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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by ae on November 3, 2002, at 19:43:14
I'm new to this board, and have been intrigued by the different threads. I've had what docs call 'severe depression' for about the last four years, though I was also retro-diagnosed as having dysthimia throughout much of my childhood. I've had fairly good results with medication and ECT, but this fall, my mood has started to drop again, probably because I'm back in school again. I'm currently taking desipramine, geodon, trazodone, ritalin, and my doc just added wellbutrin to the mix. He originally had me on a plan that would build me up to 300mg/d of the wellbutrin. When I read the little info sheet, it said that complications may arise if one is concurrently taking a tricyclic AD, trazodone, and any beta-blockers (I'm also taking atenolol to combat the side effects from the ritalin), because they might lower my seizure threshold. I called my pdoc, told him my concerns. He got back to me after contacting his Pharm.d, and said I could go ahead and take it, but at half the original dose he had prescribed. I'm wondering now what would have happened had I taken the 300mg/d instead. This guy hasn't fostered a lot of confidence in me, but I'm stuck with him because of financial reasons. Has anybody had similar problems? Does anyone know about the interactions between this large group of medications?
Posted by Alan on November 3, 2002, at 20:25:18
In reply to nervous about pdoc incompetence, posted by ae on November 3, 2002, at 19:43:14
What was the one med or two meds that worked "fairly well" for you in the past? Have you changed? If so, for what reason - to explore?
Polypharmacy is good to a certain point but 5 drugs at once would concern me, especially if you were on 4 before - no matter the interaction potential. It seems like a re-evaluation of 4 with the possibility of trading one out at a time seems more meaningful to me...or at least narrowing it down to which major component of the 4 instinctively work best for you.
The misstep by your doc would raise red flags for me - especially if they had to consult a pharmrep for interaction info...if I understand you correctly. Siezure potential is not a minor nor acceptable risk when it comes to polypharmacy induced side effect.
Alan
This is the end of the thread.
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