at 15:57:39
In reply to Re: Marijuana + Zoloft = Liver Failure?, posted by Cam W. on September 11, 2000, at 7:08:37
For whatever it's worth-----
I have heard, tho, that the SSRIs can handicap the liver's ability to metabolize other substances. What I take this to mean, tho, is that the effect of other substances might be stronger than usual.
I tend to think about how much work my liver has to do with all the meds I am now putting into my body, and feel inclined to choose carefully.
Posted by Mark H. on September 14, 2000, at 18:45:36
In reply to Marijuana + Zoloft = Liver Failure?, posted by Acero on September 10, 2000, at 18:10:33
Hi,
This is common knowledge (unless you've never heard of it), but plain ol' Tylenol taken too often becomes highly toxic and eventually causes liver failure. A friend's husband, used to "being tough" and working in the woods, thought he would deal with the pain of an accident by taking lots and lots of Tylenol while continuing to work. He died of liver failure about 6 weeks after starting his Tylenol regimen.
In combination drugs (Tylenol and codeine, for instance), it's NOT the codeine that will kill you, it's the Tylenol.
Please DO NOT exceed the recommended maximum dose for this common analgesic.
Now back to our regular programming....
Mark H.
Posted by sean o on July 6, 2001, at 8:14:46
In reply to Re: Marijuana + Zoloft = Liver Failure?, posted by noa on September 14, 2000, at 15:57:39
> Hey I have questions that someone might be able to answer. My girlfriend has been suffering from depression and she was just prescribed zoloft. Her doctor told her that marijuana would inhibit the drugs ability to help her. She wonders if this is true. She doesn't smoke pot that often, but she does like to have a joint after work sometimes. I could see how the chronic marijuana user may have problems, but is it really necesary for her to quit altogether?
Posted by SalArmy4me on July 7, 2001, at 8:48:35
In reply to Re: Marijuana + Zoloft = Liver Failure?, posted by sean o on July 6, 2001, at 8:14:46
Ecstasy is safe for your girlfriend, if you deny the mountain of evidence that proves that Ecstasy causes depression:
1: Bailly D. Related Articles
[Neuropsychiatric disorders induced by MDMA ("Ecstasy")].
Encephale. 1999 Nov-Dec;25(6):595-602.2: Henry JA.
Ecstasy and serotonin depletion.
Lancet. 1996 Mar 23;347(9004):833. PMID: 86223643: Pennings EJ, Konijn KZ, de Wolff FA. [Clinical and toxicologic aspects of the use of Ecstasy].
Ned Tijdschr Geneeskd. 1998 Aug 29;142(35):1942-6. Review. Dutch.4: Gerra G, Zaimovic A, Giucastro G, Maestri D, Monica C, Sartori R, Caccavari R, Delsignore R. Related Articles
Serotonergic function altered after (+/-)3,4-methylene-dioxymethamphetamine ('Ecstasy') in humans.
Int Clin Psychopharmacol. 1998 Jan;13(1):1-9.5: Liberg JP, Hovda KE, Nordby G, Jacobsen D. Related Articles
[Ecstasy--long-lasting effects]?
Tidsskr Nor Laegeforen. 1998 Nov 20;118(28):4384-
7. Norwegian.6: Schifano F, Di Furia L, Forza G, Minicuci N, Bricolo R. Related Articles
MDMA ('ecstasy') consumption in the context of polydrug abuse: a report on 150 patients.
Drug Alcohol Depend. 1998 Sep 1;52(1):85-90.7: Parrott AC, Lasky J. Related Articles
Ecstasy (MDMA) effects upon mood and cognition: before, during and after a Saturday night dance.
Psychopharmacology (Berl). 1998 Oct;139(3):261-8.8: Zhou FC, Tao-Cheng JH, Segu L, Patel T, Wang Y. Related Articles
Serotonin transporters affected by MDMA are located on the axons beyond the synaptic junctions: anatomical and functional evidence.
Brain Res. 1998 Sep 14;805(1-2):241-54.9: Curran HV, Travill RA. Related Articles
Mood and cognitive effects of +/-3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy').
