The doses of Prozac and Straterra are excessive imo. Prozac is a very potent
CYP 2D6 inhibitor; and Straterra is metabolized primarily by CYP 2D6.  This
would create excessive levels of Straterra in your blood plasma; on the
order of 3 to 5 or higher than normal possibly.   The trouble lies in that
the overdose symptoms of Straterra are not well known.

A very similar drug in overdose called robexetine causes effect such as

Signs and symptoms may variably include sinus tachycardia, hypertension or
hypotension, diaphoresis, mydriasis, tremulousness, anxiety, agitation, and
confusion. More serious intoxication may result in significant neuromuscular
hyperactivity, seizures, hyperthermia, and rhabdomyolysis.

I think its fair to say your probably suffering from a straterra overdose
mediated by the CYP 2D6 inhibition Prozac causes.  I would discontinus the
use of Straterra, and Prozac at least temporarily.

Thanks for the info. My straterra is 60mg, not 100 as I stated. Is
that still a possible problem with 80mg of Prozac?

I was put on Prozac for depression. 80mg because of severity.
Straterra is for my ADD which I am pretty certain is not actually
helping.

I have a Psychiatrist for the mental meds. And a pain doctor for the
pain pills. I take Kadian for chronic pain which gets really bad as
the day progresses and I need the Darvocet to help me sleep along with
the Trazadone.

The Acifex is for acid reflux wich I recently got as a problem. I
heard that Prozac can cause ulcers and/or other stomach type problems.

My prescribing doctors do know of the other meds. I hide nothing from
nobody.

I am very suicidal as well which is one reason I got up to 80mg of
Prozac. Doctor did not want to switch me yet. He did try to get me to
take Lamictal (as a mood stabilizer to control impulses), but I could
not handle that med.

Any other opinions or information is welcome. Is anybody willing to
tell me what would be a good combo of meds to take to die? I have
access to a little Xanax and Sonata, a bunch of Seroquel, Lamictal,
Neurontin. And the main ingredient would be the Kadian. Also, a
anti-emetic may be good and  I have a script for the neck patches for
travel sickness.

thanks,

Hmm, well, I would try something like this myself.

You say that Straterra is ineffective; that isnt that suprising imo.  One of
the primary mechanisms involved with ADHD, and Depression theoretically for
both is a lack of dopamine in the straitium; and straterra does not affect
that mechanism.  I believe the reason that methylphinidate is more effective
than straterra(amoxetine) in clinical trials is simply because it stimulates
dopamine release.

None of the meds your taking address that.  Straterra is probably partially
effective, but not fully.

Have you tried Methylphinidate(ritalin), Amphetamine(adderall), or some
other stimulant drug?  In this case, they would be effective for ADHD in all
odds, and also help with depression.

Considering your trouble sleeping though, a stimulant may not be ideal.  I
would suggest bupropion if your adverce to trying a stimulant.

Taking Bupropion(wellbutrin) and Celexa, Lexapro, or Zoloft together would
probably be a very effective treatment, with less severe side effects than
what you take now.

Wellbutrin - 200 mg, up dose as needed to max of 450, scale slowly.
Celexa or Lexapro - Start 10mg, up to 20 if needed. Double amounts for
Celexa (20 - 40)  Lexapro is better than Celexa , but nearly the same drug.

If you cant get Celexa or Lexapro, Zoloft will work. Start at 50, go up to
200 if needed. At higher doses, Scale down the dose of Wellbutrin somewhat,
as Zoloft will inhibit its metabolism.  Prozac could be used too, but be
sure to scale down the Wellbutrin dose quite a bit if you use that, as
Prozac inhibits more than Zoloft does.

Neurontin may be worth trying as a mood stabilizer.  Its effectiveness in
this role is questionable, but it should not be too hard to tolerate side
effect wise.

Check all this sh.t with your doc first :P

If your experiencing non bipolar depression, or psycosis, or mania, or
anything else, it changes my recomandations somewhat.

Leave your pain meds as is.if they work ok.

