Jncs: Husband - restlessness caused by drug cocktail

[Jncs]

Hi,

 

My husband takes Mirtazapine 15mg every night, along with two psychotic drugs (Trifluoperazine & Olanzapine) for his agitation/yelling and Vortioxetine 10mg (every am) and recently Prozac 20mg.  His problem was insomnia but after being put on benzos & antidepressants, it became more complex - one thing leads to another, and he has very bad daytime agitation/constant yelling, memory loss, confusion, low mood, unable to function etc... 

 

He has just started Prozac 20mg two weeks ago, to aid with tapering of Mirtazepine.

His doctor agreed on 50% cut but he suffers bad withdrawal after 1 week. 

Previously, he was able to taper off 45mg Mirt to 30mg then to 15mg without much difficulty.

So now he is on 25% cut on Mirt. 

Q: Is this too much considering that he is on Prozac which should help with the tapering as we understand.

 

We are really tired of this journey as his problem was simply Insomnia and it became so much worse after he is put on these potent addictive drugs and we realised that we were trapped!  Would really appreciate all your kind advice.

 

Thank you so much!

 

 

 

 

[Jncs]

Hi,

 

My husband takes Mirtazapine 15mg every night, along with two psychotic drugs (Trifluoperazine & Olanzapine) for his agitation/yelling and Vortioxetine 10mg (every am) and recently Prozac 20mg. His problem was insomnia but after being put on benzos & antidepressants, it became more complex - one thing leads to another, and he has very bad daytime agitation/constant yelling, memory loss, confusion, low mood, unable to function etc...

 

He has just started Prozac 20mg two weeks ago, to aid with tapering of Mirtazepine.

His doctor agreed on 50% cut but he suffers bad withdrawal after 1 week.

Previously, he was able to taper off 45mg Mirt to 30mg then to 15mg without much difficulty.

So now he is on 25% cut on Mirt.

Q: Is this too much considering that he is on Prozac which should help with the tapering as we understand.

 

We are really tired of this journey as his problem was simply Insomnia and it became so much worse after he is put on these potent addictive drugs and we realised that we were trapped! Would really appreciate all your kind advice.

 

Thank you so much!

Sorry, it's me again but desperately need your guidance....

 

Further to more reading here, I understand cross tapering is not recommended.

As we've just added Prozac two weeks ago on 18 Aug, (10mg daily 1st week, 20mg 2nd week), would it be ok to stop Prozac at this point, and just continue to direct tapering on Mirtazepine?

 

Thanks.

[brassmonkey]

Hi jncs-- welcome to the group.  It is amazing the holes people find themselves in with these drugs, just from trying to take care of one simple thing.  I'm so sorry to hear that your husband and yourself are going through such an ordeal.  Yes you have read correctly, cross tapering rarely if ever works, and frequently causes many more problems than it helps.  Most of what he is feeling is due to the very large cuts in dosage that have been made.  We need more information on how and when those cuts were made, if you would please fill out a signature block it would be of great help to us;

 

Please put your withdrawal history in your signature

 

 

There is a lot of good information about tapering off of multiple drugs that would be good for you to read;

 

What is withdrawal syndrome? 

Taking multiple psych drugs? Which drug to taper first?

Why taper by 10% of my dosage?

 

 

Also it would be a good idea to enter all of those drugs into the drug interaction checker and copy and paste the results here so we can take a look at them.

 

Drug Interactions Checker -- use it to reduce your drug burden 

[Altostrata]

Welcome, jncs.

 

I moved your topic to the Introductions forum, where it will be more easily seen.

 

It sounds like your husband has had a series of bad drug reactions that got treated with more drugs, causing more reactions, etc. This is unfortunately quite common.

 

Prozac and mirtazapine can be a harmful combination.

