Psycho-Babble Medication Thread 450411

Shown: posts 1 to 8 of 8. This is the beginning of the thread.

 

Dextromethorphan+Lamictal+Wellbutrin = Interact?

Posted by Lonely on January 30, 2005, at 23:37:31

My hubby is on Lamictal 50 mgs. a day for BP2. He's also on Wellbutrin 300 mgs a day.

For the past 3 weeks he's been coughing like crazy, it was unproductive for quite a while, then he starting coughing up clear stuff. But, he couldn't eat or sleep or talk without having a choking cough and turning purple. No fever, no sign of flu or cold so we think it's a hyper allergic state for the first time in his life. He also has MS.

After going to an ENT who acted like nothing was wrong and telling his neurologist who ignored my question, we gave him Allegra which dried him out, 4 days of decreasing Aristocort (now he has hypoglycemia) and finally, today, added an over-the-counter Dextromethorphan with guifenesin which did ease the coughing but left him with what he described as the bad side of being drugged but none of the pleasant side effects. He's pretty agitated and hyper.

Okay, the question is and I haven't been able to find this on the net ... does the ingredient in the cough med - Dextromethorphan - interact w/Lamictal and/or Wellbutrin? His agitation and choking and the lack of interest from doctors is driving me crazy. Will the cough drug aggrevate the bipolar?

Also, is coughing and choking typical of a bipolar 2? I sure haven't heard of such a thing. Ironically, when he was on Trileptal, and was coughing from previously using ACE inhibitors, he got better re the coughing. So, I'm wondering if there is a "brain" or "neurological" component to all of this?

 

Re: Dextromethorphan+Lamictal+Wellbutrin = Interact? » Lonely

Posted by Larry Hoover on January 31, 2005, at 19:16:21

In reply to Dextromethorphan+Lamictal+Wellbutrin = Interact?, posted by Lonely on January 30, 2005, at 23:37:31

> After going to an ENT who acted like nothing was wrong and telling his neurologist who ignored my question, we gave him Allegra which dried him out, 4 days of decreasing Aristocort (now he has hypoglycemia) and finally, today, added an over-the-counter Dextromethorphan with guifenesin which did ease the coughing but left him with what he described as the bad side of being drugged but none of the pleasant side effects. He's pretty agitated and hyper.
>
> Okay, the question is and I haven't been able to find this on the net ... does the ingredient in the cough med - Dextromethorphan - interact w/Lamictal and/or Wellbutrin?

Yes. Wellbutrin inhibits the destruction of dextromethorphan. The result is akin to overdose, even though normal therapeutic doses are taken.

> His agitation and choking and the lack of interest from doctors is driving me crazy. Will the cough drug aggrevate the bipolar?

No, I don't believe so. The disinterest or lack of communication with your treating physicians is most alarming, though. You shouldn't be in the position of having to guess at treatments.

If you have an internist, I'd suggest you try and get a general assessment of his condition. Prolonged coughing is not a good thing.

> Also, is coughing and choking typical of a bipolar 2? I sure haven't heard of such a thing.

No, it's not related to a mood disorder.

> Ironically, when he was on Trileptal, and was coughing from previously using ACE inhibitors, he got better re the coughing. So, I'm wondering if there is a "brain" or "neurological" component to all of this?

I doubt it. The response to the steroid and antihistamine suggest a sensitivity reaction of some sort. It could even be the Lamictal that is triggering this, despite having been on it for a period of time. Delayed sensitivity reactions are not unheard of, but I think a doctor should be involved in sorting this out with you. I hope there is another one you can find who will work through this with you.

Good luck,
Lar


 

Re: Dextromethorphan+Lamictal+Wellbutrin = Interact? » Larry Hoover

Posted by Lonely on January 31, 2005, at 19:31:30

In reply to Re: Dextromethorphan+Lamictal+Wellbutrin = Interact? » Lonely, posted by Larry Hoover on January 31, 2005, at 19:16:21

Thanks, Lar. What you've said is helpful and makes sense.

One thing I forgot to mention was that he started to get better over 2 weeks ago and then began his Copaxone injections for multiple sclerosis. It was 2 days later that he definitely got worse and the real choking began. I took him off Copaxone after 5 injections - he can go back when he gets well.

I guess I haven't used the "magic word" here enough with doctors
- C - H - O - K - I - N - G They ignore the coughing part.

Also just learned this afternoon he's not bipolar (!!!) but per psychiatric med school prof he's (for billing purposes) Mood Disorder, NOS. I'll write more about that in a different post.

Again, thanks for coming to our rescue!


