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Painkillers and BP meds


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Help me out a little? I have a broken foot -- it's been broken since March -- and I thought it had healed. But just this past week, I almost fell over from the pain. Went in for an xray, and it's still broken. My PCP immediately wrote a script for 40 Vicodin, and I'm sure she will refill anytime I ask.

The Vicodins give me the HUGE "itchies." I'm scratching more than my cat. But just like back in March, they work. 

My pdoc hasn't really said anything about mixing Vicodin with Seroquel and Depakote, and I told him right away what was going on. 

The Vicodin do wonders for the mania and anxiety, to boot. But "mixing" scares me a little. I've read all the warnings, but does anyone have any specific experience ?

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When in doubt, call your pharmacy, is the best advice I can give.

The pharmacy will have your records, and all the meds you take. If not, they should be informed of everything you're on for potential interactions. A good pharmacist is a great resource. 

Seriously, I talk to my pharmacist more about med interactions than my doc. I've had a few doc's prescribe me things with interactions that the pharmacist has caught before filling (and contacted the doc and had it changed). They should give you a PI sheet, and the pharmacist will run everything through a checker, to make sure there aren't dangerous interactions, and if there are any interactions (there often are, they just aren't that big of a deal) they'll tell you what to expect and how to take the meds properly.

I was on similar meds when I broke my shoulder. Seroquel, lithium, xanax, and some other stuff (can't recall it all) and Percocet, for the pain. My pharmacy told me to take as needed, and start with 1 pill (I was rx'd 1-2 pills every 6-8 hours). That one pill knocked me flat on my ass, so I called to see if I could cut the pills in half. I could, so I did. My memory of that time is fuzzy, I was incredibly angry (narcotic pain meds make me angry, apparently) and I was pretty out of it. On 2.5mg of percocet every 12 hours. (It hit me hard)

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Agree on talking to your pharmacist -- drug interactions fall more in their scope of work than a doctor.

I ran your list of Rx's at the drugs.com interaction checker and there're Moderate interactions between all three with the same warning: dizziness and judgement. Just about every med I'm on has the same interaction warning with every other med, so I wouldn't worry too much about that. Head and run it yourself if you want some quick peace of mind.

But also follow-up with your pharmacist :)

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Help me out a little? I have a broken foot -- it's been broken since March -- and I thought it had healed. But just this past week, I almost fell over from the pain. Went in for an xray, and it's still broken. My PCP immediately wrote a script for 40 Vicodin, and I'm sure she will refill anytime I ask.

The Vicodins give me the HUGE "itchies." I'm scratching more than my cat. But just like back in March, they work. 

My pdoc hasn't really said anything about mixing Vicodin with Seroquel and Depakote, and I told him right away what was going on. 

The Vicodin do wonders for the mania and anxiety, to boot. But "mixing" scares me a little. I've read all the warnings, but does anyone have any specific experience ?

I do! I have chronic back pain so I'm on a pain patch and take Norco(stronger form of Vicodin) everyday along with my long list of pysch drugs. I'm on Seroquel XR, along with a few other medications. I've had absolutely no problem "mixing" medications. I assure you, I'm on more medication than you, and I'm OK. Been on pain killers almost 2 years in combination with the psych meds. I do only take 2 a day though. You should only worry if your abusing it and taking like 10 a day. Other than that, your perfectly safe.

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I was on vicodin for 4 years when having hip surgeries, and I was on many meds at the time.  Took 2-3 vicodin/day.  No problems at all.  Have also been on percocet and something else (I forget) (at different times after the vicodin, with many other meds, with no problems).

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I'm not taking the Seroquel or the Depakote tonight. The Vicodin does incredibly well on its own -- no anxiety, no mania! And I think it safer to not take the other two. I'm in a pretty ridiculous degree of pain -- when you break a bone in your foot, pain happens. 

Edited by strongvoice1
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I'm not taking the Seroquel or the Depakote tonight. The Vicodin does incredibly well on its own -- no anxiety, no mania! And I think it safer to not take the other two. I'm in a pretty ridiculous degree of pain -- when you break a bone in your foot, pain happens. 

Bad idea. Going of your psych meds unmonitored, and by your own decision, can cause a serious relapse. Call your pdoc or pharmacist if you are uncertain bout the meds (like other have said). Do not do this on your own without letting the people who are treating you know about it. Listen to what they have to say about all this first. 

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I'm not taking the Seroquel or the Depakote tonight. The Vicodin does incredibly well on its own -- no anxiety, no mania! And I think it safer to not take the other two. I'm in a pretty ridiculous degree of pain -- when you break a bone in your foot, pain happens. 

Bad idea. Going of your psych meds unmonitored, and by your own decision, can cause a serious relapse. Call your pdoc or pharmacist if you are uncertain bout the meds (like other have said). Do not do this on your own without letting the people who are treating you know about it. Listen to what they have to say about all this first. 

I agree as well. Bad idea. You need to talk to your pharmacist and your pdoc. I've taken pain meds on a daily basis for a few years now. I have not had to change my meds for MI because of the pain meds. 

Triple agree. I'm on stronger pain medicine than the OP, and I have never had to stop my psych medicine.

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I suggested not combining the two, and my pdoc didn't yell. Remember, my Seroquel dosage is very low -- 100 mg for insomnia. I'll keep taking the Depakote; that's the more critical of the two anyway. There is all manner of literature in the journals about the dangers of combining the two -- especially cardiac dangers and long QT syndrome, which is no joking matter. 

