How many doctors do you have? I’ve got two that I see on a regular basis: my primary care doc, and my neurologist. Add to that the occasional specialist like a dermatologist, or an orthopedist, or what have you, and the list quickly gets pretty long. I guess it’s one of the prices you pay for getting older and having a chronic disease like migraine.
A side-effect of the number of doctors winds up being the number of prescriptions. Some are long-term prescriptions for the chronic things, and some are short term (sometimes to combat aspects of the chronic things, sometimes for yet another issue unrelated to the chronic things). When you start mixing all of these drugs together, you basically become a big lab beaker. Who knows what’s going to happen when these things mix?
Well, a couple people are going to know. . .
Your prescribing doctor should be your first line of defense against medicines that shouldn’t be mixed. However, I’m going to let you in on a little secret here:
Doctors are not omniscient. They cannot read minds. They don’t know what medicines other doctors have prescribed you. They may not even know if you are still taking a medicine that they prescribed you in the past!
Therefore, when a doctor prescribes you a new medicine, the first thing you should do is remind them of the medicines that you are currently taking, so they can tell you if there will be any adverse drug interactions.
Your second line of defense should be your pharmacist. When you get prescribed a new drug for the first time, take some time and talk to your pharmacist. Give her a list of all the other drugs that you are taking, and, if they’re worth their salt, they’ll look up the interactions for you. If there are any cautions about interactions, you can then discuss them with your pharmacist or doctor.
Either way, it comes down to two words: Full Disclosure. And it’s your responsibility to disclose. Personally, I have a small sheet of paper that I carry with me at all times that lists the brand name, generic name, and dosages of all the drugs that I take on a regular basis, just in case I need it in an emergency. You never know when you are going to need to fully disclose.
On the topic of “full disclosure,” and definitely germane to migraineurs:
The Food and Drug Administration of the United States issued a Public Health Advisory in July of 2006. This advisory cautions about mixing of certain selective serotonin reuptake inhibitors (SSRIs) and selective serotonin/norepinephrine reuptake inhibitors (SNRIs) and triptans. Since at least one of the migraine preventatives falls into the class of SSRIs that the FDA is concerned with, and since a lot of migraineurs use triptans, this is definitely something I would encourage you to discuss with your neurologist, headache doctor or primary care physician.