Addiction. 1997 Jul;92(7):821-31.10: Yau JL, Noble J, Seckl JR. Related Articles
Site-specific regulation of corticosteroid and serotonin receptor subtype gene expression in the rat hippocampus following 3,4-MDMA: role of corticosterone and serotonin.
Neuroscience. 1997 May;78(1):111-21.11: Miller RT, Lau SS, Monks TJ.
2,5-Bis-(glutathion-S-yl)-alpha-methyldopamine, a putative metabolite of (+/-)-3,4-methylenedioxyamphetamine (MDMA), decreases brain serotonin concentrations.
Eur J Pharmacol. 1997 Apr 4;323(2-3):173-80.12: White SR, Obradovic T, Imel KM, Wheaton MJ. Related Articles
The effects of methylenedioxymethamphetamine (MDMA, "Ecstasy") on monoaminergic neurotransmission in the central nervous system.
Prog Neurobiol. 1996 Aug;49(5):455-79. Review.13: Immunomodulating activity of MDMA
Ann N Y Acad Sci. 2000;914:215-24.14: Pacifici R, Zuccaro P, Shannon, M.
Methylenedioxymethamphetamine (MDMA, "Ecstasy").
Pediatr Emerg Care. 2000 Oct;16(5):377-80.15: Nielsen JC, Nicholson K, Pitzner-Jorgensen BL, Unden M. Related Articles
[Abuse of Ecstasy (3,4-methylenedioxymethamphetamine). Pharmacological, neuropsychiatric and behavioral aspects].
Ugeskr Laeger. 1995 Feb 6;157(6):724-7. Review. Danish.16: McGuire PK, Cope H, Fahy TA.
Diversity of psychopathology associated with use of 3,4-methylenedioxymethamphetamine ('Ecstasy')
Br J Psychiatry. 1994 Sep;165(3):391-5.17: Riedlinger TJ, Riedlinger JE.
Psychedelic and entactogenic drugs in the exacerbation of depression.
J Psychoactive Drugs. 1994 Jan-Mar;26(1):41-55. Review.18: Peroutka SJ, Newman H, Harris H.
Subjective effects of 3,4-methylenedioxymethamphetamine in recreational users. Neuropsychopharmacology. 1988 Dec;1(4):273-19: Schmidt CJ, Taylor VL. Related Articles
Depression of rat brain tryptophan hydroxylase activity following the acute administration of methylenedioxymethamphetamine (MDMA).
Biochem Pharmacol. 1987 Dec 1;36(23):4095-102.20: Steele TD, Nichols DE, Yim GK. Related Articles
Stereochemical effects of 3,4-methylenedioxymethamphetamine (MDMA) and related amphetamine derivatives on inhibition of uptake of [3H]monoamines into synaptosomes from different regions of rat brain.
Biochem Pharmacol. 1987 Jul 15;36(14):2297-303.21: Frith CH, Chang LW, Lattin DL, Walls RC, Hamm J, Doblin R.
Toxicity of methylenedioxymethamphetamine (MDMA) in the dog and the rat.
Fundam Appl Toxicol. 1987 Jul;9(1):110-9.22: Gibb JW, Stone DM, Stahl DC, Hanson GR.
The effects of amphetamine-like designer drugs on monoaminergic systems in the brain.
NIDA Res Monogr. 1987;76:316-21.23: Stone DM, Stahl DC, Hanson GR, Gibb JW.
The effects of 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-methylenedioxyamphetamine (MDA) on monoaminergic systems in the rat brain.
Eur J Pharmacol. 1986 Aug 22;128(1-2):41-8.24: Schifano, F.
Human neurotoxicity of MDMA ('Ecstasy'): subjective self-reports, evidence from an Italian drug addiction centre and clinical case studies.
Neuropsychobiology. 2000;42(1):25-33. Review.
--The Salvation Army Adult Rehabilitation Center Command: Changing the World One Life at a Time
Posted by Wendy B. on July 7, 2001, at 9:29:53
In reply to Marijuana + Zoloft = More Depression » sean o, posted by SalArmy4me on July 7, 2001, at 8:48:35
Sal!
Sorry, I had to speak up here...This guy is asking about marijuana.
NOT Ecstasy! combined with Zoloft.What is all this mountain of citations on E.?
