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Medical Forum / General / Pharmacy / March 2004

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Is this drug cocktail safe?

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Fred - 01 Mar 2004 23:44 GMT
My mother-in-law suffered a small bout of depression five years ago
with the death of her daughter's son (he died 2 months after birth).
She was prescribed a variety of drugs, all from ONE DOCTOR, and has
been on them all since, to date.  At night, she becomes disorientated
and hallucinates (people in photos are alive, etc).  Last night, she
actually wet herself while standing and talking to my wife, something
that never occurs during the day prior to taking the drugs -- she is
definitely not incontinent.  Her doctor won't let any of us see her
(doctor) as we are not the patient.  The doctor won't take her off the
drugs and is basically making a living off her (she gets about
$300/fortnight from my mother-in-law to pay for the drugs/sessions).
My mother-in-law is also convinced that she MUST stay on the drugs to
be "normal" but as you can see she is anything but after popping them.
During the day she is 100% fine and like any normal person.  Her
husband, like us, apparently can't do anything because the doctor
refuses to see him too.  Here is the list of drugs she takes, one drug
each night:

Aldactone (100mg spironolactone)
Celapram (20mg citalopram)
Stilnox (10mg zolpidem)
Zyprexa (10mg of olanzapine)

Any legal advice?
Hap Arnold - 02 Mar 2004 00:10 GMT
It is a crime in the US to offer legal advice without being admitted to the
bar of the state in which that advice is to be offered.
See a lawyer for legal advice.
See another doctor if you think you have a problem with medical ethics.

Signature

E Sempre l'Ora

--

> My mother-in-law suffered a small bout of depression five years ago
> with the death of her daughter's son (he died 2 months after birth).
[quoted text clipped - 20 lines]
>
> Any legal advice?
michael - 02 Mar 2004 04:45 GMT
"Fred" <fred_whitaker@hotmail.com> asks:

> My mother-in-law suffered a small bout of depression five years ago
> with the death of her daughter's son (he died 2 months after birth).

<snip>

> Here is the list of drugs she takes, one drug
> each night:
[quoted text clipped - 5 lines]
>
> Any legal advice?

I'm no doctor but I sure know that this is *not* a list
of drugs appropriate for someone who is only suffering
from a mild bout of reactive depression.

The aldactone is probably what made her incontinent
but given the other crap she is on it is probably useful
to help her flush all the other pharmacological residues
from her body.

Celapram is an antidepressant and Stilnox is a sleeper.
These might be validly prescribed for severe depression
but if your description of her problem is accurate there
is no reason she should be on them five years after
a mild bout of depression.

Zyprexa is an antipsychotic and is probably one of the
most widely overprescribed drugs in Australia today
(thanks to Eli Lilly's aggressive marketing). It is NOT
indicated for depression at all and can have harmful
side effects. If your mother was not displaying signs
of psychosis or schizophrenia then whoever prescribed
this is a quack.

If I were you I would be encouraging her to see another
doctor and get her medication reviewed.

DO NOT encourage her to quit the medication by herself.
Withdrawal from a cocktail like this can be very severe
and needs to be carefully managed if it is not to tip her
back into depression or worse. On the face of your
posting she needs to find a doctor who can manage
her withdrawal and she will need support and care
while this happens.

michael
Nom dePlume - 02 Mar 2004 05:32 GMT
Let me second the above. Please urge her to get a second opinion ASAP.
This sounds suspicious.

Signature

Nom dePlume, Ph.D

Why, yes, in fact, I am a rocket scientist.

Guide to Medications for Mental Illness:
http://www.geocities.com/nomdeplume1000
=====

> "Fred" <fred_whitaker@hotmail.com> asks:
>
[quoted text clipped - 48 lines]
>
> michael
Don W. McCollough - 10 Mar 2004 11:18 GMT
> "Fred" <fred_whitaker@hotmail.com> asks:
>
[quoted text clipped - 27 lines]
> is no reason she should be on them five years after
> a mild bout of depression.

There are some negative symptoms of schizophrenia which can be similar
to
clinical depression, but for reactive depression Zyprexa is not the
ticket.
If she is taking Zyprexa for sleep, then the Zolpidem is Superfluous.
10mg of Zyprexa is no small dose.  Are you sure the doctor hasn't
diagnosed her with
dementia or psychosis?

> Zyprexa is an antipsychotic and is probably one of the
> most widely overprescribed drugs in Australia today
[quoted text clipped - 16 lines]
>
> michael
michael - 12 Mar 2004 10:29 GMT
"Don W. McCollough" <letters@softhome.net> says:

> There are some negative symptoms of schizophrenia which can be similar
> to
[quoted text clipped - 4 lines]
> diagnosed her with
> dementia or psychosis?

Zyprexa is not a sleeper nor is it indicated for dementia,
though I am aware that there are quacks out there
prescribing it for both.

