TO ALL PEOPLE IN THE PHARMACY:I’m grateful that you saved my life! I’m convinced I wouldn’t be here today if I hadn’t seen your post regarding the possible combination between cough treatment and antidepressants like fluoxetine.
A. There may be a potentially fatal interaction between the cough suppressant dextromethorphan and SSRI-type antidepressants like fluoxetine (Prozac). This is referred to by doctors as serotonin syndrome. Hallucinations, anxiety, nausea, disorientation, fast heartbeat, muscle spasms, and hyperactive reflexes are some of the symptoms.
Dextromethorphan (DM) is included in several over-the-counter cough medications, but it is not the only source of this substance. Auvelity is an antidepressant that comprises bupropion and dextromethorphan.
In one instance, a man’s doctor prescribed Auvelity because he was still depressed despite taking fluoxetine. According to the Journal of Clinical Psychiatry (April 3, 2024), the patient experienced flushing, chills, confusion, urine retention, dysuria, agitation, paranoia, anxiety, and auditory/visual hallucinations of humming and people in his home within three days. Serotonin syndrome and dextromethorphan poisoning were identified during a hospital work-up.
Numerous other case reports include the use of cough medication, antidepressants, or the painkiller tramadol. The cardiovascular system, particularly the heart, can be impacted by serotonin syndrome in addition to changing mental condition (Journal of Cardiology Cases, Aug. 19, 2012). We’re happy you received the warning in time.
Q. I took a small amount of metoprolol for years to control my blood pressure. However, once I recovered from COVID-19, my blood pressure increased.
My doctor initially raised my metoprolol dosage, but it caused my heart rate to drop too much. A blood pressure medication containing triamterene and HCTZ came next. Since that didn’t work, lisinopril was added. Coughing uncontrollably was the outcome. I stopped taking it and was prescribed irbesartan, however this caused headaches and fluid retention. Amlodipine was then recommended, but it resulted in rashes and vertigo. Assist!
A. Your physician has tried the majority of the available blood pressure drugs. Maybe it’s time to think about some non-pharmacological alternatives, such the DASH diet (dietary techniques to control hypertension). Verify that your potassium, magnesium, and calcium levels are within normal ranges. Other strategies could involve the use of juices such as Concord grape, beet, or pomegranate. Meditation, deep breathing techniques, and sauna treatments might also be beneficial. It is recommended that you regularly check your blood pressure at home.
Tryvio (aprocitentan) is a novel kind of antihypertensive drug that was recently approved by the Food and Drug Administration. Our eGuide to Blood Pressure Solutions contains further information about the benefits and drawbacks of this medication, as well as other medications and nonpharmacological methods. This online resource is located at www.PeoplesPharmacy.com under the Health eGuides page.
Q.Your paper about magnesium and sleep has been read by me. You don’t specify which type of magnesium is ideal. The variety of varieties is enormous!
Magnesium gluconate, either alone or in conjunction with potassium, improved sleep quality, according to a study published in Frontiers in Endocrinology (Oct. 29, 2024). It has also been demonstrated that magnesium L-threonate enhances sleep (Sleep Medicine X, Aug. 17, 2024). It may be better to use magnesium L-threonate because it is less prone to cause diarrhea. Supplementing with magnesium is not advised for those with impaired renal function.
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Joe and Teresa Graedon respond to reader emails in their column. You can send them an email at www.PeoplesPharmacy.com or write to King Features, 628 Virginia Drive, Orlando, FL 32803. “Top Screwups Doctors Make and How to Avoid Them” is their most recent book.
King Features Syndicate, Inc. (c) 2024.
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