Friend who's meds are making her worse...?

Nurses General Nursing

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I need advice on how to help my friend and co-worker. She is an RN, we both work for a private duty home care agency and have shared work for a few children over the past 6 years.

The problem is that she has, over the last year and a half, been put on so many meds by so many doctors that she is showing signs of disorentation, tremors, depression, etc.

A little history--- She has somehow been convinced that she has symptoms of ADHD, not the illness-but just the symptoms. She says that it's from an earlier accident 10 years or so ago. Is this possible? anyway, she is seeing a phycologist, phyciatrist, and a physician. She is now taking Welbutrin, Prozac, and Trazadone... She is on Ritilan, and some other speed which she cant remember the name of....and is on Advair and something else for allergies and asthma. She shakes constantly, she has trouble remembering what she is going to say, she has days of depression where she won't get out of bed. I am scared for her and don't know how to advise her. I would appreciate any help for nurses with any experience in this area.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Do her doctors know all the different meds she is on? Sounds to me as if something toxic is going on---what a combination of medications. Please, URGE her to see her regular doctor ASAP, bringing all her meds with her and have this all reviewed. If you can, go along to help her out and support her. You may be saving her life. Also, don't forget to include any over-the-counter medications and/or herbals she may be taking. Interactions are many and can be deadly. The body (esp the liver/kidneys) can only take so much.

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Do her doctors know all the different meds she is on? Sounds to me as if something toxic is going on---what a combination of medications. Please, URGE her to see her regular doctor ASAP, bringing all her meds with her and have this all reviewed. If you can, go along to help her out and support her. You may be saving her life. Also, don't forget to include any over-the-counter medications and/or herbals she may be taking. Interactions are many and can be deadly. The body (esp the liver/kidneys) can only take so much.

I have asked her this question and she say's that the two phyche doc's know and that she has asked her psychiatrist if these are all "safe" and she said yes.... Well what the **** does that mean?

We work in Madison Wi. and have heard there are a group of doctors at the UW that will evaulate your meds I've told her about this but don't know how to find out specific info. Called the hospital and couldn't find out anything. She is almost ineffective in doing anything at this point and has to be reminded to do daily activities, so I was hoping I could do some of this finding out for her.

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Specializes in Med-Surg, Wound Care.

Her medication cocktail is probably causing all of these symptoms. Akasthesia is a dangerous side effect of ssri's(prozac), the wellbutrin can cause nervousness, and the trazadone can cause depression and lethargy.Now add it Ritalin and she's added a stimulant to the mix. You should be worried aobut here! She is in real danger with this group of meds.

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Should I advise her to stop anything right now.... I know it could be dangerous to do that with some meds. I feel like I need to do something soon.

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Specializes in Med-Surg, Wound Care.

With this combination of drugs she shouldn't stop anything without medical supervision! She needs to sit down with a trusted doc and lay it all out there. It appears to me that she's battling side effects of certain drugs with other drugs, instead of recognizing the side effects as the cause. This is quite common with the use of psych meds. The side effects are misinterpreted as a new diagnosis instead of possible side effects.

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With this combination of drugs she shouldn't stop anything without medical supervision! She needs to sit down with a trusted doc and lay it all out there.

:yeahthat:

You're obviously a really good friend to be so concerned. Steer her in the right direction and get her to the right docs...

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Specializes in CCU/CVU/ICU.

I would question the doc's again...and if it were me i'd listen to the psychiatrist ONLY when it comes to her psych-meds. (In children ritalin acts to calm-down the hyper-activity of ADHD... But in adults it's straight SPEED. Is ritalin even indicated in adult attention deficit????)

If this person is wired, shaky, and nervous all the time, i'd look into the ritalin and the other 'speed' she's on.

Also, many asthma meds can cause and/or worsen this nervousness/trembling.

Whatever the case, her doctors have her on a SERIOUS drug mix...and the combo can surley be wigging her out like that.

That this girl is even 'functioning' is surprising...let alone nursing.

That really sucks.

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Thanks for all your advice, it is the psychiatrist that has perscribed the anti-depression meds. She was told by the psychiatrist that the ritilan would not act as speed in her and that is contrary to what I know and to what you have indicated. I'm not so sure that she is helping her. Also, she told her that she has to be on such high doses of the Prozac that it would cause too many side effects so she combined it with Welbutrin both in lesser doses then put her on Trazadone to sleep. She (my friend) is convinced that without the ritilan she was much worse, I didn't see that in her before.

I still would like to know if anyone understands the link between her being in an accicent with no apparent head injury and having the symptoms of ADHD resulting from that. How would you know and how would you test for that with no medical intervention.

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She's on 3 antidepressants on top of everything else? Good GRIEF.

I remember how I felt just on the Welbutrin. I had a lot of side effects, which eventually went away, but it took a couple months. And my asthma medicine ALWAYS gives me the shakes.

That's just crazy that she's on so many meds though. She really needs to see a regular doctor before she ends up killing herself.

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Is ritalin even indicated in adult attention deficit????)

Yuppers :specs: :D

"In this preliminary study, lithium and MPH produced similar improvements on the primary outcome measure and on measures of irritability, aggressive outbursts, antisocial behavior, anxiety, and depression."

A randomized, double-blind, crossover study of methylphenidate and lithium in adults with attention-deficit/hyperactivity disorder: preliminary findings.

SourceThe Journal of neuropsychiatry and clinical neurosciences. 14(3):289-95, 2002.

I realize it's just one study, but there's many more out there that recognize it for use. I found one study that really only recommended it for short-term use in adults....

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But she has not been diagnosed with ADHD she is being treated for the symptoms....I really don't understand this leap.

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