Wednesday, May 30, 2012

Friday, November 07, 2008 Gail Shapiro asks

Q: I am having memory problems my doctor recently added dexedrine 5mg 2X's per day & Ambien 10mg @ bed

I was diagnosed with manic depression about 15 years ago. I am 66 and take the following drugs: Lamictal 225 mg, Lyrica 100mg (had memory problems with higher doses); Xanax .25 mg around 7 to 8pm and .5 @ bedtime, Wellbutin SR (200 mg); Prilosec 20 mg 2 X's per day; Zetia (10mg); Trazadone (75mg @ bedtime); Vivelle Dot patch (.0375 mg) every 3 days; Flexeril (10 mg @ bedtime). The above "short version" are the additional drugs added from my recent visit in September. Since I received the additional drugs, I've had memory loss, nervousness, increased anxiety and my blood pressure is low, however my pulse is between 82 to 88 beats per minute. I take OTC Sudefed PE (in AM (only 1 X per day, Vitamin D 1000 mg per day); Lutein (6mg in AM & Bed), Fish Oil, Muti-daily vitamin, Calcium + D 1300 mg; Folic acid 2100 mg; Vitamin B12 250mcg. Aside from the above my doctor wanted me to take 300mg additional to the Lamictal which I have not added. I feel I am over medicated, and even though I have insomnia. I was diagnosed with SLE in 1997 but since 1998 I have been in remission, I developed Fibromyalgia from overdosing of Prednisone when I was diagnosed with SLE.  I  have taken drugs for SLE since 1998. My allergies are to Statins, Prednisone, Opiates, Celebrex

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Answers (1)
11/ 7/08 4:45pm
I am NOT a medical professional, so this is not medical advice, but I know that Ambien can cause memory problems (not the least of which is waking in the middle of the night, engaging in an activity, and having no memory of it the next day - hence, the erroneous claims that it makes people do things like drive or eat in their sleep; you are not atually asleep at the time, you just have no memory of doing it the next morning). Also, this might not relate to the memory problem, but may to the nervousness or edginess: Sudafed is known to produce stimulant effects, and pharmacists (the folks with a PhD, not the clerks) have told me to check with my doctor before taking it along with adderall (which includes dexedrine). I think that Wellbutrin can also be stimulating (is in fact a treatment option for ADHD), so, added to the dexedrine and sudafed... not sure if any of your other meds are stimulating. I was also told by a MD with appropriate expertise that Xanax is not a good option as a sleep aide, and that Ativan is a better choice. I don't know why this is, especially since Ativan can cause sleep apnea (xanax too?), but I thought I'd share that information, in case it helps. Not sure about Ambien-Xanax interactions, but you might want to check on this in terms of memory problems. In fact, you should, of course, check with MDs about all of this. Do you have ADHD comorbid with BPD? If so, are you seeing, or can you consult with, a psychopharmacologist with expertise in both ADHD and mood disorders? Since you've probably become an expert on what works for your BPD, have a trusted relationship with your doctor, don't stop taking anything without the okay of a psychiatrist or psychopharmacologist (a type of psychiatrist) you trust. This is very important, especially with BPD. Also, of course, the memory problems could be caused by something other than ADHD, BPD and/or the meds you are on, especially given that you are 66. Accordingly, go get yourself a thorough physical and I suggest having your main physicians communicate with one another so everyone is on the same page and working with you as your team. Often doctors don't know the important subtlties, side effects, interactions, and options regarding treatments they don't provide/prescribe and in fields in which they are not specialists (e.g., the endochronologist might not know a lot about orhtopeadics, the cardiologist might not catch an interaction with a stool softener, and my experience is that even general practitioners don't know enough about psych meds and those meds are best managed by a psychiatrist. that said, many psychiatrists don't know all that much about, say, the finer points of preventing or managing heart disease and such things). Finally, it sounds like you are taking large doses of vitamins. Are your doctors and pharmacist aware of this? Not all vitamins are harmless, especially in large doses (there was just a NPR report about research on B3 and memory enhancement, and the MD stated that high doses of B3 can cause liver damage - which then can cause other symptoms, and so on). And I was told by many MDs, pharmacists and people in the naturalpathic field that one should not take vitamins within at least an hour of taking a prescription medicine. So, the vitamins might be interacting with and/or chaning the absorption rate and such of your meds. For example, I think I heard that Calcium (e.g., in antacids) can alter the body's absorption, and thus the effects, of amphetamines (such as dexedrine). I guess my overall suggestion is for you to check about all of, and each of, your drugs and OTC and supplements with your physicians and PhD pharmacist, and, if you have one, your naturapath; make sure they are communicating with each other about your treatments and response to treatment; and see if you can get a consultation with a well-regarded psychopharmacologist, preferably one with expertise in both ADHD and BPD (bipolar disorder, otherwise known as manic depression), but in at least in BPD. A university teaching hospital is a good place to start finding one in your area if you don't know anyone who can refer you. Good luck!! Reply
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By Gail Shapiro— Last Modified: 11/02/10, First Published: 11/07/08