A confused,
WendyPS: To Sean:
I think, from actual experience using Zoloft and mj, that everybody's mileage will vary.
As when you smoke mj alone, the mood you're in
when you do it has everything to do with how you
feel afterwards. If I'm cranky, it gets heightened,
if I'm relatively happy, it makes me euphoric, etc.
When you're on Zoloft at the same time, and the
Zoloft is working, it can be a very nice
experience. The one side-effect on Zoloft I had was
weight-gain (30 lbs after 3 1/2 yrs!), so if you're
prone to the munchies, take it easy. I would say:
limit mj use to weekends... And don't let comments
or diatribes like SalArmy's scare you. It seems all
sorts of psych-prescribed, FDA-approved meds and
pills are A-O-K for them, but when it comes to an
ancient herb that's been smoked for millennia, THAT
substance should be illegal and banned and so on...> Ecstasy is safe for your girlfriend, if you deny the mountain of evidence that proves that Ecstasy causes depression:
>
> 1: Bailly D. Related Articles
> [Neuropsychiatric disorders induced by MDMA ("Ecstasy")].
> Encephale. 1999 Nov-Dec;25(6):595-602.
>
> 2: Henry JA.
> Ecstasy and serotonin depletion.
> Lancet. 1996 Mar 23;347(9004):833. PMID: 8622364
>
> 3: Pennings EJ, Konijn KZ, de Wolff FA. [Clinical and toxicologic aspects of the use of Ecstasy].
> Ned Tijdschr Geneeskd. 1998 Aug 29;142(35):1942-6. Review. Dutch.
>
> 4: Gerra G, Zaimovic A, Giucastro G, Maestri D, Monica C, Sartori R, Caccavari R, Delsignore R. Related Articles
> Serotonergic function altered after (+/-)3,4-methylene-dioxymethamphetamine ('Ecstasy') in humans.
> Int Clin Psychopharmacol. 1998 Jan;13(1):1-9.
>
> 5: Liberg JP, Hovda KE, Nordby G, Jacobsen D. Related Articles
> [Ecstasy--long-lasting effects]?
> Tidsskr Nor Laegeforen. 1998 Nov 20;118(28):4384-
> 7. Norwegian.
>
> 6: Schifano F, Di Furia L, Forza G, Minicuci N, Bricolo R. Related Articles
> MDMA ('ecstasy') consumption in the context of polydrug abuse: a report on 150 patients.
> Drug Alcohol Depend. 1998 Sep 1;52(1):85-90.
>
........ug addiction centre and clinical case studies.
> Neuropsychobiology. 2000;42(1):25-33. Review.
>
>
> --The Salvation Army Adult Rehabilitation Center Command: Changing the World One Life at a Time
Posted by stjames on July 7, 2001, at 20:03:28
In reply to Marijuana + Zoloft = Liver Failure?, posted by Acero on September 10, 2000, at 18:10:33
I would say you are paying your doc to lie to you.
How is this useful ?
James
Posted by Phil on July 8, 2001, at 1:06:25
In reply to Re: Marijuana + Zoloft = Liver Failure?, posted by stjames on July 7, 2001, at 20:03:28
> I would say you are paying your doc to lie to you.
> How is this useful ?
> James> >I'd have to agree. I think it's clear now that Zoloft can be a good augmenter of marijuana in many cases. No evidence of this but there are many anecdotal accounts of marijuana successfully augmenting many anti-depressant drugs.
Gotta go, smell the brownies burning!!! :-)
Posted by lsdtrip25 on July 16, 2001, at 22:50:52
In reply to Re: Tylenol Overdose = Liver Failure, posted by Mark H. on September 14, 2000, at 18:45:36
Hi,
We might ought to be careful even saying that overdoses of Tylenol cause liver failure. I'd like to know how much this "tough guy" was taking and how old he was. It's just not that easy to wipe out your liver. When I was 17 and in high school I did some stupid stuff, like taking over 25 tylenol tabs at once. I did this on at least 3 different occasions to feel high (sometimes they were OTC cold medications containing nearly the same amount of acetaminophen as Tylenol) and I was never treated for overdose and do not have liver problems to this day and never did.
