![[dr. bob]](/dr-bob-sm.gif)
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 Miska on October 15, 2008, at 12:59:20
Hi there,
I've been on 60mg cymbalta for 3 years, was on adderall xr 15 mg for 1 year and then stopped. Recently, MD put me on 75mg topamax for migraine prevention. Psych doc put me on Lamictal 50 mg and doubled cymbalta to 120 mg. PCP put me back on Adderall because I don't knoe left from right without it. The result is I am now taking:
Cymbalta
Adderall XR
Topamax
LamictalI'm also on birth control (Yaz).
I see 3 different doctors, and I don't know if they're even checking for interactions. Am I going to have a heart attack or a stroke or something?
By the way, i'm in my early 30's don't smoke, don't do drugs or alcohol.
It'd be helpful to meet someone else who's also on this combo (or cocktail, I should say)
cheers
Miska
Posted by Racer on October 15, 2008, at 13:25:14
In reply to 4 psych meds at once, posted by Miska on October 15, 2008, at 12:59:20
Hi, welcome to Babble! There are a lot of great people here, and a lot of brain power. I hope you'll like it here enough to stick around.
Meanwhile, while I haven't been on that particular combination, I have taken multiple psych drugs myself. In fact, right now I'm taking:
Wellbutrin XR
Vyvanse
Provigil
Rozerem
SAMe (under doctor's advice)
MetanXSo, multiple drugs aren't that unusual.
For the most part, yes -- doctors will check for interactions. Sometimes they miss some, but a good pharmacist will catch most of them. (One reason it's kinda wise to stick to the same pharmacy -- if they have all your records, they'll see possible interactions and call your doctor.)
Again, welcome to Babble, and I hope that your fears can be calmed about the possibility of interactions.
Best luck.
Posted by Phillipa on October 15, 2008, at 13:30:38
In reply to Re: 4 psych meds at once » Miska, posted by Racer on October 15, 2008, at 13:25:14
What Racer says is correct to ease your mind you can google drug checker second one you put your meds in after looking up I think you will get it when there and basically they will give you safety info and if the combo is safe. Oh and lots of times there comes up a mild to moderate interraction with mine anyway and welcome to babble. Phillipa
Posted by azalea on October 15, 2008, at 16:18:36
In reply to 4 psych meds at once, posted by Miska on October 15, 2008, at 12:59:20
Combinations of medications can provide benefits; however there is a risk of drug interactions. Lamictal reduces the efficacy of oral contraceptives. Perhaps you could discuss this concern with your prescribing doctor. In the meantime, consider using another method of contraception as Yaz may not work now that you're taking Lamictal.
> Hi there,
>
> I've been on 60mg cymbalta for 3 years, was on adderall xr 15 mg for 1 year and then stopped. Recently, MD put me on 75mg topamax for migraine prevention. Psych doc put me on Lamictal 50 mg and doubled cymbalta to 120 mg. PCP put me back on Adderall because I don't knoe left from right without it. The result is I am now taking:
>
> Cymbalta
> Adderall XR
> Topamax
> Lamictal
>
> I'm also on birth control (Yaz).
>
> I see 3 different doctors, and I don't know if they're even checking for interactions. Am I going to have a heart attack or a stroke or something?
>
> By the way, i'm in my early 30's don't smoke, don't do drugs or alcohol.
> It'd be helpful to meet someone else who's also on this combo (or cocktail, I should say)
> cheers
> Miska
Posted by Kimbersaur on October 15, 2008, at 18:32:45
In reply to Lamictal and Yaz » Miska, posted by azalea on October 15, 2008, at 16:18:36
> Combinations of medications can provide benefits; however there is a risk of drug interactions. Lamictal reduces the efficacy of oral contraceptives. Perhaps you could discuss this concern with your prescribing doctor. In the meantime, consider using another method of contraception as Yaz may not work now that you're taking Lamictal.
I've heard that about Lamictal and oral contraceptives but I don't think it is true for me, or maybe it isn't true for Yasmin and Yaz (they are very similar). I know this is anecdotal, but I've been on Lamictal and Yasmin and have been consistently sexually active with no other form of contraception for the past 4 1/2 years. I'm not saying that it doesn't happen, but I'm thinking the risk might not actually be THAT great. Too bad there isn't some test you can take to see how much they interact in your body.
On a side note, in all these years no doctor has ever mentioned this interaction to me and only one pharmacist has. Kinda scary if you think about it.
Posted by Miska on October 16, 2008, at 7:39:06
In reply to Re: 4 psych meds at once » Miska, posted by Racer on October 15, 2008, at 13:25:14
Thanks guys, that was helpful! Good advice, and I'll make sure to stick to the same CVS pharmacy (I try to support independent pharmacies, but their hours suck)
PS: I use Yaz for PMS, so not too concerned about contraception right now
Posted by yxibow on October 16, 2008, at 17:27:42
In reply to Re: 4 psych meds at once, posted by Miska on October 16, 2008, at 7:39:06
> Thanks guys, that was helpful! Good advice, and I'll make sure to stick to the same CVS pharmacy (I try to support independent pharmacies, but their hours suck)
> PS: I use Yaz for PMS, so not too concerned about contraception right nowIts more than sticking to the same pharmacy -- that may help, but I think the best strategy is to have a 3-way HIPAA signature between your three doctors.
I have a signature between my GP and my psychiatrist. (Actually between my psychologist and my psychiatrist as well, but not between my psychologist and my GP -- that would be irrelevant)
This way your doctor-patient privacy is preserved as a pool between the three doctors, but your doctors are in communication with each other and know the P-450 interactions that the pharmacy may not know immediately.
It helps even more if they have email/voicemail, but I don't know how your doctors manage their practice.
And as for 4 medications at once, I have 6, one non-psychiatric, and if an "experiment" is tried, well its 7. That's where a psychopharmacologist is really valuable in drug interactions. Still, there's no guarantee in prediction.
-- tidings
Jay
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.