Thursday Thirteen #131: My Prescription Interactions

When TB and I went to see that snotty pain management doctor who wouldn't administer the spinal epidural last October because he said he was afraid TB would break his table (yes, he said that), he also said something else that scared us then. He looked at the list of meds that TB and said something to the effect--with your size and sleep apnea I'm surprised you haven't passed away in your sleep. When TB said he uses a C-PAP machine, the doctor said well, that's probably what saved you this far.

That was a shocker. And then there is what happened to Heath Ledger--this seemingly healthy young man died from a combination of legally prescribed medications. It hasn't been that long since Anna Nicole Smith and her young adult son also died of an accidental overdose, a combination of medications.

I had to go online and look. My Thursday Thirteen this week is:

13 Scary Interactions My Prescriptions Can Cause

1. Cymbalta and Zoloft can have a major drug interaction, causing a rare but potentially fatal serotonin syndrome. I later learned that this syndrome killed an 18 year old college student--it can happen to young healthy people as well as folks like me within hours of taking too many meds that overstimulate brainstem receptors.

2. Lamictal and Zoloft have a moderate drug interaction, working together to repress the respiratory system.

3. Cardizem and Lorazepam also have moderate drug interaction. They can work together to cause low blood pressure and depress the central nervous system.

4. Lisinopril and Lorazepam, moderate drug interaction, also can work together to cause low blood pressure and depress the central nervous system.

5. Lorazepam and Zoloft, moderate drug interaction, can combine to repress the respiratory system.

6. Lisinipril and Zolpidem, moderate drug interaction, can cause low blood pressure and depress the central nervous system.

7. Lisinipril and Zoloft, same as #6

8. Zoloft and zolpidem, moderate drug interaction, can cause central nervous and respiratory depression--especially in elderly or debilitated patients, non-ambulatory, I'm assuming

9. Zolpidem and Lamical, same as #8

10. Cardizem and Zoloft, moderate drug interaction, can combine together to form higher levels of the drugs that have to be metabolized by the liver.

11. Cardizem and Prevacid, same as #10

12. There are up to 2,354 other medications that interact with the ones I'm prescribed

13. There are lots of moderate food interactions with drugs I wasn't aware of. Grapefruit is a big no-no and I eat that all the time!

Heath Ledger was taking six medications with moderate drug interactions that combined to overwhelm his respiratory system. I'm thinking he stopped breathing while he was sleeping and didn't wake up again. When his breathing stopped long enough, his heart arrested.

I think that's what that snotty doctor meant when he said the C-PAPs probably saved us. A C-PAP provides continuous forced air even if you stop breathing, as happens with sleep apnea.

Do the benefits of my meds outweigh the risks? I take Cardizem and lisinopril because of high blood pressure. I take Prevacid because I have gastric reflux and also because of the pain meds I take. Cymbalta treats depression and fibromyalgic pain. Zoloft is an antidepressant and zolpidem is a sleep aid--Ativan. Lorazepam treats anxiety/panic attacks. Lamictal is a new kid on the block, prescribed because it seems I am bipolar. I am thinking that with the bipolar diagnosis, I want to get off the Zoloft and stop the Ativan.

I already have an appointment to talk to the doctor.

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Wake up, this is scary!

Like others, I was totally shocked when Heath Ledger died. He was so young, only 28 years old, and seemingly in good health. When the initial autopsy reports came back inconclusive, I had the horrible sinking feeling that he died from an accidental overdose of medications prescribed by his doctors. Today's report from the New York medical examiner confirms it. It's so sad that such a talented young man died but what is truly scary is that he wasn't abusing his medications--he wasn't necessarily even taking high doses of them. His father said,

"While no medications were taken in excess, we learned today the combination of doctor-prescribed drugs proved lethal for our boy. Heath's accidental death serves as a caution to the hidden dangers of combining prescription medication, even at low dosage."

Hidden dangers is right! I went to a website that will check drug interactions of prescribed medications and all the stuff Ledger took warned of "moderate" drug interactions--all of them depressed his respiratory system. Then I plugged in all the medications that I take and almost totally freaked out!

What are doctors thinking when they prescribe this stuff? All of them ask you for a list of meds when you go see them. None of them has ever told me about the possibilities of some of these interactions--I probably wouldn't be taking the stuff I am now had I known. Two of the meds I take for depression can cause a major interaction called serotonin syndrome. It says doctors should monitor patients "closely"--well, what does that mean? I don't particularly feel like I'm being closely monitored by any of my doctors except for the internist--for diabetes.

It's not just the depression and anxiety medications interacting with each other. They also apparently interact with the blood pressure and thyroid medications too, and all of those interact with each other. It's really scary! I'm sure that in many cases the benefits outweigh the risks but still! I printed out my report and will be showing them to my doctors. This is why patients have to question the doctors carefully when they're prescribed something.

I bet Heath Ledger never thought something his doctors would prescribe for him would work together to kill him!