And yes, I still think that the interaction between Prozac and Straterra is
making the blood plasma levels of straterra way too high.  80mg of Prozac is
a lot.  It is the maximum dose, and if it isnt bothering you, there is no
real need to decrease.  Most people respond to 40mg of prozac or less.
Simply put, it works like this kind of.  There are only X amount of any
reuptake pump for a neurotransmitter in the brain.  A dose of say, 10 Mg
will block, say, on average(the actual figure vaires according to patient
and because of tons of factors)50 percent of the pumps.  A dose of 20 Mg,
will block, say, 80 percent. A 40 Mg dose, say, 95 percent.  60 Mg, 99
percent.  Basically, anything above 40 is unlikley to do much good.  For
certain people, it can, granted.  But for the large majority of the
population, it wont.  80 mg wont hurt you.  Hell, 300 mg probably wouldnt
hurt you.  But, higher doses mean more side effects, and more severe side
effects.

P.P.S   Now that I think of it, I see one more possibility of why your
having all these side effects. Trazodone and Prozac both have effects on the
serotonurgic system.  High doses of Prozac, and that dose of Trazodone  are
likley causing serotonin syndrome.

euphoria, drowsiness, sustained rapid eye movement, overreaction of the
reflexes, rapid muscle contraction and relaxation in the ankle causing
abnormal movements of the foot, clumsiness, restlessness, feeling drunk and
dizzy, muscle contraction and relaxation in the jaw, sweating, intoxication,
muscle twitching, rigidity, high body temperature, mental status changes
were frequent (including confusion and hypomania - a "happy drunk" state),
shivering, diarrhea.

Serotonin syndrome seems quite possible.  But what the hell do I know :P  If
the above really honestly sounds like you, discontinue the Trazodone and
Prozac immediatly, and maybe seek some medical attention.

Therefore it is recommended that Zoloft, Prozac, Paxil, Luvox, Serzone, etc.
not be used concurrently with each other or any other serotonergic
drugs(Like Trazodone) and that these serious adverse reactions should be
expected with these combinations

P.S.  You dont wan't to die, just go have some fun; many a man has been made
happy by a cheap hooker and some booze.

Doctors find nothing wrong and you're on these drugs?
If there is nothing wrong with you then you shouldn't have to be on ANY
meds.

Sadly, nobody can answer your question accurately. Read the following to learn why.
Perhaps you should show it to your doctor(s).

-----

Presented by the author at the 2003 New England Seminar in Forensic Sciences, Colby
College:

Polypharmacy: What Cost in Morbidity and Mortality?©

It is common practice in  Medicine to  put patients on combinations of drugs.  The vast
majority of these combinations of drugs (especially where 3 or more drugs are involved)
have never  been studied at all, let alone in  double-blind trials ( with the exception of
Oncology/AIDS treatment, where the toxicity of the drugs demands study);  yet it is
frequent practice to prescribe these multiple-drug combinations.

It is well accepted in Pharmacology that it is scientifically impossible  to accurately
predict the side effects or clinical effects of a combination of drugs without studying
that particular  combination of drugs in test subjects. Knowledge of the pharmacologic
profiles of the individual drugs in question does not in any way
assure accurate  prediction of the side effects of combinations of those drugs, especially
when they have different mechanisms of action, which is very common because polypharmacy
is most often prescribed to patients with "multiple illnesses".  More than 100,000
patients in this country die from identified adverse drug reactions (perhaps the 4th to
6th leading cause of death in the U.S.)3  The number who die as a consequence of
polypharmacy is, to my knowledge,  unknown.

The argument that the  prescribing of drugs is the "Art" of Medicine is not valid in
defending polypharmacy, because drugs are developed (indications, dose and administration,
etc.) and approved through a "scientific" process (double-blind, placebo-controlled
studies).  The fact that the medicines are often prescribed for "different conditions"  is
irrelevant (especially to the patient's physiology).  The idea that  " we are doing the
best we can ", a frequent defense of Polypharmacy, does not in any way uphold a scientific
argument in favor of it. (We are, indeed, trying the best we can, with tools which do not
improve at the rate we would wish!)  The fact that "there is a limit to how much research
can be done" in no way makes the research unnecessary in order to predict the side effects
of specific combinations of drugs.

It has been said in the past that <30% of medical practice was backed by controlled
studies ¹ · ². Has this changed?   How do we know?  Are we looking closely enough at our
way of practicing Medicine?  Can the use of unstudied polypharmacy really be considered
evidence-based, "scientific" Medicine?[Can the Pathology community help initiate
meaningful debate regarding this subject at a level that will produce more widespread
awareness?]

Charles Sullivan, D.O.
Waterville, ME
(voluminous other references available)