Which hurts more -- the foot, or my emotions? The foot. Period. My PCP wants me to come in for an MRI this week; might even be a clot or an infection. My health care provider is so bad that they won't have any openings this week. Besides, it's the last week of summer school, leaving me with 45 papers and 15 projects to grade. I have a job interview for a line professor position on Friday. And I defend my thesis a week from tomorrow (Monday). As I told my doctors, I don't care if I have stage four ass cancer or a sucking chest wound. I don't care if my balls fall off. I am getting this done. Done, done for good -- no more grad school, a dependable position, and a class I can move from summer to spring after I finish it this week.

Stay out of my way. And if you hear me coming -- duck. 

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The prescriptions came from two different doctors, who may -- or may not -- confer with each other. There are medical journal articles (not Google, thank you, I use medical reference databases) that specifically point to possible problems in combining the two.

Like I said, my pdoc wasn't yelling about it. It's a safe decision. I am not a fan of painkillers as it is; they give me lower intestinal problems and generally aren't worth it for me. I can handle pretty big degrees of physical (and even chronic) pain, so the risks associated with the opioid class always makes that category kind of "last ditch" for me. But walking around on a fractured foot -- yeah, that's gonna need some help. 

I'm a well-informed patient who will have a terminal degree on Monday, so long as my thesis defense is successful. Most of us on this board, I would guess, can use higher-level medical reference material to have intelligent conversations with their providers. I do it all the damn time.

And I flunk my undergrads for using Google and Wiki.

Not sure about the rest of you, but I'd sure rather be taking fewer prescriptions -- not more.

Edited by strongvoice1
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Huh, that's funny. Plenty of my Drs. use Google, Google Scholar, and Pubmed right in front of me all the time. Good thing you weren't their section leader. And, surprise! They're all professors themselves!

 

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PubMed is one I use, too. Medline from EBSCO is the one that rocks, and pretty much every doctor's office has it (or should). Goog and Goog Scholar are like searching through a jewelry box with a sledgehammer -- just completely unrefined. If I'm looking for statistics on how many cases of weight gain have been reported with a Seroquel/Depakote combination where a benzo was used as opposed to a placebo, anything Goog is worthless.

i always ask my providers what databases they use. That's one of my interview questions. If they don't come back with one of the big scientific databases (EBSCO, Web of Science, et. al.), I volunteer my login. If they get snippy -- I leave.

 

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I said it's when they get snippy about me questioning their database usage that I leave. So, I can't question what database they use? I don't get to ask if they like Medscape or Medline? And, as I said, that's *one* of my questions. Before I hire a doctor of any specialty, I have a ton of questions.

I'm a researcher. People with PhD's are trained to be researchers. People with MD's are trained to be researchers. And I don't want to be driving a Ford Pinto in the Research 500 when the competition has a Porsche. It's my money in terms of insurance premiums, copays and deductibles, and I want the best treatment I can get, while staying productive in the world. That means I do have a level of expectation as to the tools used.

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I said it's when they get snippy about me questioning their database usage that I leave. So, I can't question what database they use? I don't get to ask if they like Medscape or Medline? And, as I said, that's *one* of my questions. Before I hire a doctor of any specialty, I have a ton of questions.

I'm a researcher. People with PhD's are trained to be researchers. People with MD's are trained to be researchers. And I don't want to be driving a Ford Pinto in the Research 500 when the competition has a Porsche. It's my money in terms of insurance premiums, copays and deductibles, and I want the best treatment I can get, while staying productive in the world. That means I do have a level of expectation as to the tools used.

I never thought of all that when finding a pdoc.  Fortunately I haven't had to.  You have great points.  Thanks.

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Quite welcome. Anyone messing with my brain better have the quals to do it. As an academic, I'm from the scientific community, myself. I'm finding most of my docs love that. When I message them or see them, I never talk about how I feel. I talk about what I did and am doing; feelings aren't scientifically quantifiable. 

We would all do better with fewer emotions and more math. 

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Ask your pharmacist for an antihistamine if the itching bothers you. As far as I know there's no problem with painkillers and BP meds. I am using Norspan Patches for back pain along with Lithium. Never heard of any issue. There's a caution with multiple drugs that can cause sedation. There can be an additive effect so a person could become more sedated than usual. But if that hasn't happened, no cause for concern.

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Quite welcome. Anyone messing with my brain better have the quals to do it. As an academic, I'm from the scientific community, myself. I'm finding most of my docs love that. When I message them or see them, I never talk about how I feel. I talk about what I did and am doing; feelings aren't scientifically quantifiable. 

We would all do better with fewer emotions and more math. 

I disagree. I am an artist who was first intending to be an epidemiologist (mi finished that). I was excellent at math and chemistry.

I also work closely with retired doctors and surgeons at the medical museum. Highly intelligent and logical, but watch them take a visitor through the displays and they deeply care and are emotionally attached to everything they talk about (I will also add they are all very eccentric in their personal lives). Many of my friends, too, work in science or medicine and my husband is a programmer. 

Science and and art were once closely linked. It takes a creative  and emotional mind to excel in research of almost any kind and I'd say the best scientists have a great passion for their work. If you read letters of some of the greatest minds in medical science they feel as much as they think. You need the best if both worlds to access innovation and discovery.

Oh and you also need an emotional range to engage and connect with patients. The doctors at the museum have very emotionally heavy stories from their time working. Things that touched them (especially deaths). 

Sorry, I hate the logic against creativity/emotion sentiment. They can work beside one another with brilliant results.

 

Edited by saintalto
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