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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for insomnia and depression

My friend has been being drugged by her husband nightly for 8 months. He has been crushing up 100 mgs of Trazodone (Don t know how many pills each time) with unknown amounts of Ambien he has been putting this mixture into a glass of red wine. She noticed the wine was cloudy and was eventually told by her 13 year old stepdaughter that her father was putting white Powder in her glass before pouring the drink. He filled these 2 Rxs at an alternate pharmacy from the one they normally used. He weighs 220lbs she weighs 95lbs. 1) Could this Cocktail Cause death over an extended period of time? 2) Can the ICD9 code for insomnia be used for both prescriptions or would a doctor by law have to use a Separate Code of depression to write for the Trazodone to be taken in conjunction with the ambien? The dosage of ambien was so high that when they did the UA 5 days later it was still very high. Thank You for your help
Sat, 17 Jan 2015
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Psychiatrist 's  Response
Hello thanks for choosing HCM for your health related queries

She has been given Trazodon and Ambien unknown amounts by mixing in wine. Ambien is zolpidem and trazodone is a TCA drug and which is a good anti-depressant drug. Both drugs when mixed with wine, may result in cocktail mixture and it may prove harmful in a normal individual. It may cause acute brain depression and toxicity. Now coming to your questions-

- This cocktail may cause acute deaths but chronic toxicity over extended period of time is not seen. She may become dependent on drugs and this may result in withdrawal if drugs are abruptly stopped.

- Yes ICD 10 (instand ICD 9 which is old) code can be used to make diagnosis. But the diagnosis should be made by a registered medical practitioner or a psychiatrist only. You can consult her lawyer for more details

Thanks, hope this helps you. Take care
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