Posted by Squiggles on November 21, 2006, at 17:10:03
In reply to Re: Cluster or migraine with wine and clonazepam » corafree, posted by yxibow on November 18, 2006, at 3:36:33
> > Tks, but tried SJW & just got sleepy.
> >
> > But, I have a wart, on one of my fingers, and am pretty sad about it :(
> >
> > I could use 'a good dose of serotonin'!
> >
> > cf
>
> If its a real one, salicyclic preparations have been used for ages against them....
CORRECTION:the article i cited from PubMed on aspirin and
it toxicity for lithium is wrong... I misinterpreted the meaning - it was a combo of many ACEs and NSAIDs AND Aspirin that led to a toxicity NOT aspirin.Dr. Muller-Oerlinghausen B. (CNS Drugs;
Vol. 11, No. 1, Jan. 1999, pp 41-48*8)Abstract:
Long term lithium treatment will often be combined with other pharmacological treatments, due to the need to treat insomnia or anxiety, breakthrough episodes, co-existing psychiatric (schizoaffective psychoses) or non-psychiatric (particularly in elderly patients) disorders, or self-medication with over-the-counter preparations. Adverse drug reactions resulting from such combined medication are primarily pharmacokinetic, and much more rarely pharmacodynamic, in nature. The main risk in such interactions is an increase in the plasma lithium concentration due to decreased renal lithium clearance.
A serotonin (5-hydroxytryptamine; 5-HT) syndrome resulting from the combination of lithium and serotonergic antidepressants such as selective serotonin reuptake inhibitors, or neurotoxic reactions resulting most often from high doses of lithium and antipsychotics, may be observed. In addition, increases in the intra-red blood cell concentration of lithium may occur with simultaneous antipsychotic administration. Marked electroencephalogram changes and tonic-clonic seizures have been observed with the combination of lithium and clozapine.
Combined administration of lithium and anticonvulsants is generally considered to be well tolerated. Potential pharmacokinetic interactions with anticonvulsants appear to be of minor importance.
One of the most significant interactions with lithium is the decrease in renal lithium clearance which occurs with most nonsteroidal anti-inflammatory drugs, including ketorolac. Conversely, aspirin (acetylsalicylic acid) and sulindac do not increase steady-state plasma lithium concentrations.
Another well known interaction is the clinically relevant reduction of renal lithium clearance by combined administration of diuretics. Special caution should be exercised when prescribing thiazides for long term use in patients receiving lithium medication. Potassium-sparing compounds, excluding furosemide (frusemide), can also increase plasma lithium concentrations. Risk of lithium intoxication is increased by simultaneous administration of ACE inhibitors. Finally, a case of a patient with lithium intoxication caused by combined medication with the angiotensin II receptor antagonist losartan potassium (losartan) has been reported.
----------Squiggles
Dumb like a stump -- sorry about that
poster:Squiggles
thread:702961
URL: http://www.dr-bob.org/babble/20061117/msgs/705910.html