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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by maxime on June 9, 2003, at 16:21:24
Hi all. I have a story to tell that we can learn from.
I went to the pharmacy today to pick up my new prescription for lamictal that my doctor gave me last week.
When I got home, I realised the pills were white and the pills I had been taking were pink. The new white pills did say Lamictal on them.
I knew the name was different on the pink pills but I thought they were a generic version of Lamictal because it started with "apo" which indicates a generic brand.
Turns out I have been talking Trimipramine Maleate, a trycyclic antidepressant.
Now I am already on an MAOI - Parnate. Last week I was having heart palpatations and severe nausea. I thought it was the Parnate.
Parnate and Trimipramine shouldn't be taken together.
I called the pharmacy and they looked up their records and said trimipramine is what the doctor prescribed.
I have called the doctor and left a message for her. I know mistakes can happen, but I do want her to know that a mistake has happened.
I am angry at the doctor but I am more angry at myself. I should have checked out the name of the drug on the internet when I first got it. It would have only taken a few minutes.
I am angry because I have been having mixed states like crazy and feeling suicidal. I was wondering when I would feel an effect from the lamictal. So now I have to start over at the 12.5 mg.
I know it's good that I figured out the error etc., but I have been taking the wrong med since April. I feel like I am now two months behind on way to feeling better.
Also, I could have a bad side effect to the real lamictal and not be able to take it all. Sigh.
From now on I am checking everything.
So be careful out there, OK? Check the bottles of the meds when you are starting a new one. Make sure you know what it is suppose to look like, especially if the med is available in a generic form.
Be careful out there!
maxime
Posted by maxime on June 9, 2003, at 16:31:23
In reply to An important lesson learned, posted by maxime on June 9, 2003, at 16:21:24
I spoke to the doctor and she was pissed off that I would suggest that she made a mistake. She said the pharmacy must have read it wrong. I told her that they have read it wrong twice because when I called them today they were firm that the prescription did not say lamictal.
I am saddened and angry that no one want to take ownership for the mistake.
Tomorrow I will go over to the pharmacy and ask to see the prescription.
I guess I am a naive person for thinking that someone would admit they are wrong.
Max
Posted by Larry Hoover on June 9, 2003, at 18:20:33
In reply to An important lesson learned, posted by maxime on June 9, 2003, at 16:21:24
> Hi all. I have a story to tell that we can learn from.
>
> I went to the pharmacy today to pick up my new prescription for lamictal that my doctor gave me last week.
>
> When I got home, I realised the pills were white and the pills I had been taking were pink. The new white pills did say Lamictal on them.
>
> I knew the name was different on the pink pills but I thought they were a generic version of Lamictal because it started with "apo" which indicates a generic brand.
>
> Turns out I have been talking Trimipramine Maleate, a trycyclic antidepressant.That is a bizarre error. The brand name for trimipramine, Surmontil, isn't even close to Lamictal, unless your doctor's handwriting is atrocious.
> Now I am already on an MAOI - Parnate. Last week I was having heart palpatations and severe nausea. I thought it was the Parnate.
>
> Parnate and Trimipramine shouldn't be taken together.The same pharmacy provided both?
> I called the pharmacy and they looked up their records and said trimipramine is what the doctor prescribed.
>
> I have called the doctor and left a message for her. I know mistakes can happen, but I do want her to know that a mistake has happened.
> I am angry at the doctor but I am more angry at myself. I should have checked out the name of the drug on the internet when I first got it. It would have only taken a few minutes.I know that taking personal responsibility for meds is important, but one shouldn't have to double check everything, all the time.
A few years ago, I was prescribed 10 micrograms of levothyroxine (the thyroid hormone, T4) as an augment to my antidepressant. Turns out there is no such dose, the smallest being 25 mcg. Without checking with the prescribing doctor, the pharmacist "corrected the error" to 100 mcg. I didn't catch this myself, and I was about 18 days into thyroid overdose before I figured out what was wrong.
Stuff happens, ya know? I hope you're not too pissed at yourself. It wasn't your mistake, even though you didn't catch it.
> I am angry because I have been having mixed states like crazy and feeling suicidal. I was wondering when I would feel an effect from the lamictal. So now I have to start over at the 12.5 mg.
>
> I know it's good that I figured out the error etc., but I have been taking the wrong med since April. I feel like I am now two months behind on way to feeling better.You're wiser in a way that could not be taught to you.
> Also, I could have a bad side effect to the real lamictal and not be able to take it all. Sigh.That's always a possibility, but let's not get ahead of ourselves, 'kay?
> From now on I am checking everything.
I do....now.
> So be careful out there, OK? Check the bottles of the meds when you are starting a new one. Make sure you know what it is suppose to look like, especially if the med is available in a generic form.
