Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Hi. Are There In Possible Dangerous Drug Interactions In The
Question: Hi. Are there in possible dangerous drug interactions in the following patient
Male, 18 years old
History: Diagnosed with Osteosarcoma in 2014 and treatment ended about 11 months later.
Used to have regular cardiologist visits (some chem medicine harm patients heart). Sees cardgogist for ego and EKG about 1 each year. Had a clear EKG two weeks ago though. (Was checked for unknown chest pain)
Current medication:
Was on Sertriline (Zolft) 200mg for about 3 months.
BUT, started to ween off. Took 100mg for the last consecutive week. And today, started to take 50mg of Zolft each morning.
but: is now also taking a new antidepressant, an SNRI, Efexor 75 mg once daily.
Also prescribed: Ritilin10 mg each morning (started taking pills 2 days ago) for prior untreated ADHD
And also taking the Ritilin 10mg extended release as needed only once per day in afternoon
Holds Medical Marijuana Card.
::::: other none prescribed used in the last 75 hours:
Patient ingested 900mg if pure Dextromethorphan (DXM) (common cough suppressant teens abuse. It is also a drug that is being researched in institutions such as XXXXXXX XXXXXXX University as a new kind of Antidepressant. This is because DXM works in a similar way as ketamine by blocking Gultamate receptors.) —- note // reasoning patient justified usage. We assume it’s a side effect of his PTSD (from life threading illness)
Furthermore,
Patient has been taking a pill called Modafininl. It is used for narcolepsy and psychiatrists also can prescribe it off label for ADHD. (Patient buys Modafinil because he does not like the ritilin)
BUT,
Recently,
He tried the ritilan and still took the Modafinl.
Patient states he is focused on heart rate and chest discomfort after smoking marijuana and having a Ritilin extended release 2 hours before.
Male, 18 years old
History: Diagnosed with Osteosarcoma in 2014 and treatment ended about 11 months later.
Used to have regular cardiologist visits (some chem medicine harm patients heart). Sees cardgogist for ego and EKG about 1 each year. Had a clear EKG two weeks ago though. (Was checked for unknown chest pain)
Current medication:
Was on Sertriline (Zolft) 200mg for about 3 months.
BUT, started to ween off. Took 100mg for the last consecutive week. And today, started to take 50mg of Zolft each morning.
but: is now also taking a new antidepressant, an SNRI, Efexor 75 mg once daily.
Also prescribed: Ritilin10 mg each morning (started taking pills 2 days ago) for prior untreated ADHD
And also taking the Ritilin 10mg extended release as needed only once per day in afternoon
Holds Medical Marijuana Card.
::::: other none prescribed used in the last 75 hours:
Patient ingested 900mg if pure Dextromethorphan (DXM) (common cough suppressant teens abuse. It is also a drug that is being researched in institutions such as XXXXXXX XXXXXXX University as a new kind of Antidepressant. This is because DXM works in a similar way as ketamine by blocking Gultamate receptors.) —- note // reasoning patient justified usage. We assume it’s a side effect of his PTSD (from life threading illness)
Furthermore,
Patient has been taking a pill called Modafininl. It is used for narcolepsy and psychiatrists also can prescribe it off label for ADHD. (Patient buys Modafinil because he does not like the ritilin)
BUT,
Recently,
He tried the ritilan and still took the Modafinl.
Patient states he is focused on heart rate and chest discomfort after smoking marijuana and having a Ritilin extended release 2 hours before.
Brief Answer:
Interaction between the medications are explained below in detail.
Detailed Answer:
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
I understand your concern.
The medical condition of the patient is very complex.
Zoloft and Effexor should not be taken together.
Using these two medications together can increase the risk of a serious condition called the serotonin syndrome.
It may include symptoms such as confusion, seizure, extreme changes in blood pressure, increased heart rate and shaking.
Zoloft and Ritilin when used together may also increase the risk of the serotonin syndrome.
In this case, Ritalin may increase the blood levels and effects of Zoloft.
The same interaction may happen when using Dexomethorphan and Zoloft or Effexor.
So, to conclude the patient that takes these medications has an increased risk of the serotonin syndrome.
If he presents one of the symptoms explained above, you should go in the emergency room for proper treatment.
Hope I have answered your query. Let me know if I can assist you further.
Interaction between the medications are explained below in detail.
Detailed Answer:
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
I understand your concern.
The medical condition of the patient is very complex.
Zoloft and Effexor should not be taken together.
Using these two medications together can increase the risk of a serious condition called the serotonin syndrome.
It may include symptoms such as confusion, seizure, extreme changes in blood pressure, increased heart rate and shaking.
Zoloft and Ritilin when used together may also increase the risk of the serotonin syndrome.
In this case, Ritalin may increase the blood levels and effects of Zoloft.
The same interaction may happen when using Dexomethorphan and Zoloft or Effexor.
So, to conclude the patient that takes these medications has an increased risk of the serotonin syndrome.
If he presents one of the symptoms explained above, you should go in the emergency room for proper treatment.
Hope I have answered your query. Let me know if I can assist you further.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