 

What drugs is your husband taking now, and at what dosages? Please put ALL the drugs in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

 

I suspect one major problem is a drug-drug interaction between vortioxetine and mirtazapine as well as the other drugs, see http://www.drugs.com/monograph/vortioxetine-hydrobromide.html 

 

Serotonin Syndrome

Potentially life-threatening serotonin syndrome reported with serotonergic antidepressants, including vortioxetine, when used alone, but particularly during concurrent therapy with other serotonergic drugs (e.g., 5-HT₁ receptor agonists [triptans], TCAs, buspirone, fentanyl, lithium, tramadol, tryptophan, St. John’s wort [Hypericum perforatum]) and with drugs that impair the metabolism of serotonin (particularly MAO inhibitors, both those used to treat psychiatric disorders and others, such as linezolid and methylene blue).^{1 47 48} (See Contraindications under Cautions and also see Interactions.)

 

Symptoms of serotonin syndrome may include mental status changes (e.g., agitation, hallucinations, delirium, coma), autonomic instability (e.g., tachycardia, labile BP, dizziness, diaphoresis, flushing, hyperthermia), neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination), seizures, and/or GI symptoms (e.g., nausea, vomiting, diarrhea).^{1 47 48}

 

 

 

Interactions between your selected drugs

mirtazapine ↔ vortioxetine

Applies to: mirtazapine, vortioxetine

Using mirtazapine together with vortioxetine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death...

 

 

If his original problem was insomnia, I might taper vortioxetine first, then the antipsychotics, leaving mirtazapine for last.

 

How long has he been taking vortioxetine? When was mirtazapine added?

 

 

[Jncs]

Hi all,

 

Thank you for your quick response. Here is a brief history (sorry it cant fit in the Signature).

 

Nov 13 - start of Insomnia. GP prescribed xanax for 5 days, slept well.Insomnia returned thereafter.

15 Nov 13 - Jan 14 - Saw Psychiatrist given Lexapro, benzos (xanax or lexotan). Still can't sleep. Agitation starts.

Mid Jan 14 - change Psychiatrist, given Mirtazapine, sleeps better. Also given Quetiapine, Lorazepam. Agitation, low mood, nervous.

Jul 14 - referred to Mood Disorder clinic. Still on Mirtazapine. Also added other various drugs, Sodium Valproate, Valdoxan, Sulpiride, Tianeptine, Effexor.

Nov 14 - Mirt. Started Olanzapine 5mg.

Dec 14 - Agitation worsens, morning yelling. Addicted to benzos. Warded for ECT.

Jan 15 - almost 90% recovered but only for 1 month, milder agitation and yelling returns.

Read Books by Julia Ross & Dr Slagle, Tried various amino acids & supplements (vits, fish oil) , seems to help.

Apr 15 - Agitation returns, stop supplements.

May 15 - consulted TCM, took the wrong advice, stopped all meds. Relapsed.

June 15 - V Bad agitation, loud yelling morning to night. Addicted to benzos.

warded for unilateral ECT. Better, after 1 week, mild agitation and morning yelling returns.

May 15 - Mirtzapine 15mg (night), Olan 15mg daily, Started Vortioxetine 10mg every am. Chlorpromazine 25mg 3x daily.

4 Aug 15 - Mirt, Olan, Vort. Started Trifluoperazine 1mg 3x (replace Chlorpromazine)

18 Aug 15 - Olan 5mg 2x, Vort 10mg am, Trifluoperzaine 1mg 3x. Added Prozac 10mg (am). Mirt reduced 7.5mg.

24 Aug 15 - as above. Prozac increased to 20mg. Mirt increased to 11.25mg. Bad morning agitation and loud yelling. Usually subsides by later PM .

Also taking some supplements (amino acids & vitamins, fish oil).

Also taking 100mg Hydrozyxine (Atarax) to help with agitation, or Valium 2mg.

 

We have a doc appt tomorrow (1 Sep), so really appreciate your kind advice pl.

Also, not sure how we should approach our docs tomorrow as we have questioned them before on the side effects & withdrawals which were denied of course and told us not to read too much from the online forum (sorry!).

 

This is mid life crisis for both of us, I am at a total loss as nobody around us seem to know much about these drugs and our agony. My husband has stopped working (of course) and spent the past 20 months yelling or sleeping sedated by drugs. He is a totally different man now, please help us.