> > After going to an ENT who acted like nothing was wrong and telling his neurologist who ignored my question, we gave him Allegra which dried him out, 4 days of decreasing Aristocort (now he has hypoglycemia) and finally, today, added an over-the-counter Dextromethorphan with guifenesin which did ease the coughing but left him with what he described as the bad side of being drugged but none of the pleasant side effects. He's pretty agitated and hyper.
> >
> > Okay, the question is and I haven't been able to find this on the net ... does the ingredient in the cough med - Dextromethorphan - interact w/Lamictal and/or Wellbutrin?
>
> Yes. Wellbutrin inhibits the destruction of dextromethorphan. The result is akin to overdose, even though normal therapeutic doses are taken.
>
> > His agitation and choking and the lack of interest from doctors is driving me crazy. Will the cough drug aggrevate the bipolar?
>
> No, I don't believe so. The disinterest or lack of communication with your treating physicians is most alarming, though. You shouldn't be in the position of having to guess at treatments.
>
> If you have an internist, I'd suggest you try and get a general assessment of his condition. Prolonged coughing is not a good thing.
>
> > Also, is coughing and choking typical of a bipolar 2? I sure haven't heard of such a thing.
>
> No, it's not related to a mood disorder.
>
> > Ironically, when he was on Trileptal, and was coughing from previously using ACE inhibitors, he got better re the coughing. So, I'm wondering if there is a "brain" or "neurological" component to all of this?
>
> I doubt it. The response to the steroid and antihistamine suggest a sensitivity reaction of some sort. It could even be the Lamictal that is triggering this, despite having been on it for a period of time. Delayed sensitivity reactions are not unheard of, but I think a doctor should be involved in sorting this out with you. I hope there is another one you can find who will work through this with you.
>
> Good luck,
> Lar
>
>
>

 

Re: Dextromethorphan+Lamictal+Wellbutrin = Interac

Posted by mqduck on October 7, 2007, at 10:26:55

In reply to Dextromethorphan+Lamictal+Wellbutrin = Interact?, posted by Lonely on January 30, 2005, at 23:37:31

I apologize for being more than a year and half late, but perhaps other people who stumble on this through Google will find my reply mildly interesting...

I've noticed that Lamictal strongly counteracts the effect of certain recreational drugs, including DXM. On a mild trip, it can virtually nullify the effect.

Whether it also counteracts the cough suppressing effect, I don't know... but it seems likely.

 

Re: Dextromethorphan+Lamictal+Wellbutrin = Interac » mqduck

Posted by mqduck on October 7, 2007, at 10:28:18

In reply to Re: Dextromethorphan+Lamictal+Wellbutrin = Interac, posted by mqduck on October 7, 2007, at 10:26:55

Heh... more than TWO and a half years. Going senile already.

 

Re: Dextromethorphan+Lamictal+Wellbutrin = Interac

Posted by mqduck on October 7, 2007, at 10:39:35

In reply to Dextromethorphan+Lamictal+Wellbutrin = Interact?, posted by Lonely on January 30, 2005, at 23:37:31

And another comment:

"added an over-the-counter Dextromethorphan with guifenesin which did ease the coughing but left him with what he described as the bad side of being drugged but none of the pleasant side effects. He's pretty agitated and hyper."

DXM is certainly not a euphoric drug (and there's no universal feeling of "being drugged"). If anything, it's dysphoric. It can be scary and... dark, in my experience. Any pleasure gained from taking DXM is a secondary effect resulting from finding the primary effects fun, interesting and/or enlightening.

If his coughing is (well, "was" by now) so sever that he needs to take amounts of DXM that are psychoactive, he should seek a prescription for some codeine, IMO. Hopefully you can ("could have") somehow make your doctors more sympathetic than you imply they have been.

 

Re: Dextromethorphan+Lamictal+Wellbutrin = Interac

Posted by Lonely on October 7, 2007, at 13:20:29

In reply to Re: Dextromethorphan+Lamictal+Wellbutrin = Interac, posted by mqduck on October 7, 2007, at 10:26:55

Oh, goodness, I had forgotten about this. Re getting healthcare givers to be more sympathetic is ... well, a dream world. It's not a sympathetic industry and it IS an industry.

Two days ago as we had brunch before taking my husband to his MS infusion we listened to a bunch of ratty looking docs next to us talk about buying a machine and then finding patients they could diagnose to use the machine so they could get their $$$ on their investment. My husband said he wanted to go over and point to himself and say "this is the face of a real patient."

He's reduced Lamictal now and was off Wellbutrin probably shortly after I made the post. Now he's on Depakote and 100 mgs Lamictal. He's finally diagnosed as manic depressive and the least little thing sets him off whether human interaction or add/subtract any other med. Antidepressants made him worse for years but psychiatrists did not listen and he didn't want me to go with him. I finally forced the issue despite the meanness. His brain is being destroyed by MS among other things. He is H*** to live with. My life and health are suffering as a result.

I can't exactly remember what dextromethorphan is but if it's the stuff that's replaced Sudafed, it's known to cause strokes. It just about sent me off the deep end so I sign for REAL Sudafed w/backing of docs who really know me. I have chronic sinusitis.

Incidentally, I have NO USE for recreational drugs.


 

Re: Dextromethorphan+Lamictal+Wellbutrin ((mqduck

Posted by cumulative on October 12, 2007, at 22:05:57

In reply to Re: Dextromethorphan+Lamictal+Wellbutrin = Interac, posted by mqduck on October 7, 2007, at 10:39:35

"DXM is certainly not a euphoric drug"

I strongly disagree. Dextromethorphan inhibits the dopamine reuptake pump. At lower doses I find it powerfully euphoric and stimulating in a weird sort of way -- at higher doses, indeed, I wasn't really in my body.

Wellbutrin could definitely interact with dextromethorphan -- IIRC they may interfere with each other's metabolism, and as both hit the dopamine reuptake pump and lower the seizure threshold, if your friend is feeling some acute effect from adding the dextromethorphan I wouldn't be surprised.

DXM isn't even very effective for coughs. Try some theobromine, or better yet, opioids. Or some rest.


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