>
> Be careful out there!
>
> maximeThanks for sharing your story with everybody. It's an important lesson, just as you said in the subject line.
Lar
Posted by maxime on June 9, 2003, at 22:04:16
In reply to Re: An important lesson learned, posted by Larry Hoover on June 9, 2003, at 18:20:33
Hi Larry - yes, the same pharmacy provided both.
The other name for Trimipramine is Sumontil. Still not very close to lamictal except for the "l" on the end.I took my first dose of the real Lamictal about 5 hours ago and no weird response or anything. I hope it continues that way. :-)
G'night.
Max
> > Hi all. I have a story to tell that we can learn from.
> >
> > I went to the pharmacy today to pick up my new prescription for lamictal that my doctor gave me last week.
> >
> > When I got home, I realised the pills were white and the pills I had been taking were pink. The new white pills did say Lamictal on them.
> >
> > I knew the name was different on the pink pills but I thought they were a generic version of Lamictal because it started with "apo" which indicates a generic brand.
> >
> > Turns out I have been talking Trimipramine Maleate, a trycyclic antidepressant.
>
> That is a bizarre error. The brand name for trimipramine, Surmontil, isn't even close to Lamictal, unless your doctor's handwriting is atrocious.
>
> > Now I am already on an MAOI - Parnate. Last week I was having heart palpatations and severe nausea. I thought it was the Parnate.
> >
> > Parnate and Trimipramine shouldn't be taken together.
>
> The same pharmacy provided both?
>
> > I called the pharmacy and they looked up their records and said trimipramine is what the doctor prescribed.
> >
> > I have called the doctor and left a message for her. I know mistakes can happen, but I do want her to know that a mistake has happened.
>
> > I am angry at the doctor but I am more angry at myself. I should have checked out the name of the drug on the internet when I first got it. It would have only taken a few minutes.
>
> I know that taking personal responsibility for meds is important, but one shouldn't have to double check everything, all the time.
>
> A few years ago, I was prescribed 10 micrograms of levothyroxine (the thyroid hormone, T4) as an augment to my antidepressant. Turns out there is no such dose, the smallest being 25 mcg. Without checking with the prescribing doctor, the pharmacist "corrected the error" to 100 mcg. I didn't catch this myself, and I was about 18 days into thyroid overdose before I figured out what was wrong.
>
> Stuff happens, ya know? I hope you're not too pissed at yourself. It wasn't your mistake, even though you didn't catch it.
>
> > I am angry because I have been having mixed states like crazy and feeling suicidal. I was wondering when I would feel an effect from the lamictal. So now I have to start over at the 12.5 mg.
> >
> > I know it's good that I figured out the error etc., but I have been taking the wrong med since April. I feel like I am now two months behind on way to feeling better.
>
> You're wiser in a way that could not be taught to you.
>
> > Also, I could have a bad side effect to the real lamictal and not be able to take it all. Sigh.
>
> That's always a possibility, but let's not get ahead of ourselves, 'kay?
>
> > From now on I am checking everything.
>
> I do....now.
>
> > So be careful out there, OK? Check the bottles of the meds when you are starting a new one. Make sure you know what it is suppose to look like, especially if the med is available in a generic form.
> >
> > Be careful out there!
> >
> > maxime
>
> Thanks for sharing your story with everybody. It's an important lesson, just as you said in the subject line.
>
> Lar
Posted by Ron Hill on June 9, 2003, at 23:35:45
In reply to Re: An important lesson learned - update, posted by maxime on June 9, 2003, at 16:31:23
Maxime,
> I spoke to the doctor and she was pissed off that I would suggest that she made a mistake. She said the pharmacy must have read it wrong. I told her that they have read it wrong twice because when I called them today they were firm that the prescription did not say lamictal.
Ask your pdoc if she knows how to spell MALPRACTICE! And if so, inquire if she has been paying her insurance premiums. Her irresponsible mistake could have caused serotonin syndrome. Unbelievable!
This was NOT your fault. I'm sorry it happened to you.
-- Ron
Posted by stjames on June 10, 2003, at 0:37:31
In reply to Re: An important lesson learned - update, posted by maxime on June 9, 2003, at 16:31:23
I think the pharmacy has to take some heat for this. It matters not that the doc did or did not
write the wrong med. Thes are the ones that should also knwo they are dispensing a well
know contrindicated combo. They sould of check with the doc.If the doc did write for the wrong med, then 2 systems failed here.
Posted by Questionmark on June 10, 2003, at 0:42:26
In reply to An important lesson learned, posted by maxime on June 9, 2003, at 16:21:24
Oh my gosh-- that SUCKS!! Thanks for the words of caution though. Man, thats terrible. i hope it all works out for good for you.