 

Thank you so much!

[Altostrata]

Thank you.

 

It sounds like your husband had a rebound reaction from Xanax after 5 days, causing sleeplessness.

 

It could be your husband is one of those people who have immediate bad reactions to SSRIs like Lexapro, or that the doctor prescribed an excessive amount then and he had serotonin toxicity from that. See Serotonin Syndrome or Serotonin Toxicity

 

From then on, he might have had adverse reactions to everything because his nervous system was sensitized by the earlier adverse effects.

 

I suggest you use the put ALL the drugs your husband takes in the Drug Interactions Checker http://www.drugs.com/drug_interactions.htmland print out the results to discuss with your doctors. Also, copy and paste the results in this topic.

 

You need to find a doctor who will MINIMIZE drugs. Your husband is taking an excessive number of drugs.
 

[Jncs]

Thank you for all your advice and concern.

 

I checked the Drug Interations Checker and you're right, there are major and moderate drug interations amongst the the drugs he is taking (Apologise I can't cut & paste here as I'm using Ipad). We showed this report to our doc and she said every drug will have some interations. The dosage given to my husband is low, and complied with their own drug checker. She said it is also common to take both Prozac & Remeron together - "we give this all the time" were her words.

 

She told us to wait for two weeks for Prozac 20mg to be effective, and gradually reduce Remeron.

It has been almost 2.5 weeks since he started Prozac, and Remeron reduced from 15mg to 11.25mg nightly.

Other drugs remained unchanged. Doc is supportive of Prozac in place of Remeron for the tapering process.

As of now, he is still yelling and very agitated in the morning.

 

As advised by the doctor, we can't taper the other drugs in case of relapse.

What should we do... My husband is suffering, yet we dare not taper any of his other drugs. We feel trapped!

 

Please advise:

- From the drugs that he is taking, which one can be tapered first and has less side effects?

- He is also taking supplements recommended by Julia Ross and Dr Priscilla Slagle - to avoid interactions with the drugs, he is taking at a modest dose.

- Recently, he has started taking bio-resonance therapy to detox, has anyone tried this?

- homeopathy, has anyone tried?

 

Appreciate all your advice.

Thank you.

[Altostrata]

Please paste the link from the Drug Interactions Checker that shows all your husband's drug interactions. I need to see the list of his drugs.

 

Yes, you will find differences between what you see here and what you hear from your doctor.

 

The reason this site exists is because people are not getting reliable information from their doctors. Why do you think the interactions checker shows a Major dangerous interaction?

 

If you want to follow your doctor's advice, that's your choice. Your husband has been very sick. How well has the doctor's advice worked for him so far?

[Jncs]

OK, here it is.  Thank you. Interactions between your selected drugs

Major fluoxetine  mirtazapine

Applies to: Prozac (fluoxetine), Remeron (mirtazapine)

Using FLUoxetine together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major fluoxetine  vortioxetine

Applies to: Prozac (fluoxetine), vortioxetine

FLUoxetine may increase the blood levels and effects of vortioxetine. You may be more likely to experience side effects, including a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Contact your doctor if you experience increased side effects or your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major mirtazapine  vortioxetine

Applies to: Remeron (mirtazapine), vortioxetine

Using mirtazapine together with vortioxetine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate fluoxetine  trifluoperazine

Applies to: Prozac (fluoxetine), trifluoperazine

FLUoxetine may increase the blood levels and effects of trifluoperazine. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate fluoxetine  olanzapine

Applies to: Prozac (fluoxetine), olanzapine

Using FLUoxetine together with OLANZapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate trifluoperazine  mirtazapine

Applies to: trifluoperazine, Remeron (mirtazapine)

Using trifluoperazine together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate trifluoperazine  olanzapine

Applies to: trifluoperazine, olanzapine

Using trifluoperazine together with OLANZapine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

No other interactions were found between your selected drugs.

Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs that your selected drugs interact with

• olanzapine interacts with more than 400 other drugs.
• trifluoperazine interacts with more than 500 other drugs.
• vortioxetine interacts with more than 200 other drugs.
• Prozac (fluoxetine) interacts with more than 500 other drugs.
• Remeron (mirtazapine) interacts with more than 300 other drugs.

 

 

Interactions between your selected drugs and food

No results found - however, this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

 

 

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication Antidepressants

Therapeutic duplication

The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes three medicines belonging to the 'antidepressants' category:

• vortioxetine
• fluoxetine (active ingredient in Prozac)
• mirtazapine (active ingredient in Remeron)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication Psychotherapeutic agents

Therapeutic duplication

The recommended maximum number of medicines in the 'psychotherapeutic agents' category to be taken concurrently is usually three. Your list includes five medicines belonging to the 'psychotherapeutic agents' category:

• olanzapine
• trifluoperazine
• vortioxetine
• fluoxetine (active ingredient in Prozac)
• mirtazapine (active ingredient in Remeron)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication CNS drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'CNS drugs' category to be taken concurrently is usually three. Your list includes five medicines belonging to the 'CNS drugs' category:

• olanzapine
• trifluoperazine
• vortioxetine
• fluoxetine (active ingredient in Prozac)
• mirtazapine (active ingredient in Remeron)

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

[Altostrata]

Okay, look carefully at this:

 

Using ***** together with ***** can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea.

 

 

This applies to at least THREE of the drugs your husband is taking: mirtazapine, fluoxetine, and vortioxetine.

 

These symptoms are similar to what your husband is exhibiting, aren't they? Now do you think your doctors know what they are doing? He is vastly overmedicated and suffering from adverse effects, if not outright serotonin syndrome -- which can kill him.

 

You need to find new doctors, ones that will work on minimizing his drugs. Your husband's drug cocktail is bizarre.

 

As for what to reduce first:

 

24 Aug 15 - as above. Prozac increased to 20mg. Mirt increased to 11.25mg. Bad morning agitation and loud yelling. Usually subsides by later PM .

 

 

Increasing drugs that are causing adverse reactions increases the adverse reactions.

 

If I were you, I would make a fast taper off the Prozac, by 25% per week. I choose Prozac because it has a longer half-life than the others and, if luck holds, is less likely to add withdrawal symptoms to his problems.

 

Then I would go off vortioxetine. These are only my personal, non-doctor opinions.

[ang]

Hello jncs             I send you all the best wishes I can................     a hard journey.      I just wanted to say ECT only ever lasts a month or two,, and for the damage it does, is just not worth it.......

 

so glad you found this site, I totally agree with Altos recommendations................  

 

there comes a time, when the reality stares us in the face, the drugs make us worse, and adding more drugs, to stop side effects of the first, yes, a downward spiral,  the only way out, is to cut drugs, not add.

[Jncs]

Hi Alto & Ang,

 

Thank you so much for your quick advice.  We wanted to back out of Prozac at last clinic visit but doc disagreed. But will take your advice to cut down on Prozac.  The docs just keep on adding more and more drugs, promise us of better days but it just got worse and worse!

[Jncs]

Sorry, a quick question.... in the meantime how can we cope with his yelling / agitation (other than benzos) as it can get really scary and uncontrollable in the mornings. Thanks!

[dalsaan]

Would he try some gentle breathing and stretching via qi gong?

[Jncs]

Thanks, Dal. Will encourage hb to try this although with his agitation and yelling, it's kinda hard to get him cooperate.

 

Btw, Alto, should we up Mirtazapine back to 15mg, with Prozac down 25%?

 

Sorry to ask so many questions as I'm really desperate, lost, very afraid and lonely in this battle. We have suffered and lost so much in the last 20 months and hope to have both our lives back soon.

i'm so glad to discover SA and to start our journey of recovery, at the same time, am really afraid of more setbacks. Every morning, upon waking up and hearing my hb's hysterical yelling, my whole body would just freeze.

 

Thank you all.

[Altostrata]

If I were you, I would not increase anything. Increasing the dosage will increase the adverse effects and interactions.

