One pill makes you larger

And one pill makes you small

And the ones that mother gives you

Don't do anything at all

Go ask Alice When she's ten feet tall

(Lyrics from White Rabbit-Jefferson Airplane)

We get a lot of questions here on MyDepressionConnection about medication and particularly about using a combination of meds. Using a variety of medications to treat a medical condition or mental health disorder is described by some as taking a “medication cocktail.” In the field of mental health it is becoming more common than not for doctors to prescribe multiple medications to treat your mood disorder or mental illness. You add your other medications and supplements to the mix and it makes you wonder how all these chemicals are interacting with one another and if the combination is safe.

You don’t have to search very far in the news to find incidents where a combination of certain medications proves deadly. The tragic case of seven-year old Gabriel Myers  comes to mind. According to news reports, Gabriel was a foster child who had been prescribed several psychiatric medications to treat his childhood Bipolar Disorder. He was found dead in his foster parent’s home after he hung himself with an extendable shower head. News reports suggest that the combined effect of prescribed psychiatric drugs were the cause of this child’s suicide. This case leaves many unanswered questions. Should psychotropic drugs be prescribed to young children? Did the doctor warn this child’s foster parents of the potential side effects of his medication including the increased risk for suicide? Was he being closely monitored for any sudden change in his mood? Were the meds to blame for his suicide or were there other more probable reasons? Some people, such as State Senator Ronda Storms, believe that the cocktail of medications did contribute to Gabriel’s state of mind leading to his death. Storm has been an advocate for legislation in Florida to require an independent review prior to administering psychiatric drugs to children who are 10 or younger.

When adults die from a lethal combination of prescribed medications we usually hear about celebrities. Anna Nicole Smith is one celebrity whose death was blamed on her prescription drug cocktail which consisted of three anti-anxiety medications, a sleeping drug, and more. Likewise, the death of mega pop star Michael Jackson was found to be due to a toxic level of prescribed medications. His doctor has been charged with involuntary manslaughter.  Recent reports are that the trial for Michael Jackson’s doctor will be televised.  I am sure the public will be very interested to see if a doctor can be held responsible for prescribing a potentially dangerous combination of prescription medications.

There are no easy answers when it comes to whether or not a particular combination of medications will be safe to take or not. Although there may be some clear cut boundaries and limits of what medications can safely be used when taken together, there are still a lot of grey areas. So much depends upon our unique physical and biological make-up as to which combinations of meds will prove to be safe and effective. As we all know what works for one person may not work for another. Likewise, we will not all experience the same side effects or severity of side effects. You really cannot predict what will happen when you take any medication until you do. Taking medication is always somewhat of a risk or gamble in that you have to constantly assess the potential risks with the potential benefits. A good doctor will guide you on this but certainly there can be mistakes and errors of medical judgment as we have seen in the high profile cases I have discussed.