Anna S. (eliade) wrote,
Anna S.

Oh, for crying out LOUD. !&!%%)*#!!: a PSA

I was going to friends-lock this, but then I decided no, I want anyone to be able to see it--anyone who's interested, anyway--because maybe it could be helpful. It's probably only of special interest to people who are taking various combos of prescription meds, or thinking of taking antidepressants, etc.

So for a few years now, I've taken a medication to lower my blood pressure. A year ago, I began to try and find a better antidepressant, because a longstanding prescription of Wellbutrin wasn't doing much for me.

The sequence of my recent attempts at better living through chemistry:
  1. I start visits with a psychiatrist who was recommended by my general practitioner and seconded by my therapist. (My therapist can't prescribe medications.)
  2. The psychiatrist prescribes Prozac, then adds in Lamictal. Together, no trouble.
  3. When adding in an ADD/ADHD medication, he prescribes Adderall.
  4. At this point, I'm taking Prozac, Lamictal, and Adderall.
  5. New side effects: sharp rise in blood pressure; tachycardia (100-130+ pulse).
  6. Recommendation of my general practitioner: stop the Adderall.
  7. Recommendation of my psychiatrist: keep Adderall, and bump up the blood-pressure meds to compensate.
  8. I decide to go off Adderall, which sucks, because it's effective. I start Ritalin, which doesn't work and also has many negative side-effects.
  9. I quickly abandon the Ritalin, and at my psychiatrist's recommendation start taking Strattera instead, which is a different drug type (not an amphetamine like Adderall or Ritalin). It's only at this point that the psychiatrist says, "You'll need to stop taking the Prozac, because it has an interaction with Strattera."
  10. I go off Prozac--without tapering off, so that I can start Strattera--and my mood and energy plummet noticeably. Maybe related to cutting out the Prozac, maybe not.
  11. So now I'm off Prozac, off Adderall, and on Strattera. Note: I've been told that it takes several weeks for the effects of Strattera to be felt. So at this point it's safe to say that it doesn't factor in to any moods or issues of focus that I'm having. Anyway, with this combo, I'm feeling pretty crappy. And because I'm desperate to keep doing well at work, I've been "cheating" by taking Adderall now and then. It works well, and whenever I take it I'm reminded of how much I'd like to continue on it. So today I decide to research drug interactions a bit more and find out that:
    • Though there's a general warning that Adderall can inhibit effectiveness of blood-pressure medication, it doesn't have a specific interaction with the kind I'm taking.
    • None of the other drugs I've been taking have interactions, but
    • "FLUOXETINE may interact with AMPHETAMINES"
HELLO? So, Prozac (fluoxetine) interacts negatively with Adderall (amphetamine). This next quote is from a site I've found to be reliable:
Although the cause of this potential interaction is not clearly understood, fluoxetine may increase the effects of amphetamine. This could cause an increase in side effects including irritability and depression, restlessness, and anxiety. Other more serious side effects include an increase in blood pressure, a rapid heart beat, and an abnormal heart rhythm.

If fluoxetine and amphetamine are used together, your doctor may want to monitor you closely for side effects and adjust the dose of either drug if needed. Ask your healthcare provider about these drugs and this potential interaction as soon as possible.

This interaction is poorly documented and is considered major in severity.
Lesson? Do all the research yourself. Don't assume the doctor knows what the fuck he's doing.

And the thing is, I'd been saving all the documentation I got with each prescription, and had been asking all the right questions. I just hadn't paid close *enough* attention.

Of course, now that I've cut the Prozac, I want to see whether I can take the Adderall without any negative effects on my blood pressure, etc.

And now I'm returning to the work that I get paid to do. Later I think I may remedy my frustration by stuffing big wads of chocolate in my mouth and reading gay porn.
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