 

What times of day do you give him his drugs, and which ones at what times?

[dalsaan]

This is probably the least of his worries but B vitamins can be activating and he probably doesn't need that or too many other supplements that can complicated an already complex and over-medicated drug regime

 

D

[Jncs]

As of 24 Aug 15 - Olanzapine 5mg 2x (AM & Nite), Vortiozetine 10mg (AM), Trifluoperzaine 1mg 3x (AM/PM/Nite), Prozac 20mg (AM). Mirtazapine 11.25mg (Nite). V Bad morning agitation and loud yelling. Usually subsides by late PM. Also taking some supplements (amino acids & vitamins, fish oil). Also taking 100mg Hydrozyxine (Atarax) to help with agitation, or Valium 2mg.

 

Gradually, reducing supplements to just Magnesium, Fish oil, Vit C.

Stopped Tryptophan, L-Theanine, Glutamine, Taurine due to his multiple drugs (although these aminoes seem to help a bit).

 

Thanks.

[Jncs]

Alto,

 

As my hb's yelling worsened after he cut Mirt to 7.5mg then up to 11.25mg, and concurrently added Prozac,

could this be withdrawal symptoms to Mirt? As I understand, if it's withdrawal, we should wait for him to stabilise first?

 

It's morning here and his yelling is just hysterical, these two days are getting worse. Is there any other relief for him that you can share pls. I try not to give him Valium if possible.

 

Thanks so much.

[Altostrata]

and concurrently added Prozac

 

 

My guess is it's not the mirtazapine, it's the combination of Prozac and Vortiozetine that he takes AT THE SAME TIME that's the problem.

 

What does he say is bothering him? Has anyone asked him?

 

Also put Hydrozyxine in the Drug Interactions Checker. Please include ALL his drugs.

[Jncs]

Since taking antidepressants, he frequently complains of agitation and tight chest discomfort (no pain), and at times like now, it will intensify when we add or reduce a drug.  His recent chest ECG, blood test is normal.

 

He takes histamines promethazine (or atarax) or valium, as needed.  Thanks!

Interactions between your selected drugs

Major mirtazapine  vortioxetine

Applies to: mirtazapine, vortioxetine

Using mirtazapine together with vortioxetine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major fluoxetine  mirtazapine

Applies to: fluoxetine, mirtazapine

Using FLUoxetine together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major fluoxetine  vortioxetine

Applies to: fluoxetine, vortioxetine

FLUoxetine may increase the blood levels and effects of vortioxetine. You may be more likely to experience side effects, including a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Contact your doctor if you experience increased side effects or your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate hydroxyzine  mirtazapine

Applies to: Atarax (hydroxyzine), mirtazapine

Using hydrOXYzine together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate trifluoperazine  mirtazapine

Applies to: trifluoperazine, mirtazapine

Using trifluoperazine together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate promethazine  mirtazapine

Applies to: codeine / promethazine, mirtazapine

Using promethazine together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate diazepam  mirtazapine

Applies to: Valium (diazepam), mirtazapine

Using diazepam together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate codeine  mirtazapine

Applies to: codeine / promethazine, mirtazapine

Using codeine together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate trifluoperazine  hydroxyzine

Applies to: trifluoperazine, Atarax (hydroxyzine)

Using trifluoperazine together with hydrOXYzine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate promethazine  hydroxyzine

Applies to: codeine / promethazine, Atarax (hydroxyzine)

Using promethazine together with hydrOXYzine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate fluoxetine  hydroxyzine

Applies to: fluoxetine, Atarax (hydroxyzine)

Using FLUoxetine together with hydrOXYzine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate codeine  hydroxyzine

Applies to: codeine / promethazine, Atarax (hydroxyzine)

Using codeine together with hydrOXYzine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate codeine  fluoxetine

Applies to: codeine / promethazine, fluoxetine

FLUoxetine may reduce the effectiveness of codeine. You may need a dose adjustment if you have been taking codeine and are starting treatment with FLUoxetine. Let your doctor know if your condition changes or you experience reduced or inadequate relief of your symptoms. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate diazepam  fluoxetine