Posted by sukarno on April 14, 2005, at 0:31:56
In reply to Marijuana + Zoloft = Liver Failure?, posted by Acero on September 10, 2000, at 18:10:33
This is an old thread and I'm not sure if anyone will read this, but at one point in time Zoloft was about to be pulled off the market because it was hard on the liver. I don't remember the details, but I do remember now that Zoloft is indeed hard on the liver, but I have no idea about marijuana. As far as we know, marijuana is hard on the lungs and possibly the heart.
Marijuana is safer than Zoloft and most prescription and OTC drugs.
If Tylenol or aspirin were discovered today, they'd never be approved by the FDA due to their toxicity.
Posted by crazykock on October 24, 2006, at 6:12:20
In reply to Re: Tylenol Overdose = Liver Failure, posted by Mark H. on September 14, 2000, at 18:45:36
Hello:
I have hep c but it is not active. I have been takeing tylenol. Day 1 and 2 took 1300 mg each and day three took 3900. I've been taking tylenol regularly and was not feeling well and was wondering about toxicity. Should I be concerned. What are the symptoms. My right upper quadrant is tight and there is pressure pain. I have nausea but no vomiting. No diarrhea. Took the 3900 dose 12 hours ago. How fast does this stuff clear your system and how does it accumulate?
Thanks
Carl
Posted by sukarno on October 24, 2006, at 9:58:01
In reply to Re: Tylenol Overdose = Liver Failure, posted by crazykock on October 24, 2006, at 6:12:20
That is too much Tylenol. Try taking only 500mg every 6 hours (no more than 4 times a day).
Tylenol is paracetamol (also known as acetaminophen). When ingested it is metabolised into reactive metabolite(s) that are toxic to the liver.
If you need pain control that requires that much Tylenol, you'd be better off to go to a pain clinic or have your doctor refer you to someone who specialises in pain control.
Narcotic analgesics, although they are controlled substances, are much safer than taking excessive doses of Tylenol as you are doing.Good luck and please don't take that much Tylenol again. 2000mg/day maximum.
Posted by Declan on October 24, 2006, at 14:22:18
In reply to Re: Tylenol Overdose = Liver Failure, posted by crazykock on October 24, 2006, at 6:12:20
You should be worried about toxicity. Do you *have* to take the Tylenol? Perhaps there are other ways of handling your pain? People with hepC should avoid Tylenol. Perhaps you could take aspirin? Or perhaps there are other natural less toxic antiinflmmatories that would suit?
Posted by ed_uk on October 24, 2006, at 16:21:02
In reply to Re: Tylenol Overdose = Liver Failure, posted by crazykock on October 24, 2006, at 6:12:20
Hi
>2000mg/day maximum
The maximum dose of acetaminophen is 4000mg per 24 hours. Single doses must NOT exceed 1000mg. No more than 1000mg should be taken within any 4 hour period. In the UK, the standard dose is 1000mg every four to six hours, which millions of people take every day. Acetaminophen only comes in 500mg tabs here, we do not have 325mg tabs. Side effects are rare at 1000mg q4-6, but certain groups are susceptible to toxicity and should avoid acetaminophen........
1. People who are malnourished or who suffer from anorexia nervosa.
2. People who have AIDS
3. People who take enzyme-inducing medications
4. People who are alcohol dependent or heavy drinkers
5. People with established liver disease
Take care
Ed
Posted by ed_uk on October 24, 2006, at 16:31:35
In reply to Re: Tylenol Overdose = Liver Failure, posted by crazykock on October 24, 2006, at 6:12:20
>Took the 3900 dose 12 hours ago. My right upper quadrant is tight and there is pressure pain. I have nausea but no vomiting
You took 3900mg all at once? I think you should contact your doc at once. Never take more than 1000mg at once. The dose must not be repeated within four hours. Never take more than 4000mg in any 24 hour period.
Posted by Mark H. on October 24, 2006, at 18:00:01
In reply to Re: Tylenol Overdose = Liver Failure » crazykock, posted by ed_uk on October 24, 2006, at 16:31:35
In support of what Ed recommends, you might want to read the brief article under "Introduction" at the following site: http://www.emedicine.com/emerg/topic819.htm
Best wishes,
Mark H.
This is the end of the thread.
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