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Drug interactions between Antidepressants and Narcotics - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Medicines and Side Effects
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1766 Questions
Doctor :   hi
User :   hello dr.
Doctor :  
how can i help you
User :   i have a question about my medications
User :   i take prozac for major depression
Doctor :   ok
User :   and over a month a go i started gabapentin and a time released morphine and diladid for break through pains
User :   could any of that make my depression meds less effective?
User :   or could it just be possible for my depression meds to not have the same effect
User :   i've been on prozac for only about 4 months
Doctor :   ok

User :   ?
Doctor :   are you there

User :   yes...
User :   i asked u my question
User :   could my pain meds be interacting with my antidepressants and making my antidepressants less effective?
Doctor :  
Antidepressants have such interactions with other pain killers
Doctor :  
so they make the few other pain killers less effective
Doctor :  
Gabapentin is itself a pain killer
User :   i'm talking about my depression meds
User :   i know
User :   could they be making my depression meds less effective
Doctor :  
No
User :   because my depression seems to be back again
User :   then i don't understand about my depression
User :   because i havn't been on the prozac long enough for it to stop working
Doctor :  
when were they last revised by your Doctor
User :   i just started them about 4 months ago
Doctor :  
ok when was the last follow up
User :   i think that's too soon for it to be less effective
User :   a few weeks ago
User :   i was in more for the pain and less for the depression
Doctor :  
Ok now what symptoms are you getting back
Doctor :  
as part of your depression
User :   i'm tired and sluggish (and i know that can be due to the pain meds)
User :   i don't feel like talking to anyone, family, or friends
User :   i'm upset easily again
User :   and i get anxious very easily
User :   almost had a panic attack today
Doctor :  
Ok
User :   i'm just really down for the past week
User :   my mom thinks i may be suicidal again but i don't feel that far
Doctor :  
Were these symptoms not there when you started on the antidepressants
User :   but i'm afraid that it will get that way
User :   i attempted suicide 4 times i've been on lexapro, cymbalta and now prozac
User :   i have major depression and borderline personality disorder plus i'm suffering with chronic pain which makes things worse
Doctor :  
Ok
User :   i was better with the prozac but this past week i just feel down again
Doctor :  
You said your last doctor meeting was just a week away
Doctor :  
sorry back
Doctor :  
Is it not?
User :   was about 2 weeks ago..maybe going on 3
Doctor :  
Were you taking help from clinical psychologist
Doctor :  
too
Doctor :  
as part of Psychotherapy , coping skills
User :   my dr is a psychologist and an internal medicine dr
Doctor :  
Ok good
User :   i'm suppose to start a steps program this month for the bpd
Doctor :  
Wonderful
User :   and get with a pain psychologist this month too to help coping with the pain
Doctor :  
You are doing good as part of therapeutic program
Doctor :  
then
Doctor :  
Did you take any steps for yourself to reduce the chances of attacks like Yoga, Relaxation techniques
User :   and i'm doing research and talked to another dr on here last time and they mentioned chronic pancreatitis, but my dr i have doesn't want to look into that because i think when i mentioned it to him he was thinking of the acute form of pancreatitis with the raised enzymes and all
User :   breathing
User :   idon't know if i should ask for another opinion from someone else
Doctor :  
Ok
Doctor :  
So continue with the breathing techniques regularly
User :   i'm concerned with the depression
Doctor :  
Actually yes some pain medicines like Morphine can make the antidepressants less effective
User :   i'ave already attempted 4 times this year, i don't want to go down that road again or even get close to it again
Doctor :  
Yes you should not
User :   i';m on time released morphine
User :   and diladid
Doctor :  
Do you mean Dilaudid
User :   yes
Doctor :  
Ok this is also a narcotic pain killer
User :   yes
Doctor :  
They seems to interact with the antidepressants but it should not be more.
Doctor :  
I think there might be some other factors that is making your symptoms come back
User :   such as, examples?
Doctor :  
any abnormal event
Doctor :  
other drugs
Doctor :  
anxiety about another problem
Doctor :  
thoughts about other important and personal issues
User :   i have school
User :   i'm a premed student
User :   but other than that no
Doctor :  
What is your age
User :   i do get concerned that i'm on the narcotics and so far sounds like i'm gonna be on them the rest of my life and i don't want that
User :   21
User :   i've mentioned a celiac ganglion block to try to get off the narcotics then and still have pain relief
Doctor :  
Might be that is making you worried and the symptoms are coming back
User :   but he wont look into it
Doctor :  
Ok I suggest you to seek a second opinion then
User :   ok, i just am tired of drs saying i'm addicted to the narcotics when i want nothing more than to get off them and be pain free
Doctor :  
Ok
Doctor :  
Since how long you have been taking narcotics
User :   off an on over 2 years
User :   i had my gallbladder out in 2007 january
Doctor :  
Okie
User :   seen specialists, had 4 ERCPs
User :   all kinds of procedures and tests
Doctor :  
ok
User :   they've come to the conclusion that it's just a pain that i'm going to have to live with and will just have to cope with
Doctor :  
Do you think you have been addicted to narcotics
User :   but i'd like for them to test for the chronic pancreatitis since it can lead to diabetes
User :   i think that my body has grown a little of a dependance now but i'm not seeking it
User :   i'm on a scheduled timed released morphine 2 times a day
User :   with the meds they're giving it of course my body is dependent upon it now
Doctor :   ok
User :   which upsets me cause i was refered to this doctor because he knew how to handle narcotics supposivley
User :   and i told him i was concerned about this
User :   it's just sometimes it gets so bad i end up in the ER
Doctor :  
ok
User :   and we're trying to keep me out of the hospital as much as possible
Doctor :  
DO you think the doctor is not doing a good job
User :   i don't know
User :   he's the only one who listens to me
User :   but i think he's falling into the cracks of every other dr
User :   saying it's something i'm just going to have to live with
Doctor :  
Ok
User :   will i even be able to be a practicing dr while on narcotics?
Doctor :  
Usually the narcotic dependency will not put you against practising unless you have a bad track record
User :   i don't
User :   i just don't like it, cause then after time the dose wil have to be increased to be efficant
Doctor :  
I understand all your concerns but you should try all your best to come out of the dependence
User :   and then i just hear it from other doctors calling me a seeker and such
Doctor :  
You should prove it as a medical miracle to the now treating doctor
User :   and what end up back in the ER?
User :   and drop out of school?
User :   again
User :   i've already stopped taking them for half a year last year to stop the gossips from the drs
Doctor :  
Good
User :   i just ended up taking medicines that would make me tired so i wouldn't be dealing with the pain
Doctor :  
continue with that
User :   then i can't continue with school
User :   can't work
Doctor :  
I think wellbeing is more important than your routine
Doctor :  
work and school
Doctor :  
If you can take a break from your usual schedules
User :   easy to say when u don't have your life taken away from you
Doctor :  
and start working on these things it takes less time
User :   i've had to drop out of school twice to take a break
User :   quit over 5 jobs
Doctor :  
ok
User :   my mom doesn't have the money to support me anymore when i'm not working due to all the hospital bills
Doctor :  
ok
User :   this whole thing has taken my life away and i don't know where to go
Doctor :  
To say short, to tide away the current problem you have to try to reduce the narcotics
Doctor :  
as they might interact with your antidepressants too.
User :   and how am i suppose to do that deal with the stabbing pain?
Doctor :  
You have to take alternative pain relieving measures
User :   they're trying gabapatin so far isn't working
Doctor :  
like Numbing the area with cold packs
User :   i've tried lyrica didn't work
User :   cold and hot packs doesn't work
User :   i've had trigger point injections
Doctor :   I know the narcotics are the ultimate pain relievers
User :   i've had 2 bile duct sphincterotomies
User :   chiropractor doesn't help
User :   they're not for long term use
User :   i get that i've tried all kinds of stuff besides the narcotics
Doctor :   but since you have to take a balance of all the things going out of narcotic addiction, using alternative pain therapies and pain bearing.
User :   i know all this
User :   being a premed student and a former radiology student and a former pharmacy tech i know all the side effects
User :   doctors all tell me the same thing, and i'm all for weaning off all narcotics
User :   if i was also given a way to not have to deal with the pain head on
Doctor :   ok
User :   a way so i'm not going to the er in pain
User :   doctors always come to the conclusion that i'm hooked and get me off
User :   but no one helps me find a way to do it in a way to control my pain as well
Doctor :   Being a med student I guess you know it is really tough to bring a balance between these two