Applies to: Valium (diazepam), fluoxetine

Before taking diazepam, tell your doctor if you also use FLUoxetine. You may need dose adjustments or special tests in order to safely take both medications together. Notify your physician if you have symptoms of drowsiness, dizziness, or confusion. Avoid driving until you know how these medications will affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

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Moderate diazepam  promethazine

Applies to: Valium (diazepam), codeine / promethazine

Using diazepam together with promethazine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate fluoxetine  promethazine

Applies to: fluoxetine, codeine / promethazine

FLUoxetine may increase the blood levels and effects of promethazine. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate codeine  trifluoperazine

Applies to: codeine / promethazine, trifluoperazine

Using codeine together with trifluoperazine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate diazepam  trifluoperazine

Applies to: Valium (diazepam), trifluoperazine

Using diazepam together with trifluoperazine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate fluoxetine  trifluoperazine

Applies to: fluoxetine, trifluoperazine

FLUoxetine may increase the blood levels and effects of trifluoperazine. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate promethazine  trifluoperazine

Applies to: codeine / promethazine, trifluoperazine

Using promethazine together with trifluoperazine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate codeine  diazepam

Applies to: codeine / promethazine, Valium (diazepam)

Using codeine together with diazepam may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

[Altostrata]

Well, you've heard it from him. The drugs are causing him problems.

[Jncs]

We've started on 25% tapering of Prozac. As he just started taking on Aug 18, hopefully this will not be too rough for him.

 

In the meantime, as we are dealing with his loud yellings and agitations (which his docs have always denied as side effects but rather Anxiety!), could someone share their experience on this pls. Would taking more fish oil, magnesium help to relieve his sufferings? We go for evening walks etc but in the mornings, its hard to get him to cooperate.

 

I'm new to this forum, and still trying to find all the relevant information as fast as I could. Thanks!

[dalsaan]

We have a symptoms forum that you can look through.  I've not heard about people yelling.  Can you tell us more about this.  Does he feel compelled to yell?  Is he conscious of doing so?  Can he choose not to?

 

Dalsaan

[Jncs]

We have a symptoms forum that you can look through.  I've not heard about people yelling.  Can you tell us more about this.  Does he feel compelled to yell?  Is he conscious of doing so?  Can he choose not to?

 

Dalsaan

Hi Dal,

 

He is fully conscious of his loud yellings but he repeatedly says he cant control it. he feels slightly better by yelling. By afternoon he's quieter, and by evening, he's smiling. He says his chest is very tight and he feels agitated. These symptoms started after he started on Lexapro, Mirt and his yellings more aggressive and less when there are changes made to his drugs. So far, his docs have ruled out other health problems other than Anxiety/Depression. His problem started in Nov 2013 with just Insomnia. Thanks.

[Altostrata]

Jncs, perhaps you can reason with him about the yelling. The doctors are interpreting it as serious mental illness.

 

Or, you could yell together with him. What does he yell?

 

Please let him know that while the drugs are reduced, he may very well feel strange at times, but he's taking too many drugs and they're hurting him.

[brassmonkey]

"It's morning here and his yelling is just hysterical.....By afternoon he's quieter, and by evening, he's smiling. " (Taken from two different posts)

 

I'm betting this is a manifestation of the cortisol cycle.  Most people effected by it have severe morning agitation/anxiety/panic that calms over the course of the day and is quiet by evening, only to be repeated the next morning.  In this case its is manifesting as uncontrollable yelling.  There is a lot of information floating around here about the cortisol cycle, a quick search would should find a lot.  Could be worth looking into.

[Jncs]

"It's morning here and his yelling is just hysterical.....By afternoon he's quieter, and by evening, he's smiling. " (Taken from two different posts)

 

I'm betting this is a manifestation of the cortisol cycle.  Most people effected by it have severe morning agitation/anxiety/panic that calms over the course of the day and is quiet by evening, only to be repeated the next morning.  In this case its is manifesting as uncontrollable yelling.  There is a lot of information floating around here about the cortisol cycle, a quick search would should find a lot.  Could be worth looking into.