P.S., i totally agree w/ what stjames had to say about this.
Posted by kalyb on June 10, 2003, at 8:06:58
In reply to Re: An important lesson learned » maxime, posted by Questionmark on June 10, 2003, at 0:42:26
Maxine - I hope you're feeling better now. What a shock...
I know I am careful about checking meds after a small error a few years ago. I went to the doctor, (not one I'd seen before, my usual one was unavailable) knowing I needed some AD's. I told her that SSRI's didn't work well for me, so she told me she was going to prescribe "one of the older types" of AD.
When I got the prescription, it turned out to be Celexa.... which of course I looked up on the net and saw to be... a SSRI.
At the time I was feeling SO depressed I didn't even have the energy to make a fuss so I just started taking it. It wasn't right for me but it got me through a few painful weeks, after which I stopped it, had a few months med-free, then saw my regular doctor for something more suitable. But that one small experience has taught me to be really careful.
I might be being too careful though. When my pdoc prescribed Effexor I started reading through this board and realised that most people start off on either 37.5mg of normal effexor twice a day, or 75mg of XR. I'd been given 75mg of normal effexor to be taken once a day.
So I queried it with my pdoc. He called me and left a message that he finds people have less side effects with the dose I'd been given. And I have to say that in my case, that was perfectly true. He then went on to say that if I wished, in my next scrip he'd give me the XR. I didn't respond to his message, thinking that "if it ain't broke, don't fix it" - the 75mg per day of normal was working just fine.
Last week when I went to get a repeat scrip, guess what had been written on it? XR. The pharmacist pointed that out to me, but only after I'd been asking her about diphenhydramine; she casually mentioned "Oh, by the way, you've been given the capsules this time."
I had to go back to the doctor's surgery and see the practice secretary, explain the situation and be given another prescription for the normal Effexor.
I'm seeing my pdoc in about a week's time, so I will be sure to mention this to him!! I'm not happy... but at least I noticed the change. If he *really really* wants me on the XR for some reason, he can give me a scrip when I see him then!!
So you really do have to be alert sometimes... it almost makes me wonder if he didn't do it just to see if I would notice!! To be honest, had I been as depressed as I was when I first went to see him, I wouldn't have cared. Ironic, really....
Kalyb xx
Posted by maxime on June 10, 2003, at 11:06:55
In reply to Re: An important lesson learned, posted by kalyb on June 10, 2003, at 8:06:58
What is ironic about all this is that although my depression is under control with the Parnate, the mixed I have been in have made very suicidal. I almost went to the hospital last week because I felt like I was going to kill myself (well attempt to). I have attempted several times before.
So yesterday when I was reading that the two meds together could have killed me I thought "figures I would be one of the ones who doesn't die from the combo".
I'm still suicidal but knowing that I am on the right med ... a med that might help me, I think is going to prevent me from acting out on my suicidal thoughts.
Maxime
Posted by Ron Hill on June 10, 2003, at 11:50:45
In reply to Re: An important lesson learned - ironically, posted by maxime on June 10, 2003, at 11:06:55
Maxine,
> I'm still suicidal but knowing that I am on the right med ... a med that might help me, I think is going to prevent me from acting out on my suicidal thoughts.
You have been dealt a bad hand, but nobody wins if you fold. We are here for you, cheering from the sidelines. Don't you dare quit!
IMO, there are legal implications in this case. If I were in your shoes, I would ask (insistently, if necessary) for a photocopy of the prescription to keep in your files when you go to the pharmacy to view the script. I would also keep the empty pill containers, all remaining medication (if any), the instructions provided by the pharmacy with the medication, the co-pay sales receipt for the transaction, and a printout of your insurances company’s payment to the pharmacy. In other words, document the case as thoroughly as you can.
If it turns out that the pdoc wrote the wrong script and the pharmacy filled it without considering contraindications issues, then they both need a wake up call before another patient is seriously harmed. In our Western society, legal action is the mechanism to bring about these types of needed change.
-- Ron
Posted by JudyN on June 11, 2003, at 0:30:50
In reply to Re: An important lesson learned - ironically » maxime, posted by Ron Hill on June 10, 2003, at 11:50:45
This is a good lesson for anyone on any kind of meds. My psych doc always writes my Rx and hands it to me & asks me to look it over to see if it looks right to me. I appreciate that she does that--I'm more engaged in my medications and its a good way to intercept mistakes.
Also, I have developed a little graphing system where I plot my mood, functioning and side effects on a scale of 1 to 10 everyday. Its helpful in making me be aware of whats happening & helps me to see the gradual changes that I would otherwise miss.
This is the end of the thread.
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