Doctor :  
even for doctors
Doctor :  
That is why I ask you to start bearing the pain with other alternative therapies like Yoga
Doctor :  
You know Yoga has log ot pain relieving pwoer
Doctor :  
You do it along with the low dose narcotics
User :   i need to find a way to get off narcotics all together
Doctor :  
yes it can be done slowly with combination of these things
User :   and if it's chronic pancreatitis?
Doctor :  
Yoga, Alternative apin therapies and slowly withdrawl of narcotics
User :   well i'm telling you right now i'm not doing yoga
Doctor :   You have to start with it it is easy to practice, no side effects besides it helps in your depression problems

Doctor :  
Why cant you start with it for two months and see the change
Doctor :  
If it s not of any help to you and you can always stop it
User :   i've tried yoga before
User :   ...i end up falling asleep because it's too boring
Doctor :  
You can restart it
User :   and i have time for this when....
Doctor :  
I think you shave larnt 6the right way to do it
Doctor :   I think our chat is hanging now because of load of content for the last 90 minutes

Doctor :  
We have to end up soon
User :   i just don't get how to do all of it
User :   when i feel like drs keep turning me in circles
User :   yoga isn't something i'm up for, and the only other pain coping techniques anyone has talked to me about is therapy
Doctor :  
This is also called Yogatherapy
User :   but the time for that is draging on before i start and i stil struggle with pain while i wait for it
User :   i'm not interested in yoga
Doctor :  
Ok
Doctor :  
Fine
Doctor :  
Can you please login in a second browser again so that we can continue chat
User :   ok how do i do that?
User :   can i just press refresh on the page?
Doctor :  
Let me close it after feedback form
Doctor :   Logout and login back
Question is related to
Diseases and Conditions
Drug/Medication
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