Thanks for the lead!  We've not explored the possibility of Cortisol.  I will certainly read up now, should I start a new thread there under "Symptoms...?

Is it safe to take Seriphos along with his other meds?  His anxiety yelling starts as soon he wakes up and docs has been sedating him with drugs.

Thanks again.

[dalsaan]

As Alto asked - what does he yell?

 

and here is a thread on Seriphos - http://survivingantidepressants.org/index.php?/topic/3782-phosphatydilserine-aka-phosphatidyl-serine-seriphos-or-cortiphos/?hl=seriphos

[Jncs]

As Alto asked - what does he yell?

 

and here is a thread on Seriphos - http://survivingantidepressants.org/index.php?/topic/3782-phosphatydilserine-aka-phosphatidyl-serine-seriphos-or-cortiphos/?hl=seriphos

What does he yell? Sorry, I dont know how to describe. Its like forceful shouting, ARGHHHHH....

Why? He says he feels agitated, chest is tight, uncomfortable (but no pain).

[Jncs]

Hi, my husband suffers from insomnia and since taking antidepressants 20 months ago, he now has very bad agitations and loud yellings in the mornings. Most days, he will calm down by late afternoons.

I was told he may have very high cortisols.

Can he try Phosphatidyl serine, if so, should he take in the early mornings?

We order from iherb, is there any recommended brand?

Thank you.

[dalsaan]

well maybe he is onto something - http://gimundo.com/news/article/yelling-can-help-your-health/

 

Perhaps he could try doing that into a pillow so its lest disturbing for the household

 

Dalsaan

[Jncs]

well maybe he is onto something - http://gimundo.com/news/article/yelling-can-help-your-health/

 

Perhaps he could try doing that into a pillow so its lest disturbing for the household

 

Dalsaan

nope. As mentioned, this started after he is on insomnia drugs. Some days, he is quieter if sedated by drugs, other days it can be really loud like the past weeks with changes made to his drugs. We resort to ECT previously, but it only worked temporarily. Using the pillows will not help to relieve his agony.

Hopefully, somebody can provide some advice here.

[Skyler]

 

well maybe he is onto something - http://gimundo.com/news/article/yelling-can-help-your-health/

 

Perhaps he could try doing that into a pillow so its lest disturbing for the household

 

Dalsaan

nope. As mentioned, this started after he is on insomnia drugs. Some days, he is quieter if sedated by drugs, other days it can be really loud like the past weeks with changes made to his drugs. We resorted to ECT previously, but it only worked temporarily.

Hopefully, somebody can provide some advice here.

 

 

But if benzos (or a related class) are the insomnia drugs to which you refer, what he experiences may be a cortisol spike.  I had a cortisol spike for several months, and it was pretty miserable.  This is a thread on how the cortisol effect may manifest itself.  See what you think.

 

I think Dalsaan is pointing out that given the amount of angst your husband is feeling, yelling may be a healthy response.  Also, if he is getting caffeine in his diet.. such intake should be avoided.  Coffee, tea.. chocolate, etc. 

 

edited to add caffeine info

[dalsaan]

Yes Skyler is right, that was my point. Sorry I wasn't clear initially

 

D

[Altostrata]

Please don't add more things to this hellish cocktail he's taking. That only confuses the situation.

 

Please concentrate on reducing the drugs. Did you reduce the Prozac?

 

Please keep notes on paper tracking his daily symptom pattern relative to when he takes the drugs, and their dosages.

 

You might ask him to describe the sensations in more detail that lead up to his yelling.

 

It sounds like the doctors are engaged in "treatments" to shut him up, not to relieve whatever is bothering him. He sounds like he's alert and articulate enough to participate in his own care rather than being treated like an unruly animal. Discuss the situation with him.

 

I can imagine the yelling is disturbing, but it has meaning. He may be relieved to find what he has to say is taken seriously.

 

Please remind him he may feel odd as the drugs are reduced and not to get panicked by that.