Eli Lilly is even trying to flog it as a cure for stuttering now.

michael
Fred - 02 Mar 2004 06:25 GMT
> Aldactone (100mg spironolactone)
> Celapram (20mg citalopram)
> Stilnox (10mg zolpidem)
> Zyprexa (10mg of olanzapine)

Just to clarify (in case it wasn't clear): she's been on the above
drugs for five years, and only hallucinates at night after taking
them.  So basically I'm asking: is that normal, or is the doctor just
prescribing it to fund her practise?
Rod Speed - 02 Mar 2004 07:46 GMT
>> Aldactone (100mg spironolactone)
>> Celapram (20mg citalopram)
>> Stilnox (10mg zolpidem)
>> Zyprexa (10mg of olanzapine)

> Just to clarify (in case it wasn't clear): she's been on the
> above drugs for five years, and only hallucinates at night
> after taking them.  So basically I'm asking: is that normal,
> or is the doctor just prescribing it to fund her practise?

Unlikely.

She may not have much of a clue tho.

She may have decided that there is a mental
problem and that what made that obvious is
irrelevant to the ongoing treatment of it.
Darryl - 02 Mar 2004 12:30 GMT
>> Just to clarify (in case it wasn't clear): she's been on the
>> above drugs for five years, and only hallucinates at night
[quoted text clipped - 8 lines]
>problem and that what made that obvious is
>irrelevant to the ongoing treatment of it.

Or the doctor may have performed a full differential, sent the patient
to the appropriate specialists and has prescribed where appropriate.
Time for a second opinion

My car is making a funny sound when I accelerate.  Can someone tell me
what it is?
Colleen - 02 Mar 2004 19:06 GMT
Hypnogogic (sp) hallucinations are often med induced (especially from
hypnotics like zolpidem).  They do not indicate psychosis but are a result
of the brain's reaction to the med.  If she doesn't have the hallucinations
during her normal waking hours, it probably is the hynogogic hallucinations,
especially if she if aware that they are hallucinations and not real.

Sounds like she's being overdrugged to me.  Not a doctor, so I can't say for
sure, but I have been overmedicated before and that usually requires a new
doc to help the person get off the meds and start a new regimine if
necessary.

IMO...get a second opinion.
c

> > Aldactone (100mg spironolactone)
> > Celapram (20mg citalopram)
[quoted text clipped - 5 lines]
> them.  So basically I'm asking: is that normal, or is the doctor just
> prescribing it to fund her practise?
. - 02 Mar 2004 21:01 GMT
Fred wrote...
> Just to clarify (in case it wasn't clear): she's been on the above
> drugs for five years, and only hallucinates at night after taking
> them.  So basically I'm asking: is that normal, or is the doctor just
> prescribing it to fund her practise?

I hallucinated on Stilnox, so I wouldn't be surprised if your friend is
hallucinating from that.

Signature

Regards,
.

. - 02 Mar 2004 21:02 GMT
Fred wrote...
>  or is the doctor just
> prescribing it to fund her practise?

I think psychiatrists have more than enough patients anyway.
Signature

Regards,
.

michael - 02 Mar 2004 07:20 GMT
As far as legal advice goes, I would suggest going
to a community legal centre if you think that your
best recourse is legal. Find out which one covers
your area from http://www.naclc.org.au/

I would be inclined to try a community based mental
health or disability support group or if I were you.
If you can say what state you are in I can offer some
suggestions. You need to be careful with some of
these groups as several are funded by the pharmaceutical
industry and are essentially front organisations for
promotion of precisely the drugs that are the problem
here (e.g. Eli Lilly funds the Schizophrenia Fellowship
of NSW, so you would be foolish to seek advice from
them about the usefulness of Zyprexa).

As to the doctor herself, I'm afraid that most medical
complaint bodies are toothless at best. At worst they
will tie you up with meaningless bureaucratic procedure
while keeping the doctor informed about your every move.
If I was determined to follow this path I would try the
Doctors Reform Society http://www.drs.org.au/.
Avoid the Royal Australian and New Zealand College of
Psychiatrists.

But the most important thing is to try to work patiently
with your mother-in-law to try to gently encourage her
to question the medication she is on - at least enough
to seek a second opinion. Doing everything behind
her back and seeking to undermine her faith in her
doctor is likely to be counterproductive.

Good luck with it.

michael
Vaughan Williams - 02 Mar 2004 12:18 GMT
You're asking for medical advice, not legal advice, but those meds don't
seem too unusual for someone with major depressive issues.

> My mother-in-law suffered a small bout of depression five years ago
> with the death of her daughter's son (he died 2 months after birth).
[quoted text clipped - 20 lines]
>
> Any legal advice?
Harold Boxenbaum - 19 Mar 2004 02:57 GMT
Without taking any sides on the issue, if you have any concerns such as your
have expressed, a good idea is to find a specialist in the area, and get a
second opinion.  Good luck.  Harold.

Harold Boxenbaum, Ph.D.
Pharmaceutical Consultant
Arishel Inc.
14621 Settlers Landing Way
North Potomac, MD 20878-4305
(P) 301-424-2806
(F) 301-424-8563
Email: harold@arishel.com
Website: www.arishel.com

> My mother-in-law suffered a small bout of depression five years ago
> with the death of her daughter's son (he died 2 months after birth).
[quoted text clipped - 20 lines]
>
> Any legal advice?
 
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