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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by lori on October 31, 1999, at 6:19:31
Does anyone know of links to info on effects of alcohol/drugs on psychiatric meds? Thanks!
Posted by saint james on October 31, 1999, at 6:29:45
In reply to psych meds and substance abuse, posted by lori on October 31, 1999, at 6:19:31
> Does anyone know of links to info on effects of alcohol/drugs on psychiatric meds? Thanks!
James here....
The PDR or perscribing insert ( ask for it from your Rx) will generally will mention alcohol use with meds. other illicit drugs are da facto contraindicated. If you could be more specific as to which meds and illicit drugs you need info on I'll give you the straight dope as I see it. However, actual mileage may vary.
j
Posted by lori on October 31, 1999, at 7:03:41
In reply to Re: psych meds and substance abuse, posted by saint james on October 31, 1999, at 6:29:45
> > Does anyone know of links to info on effects of alcohol/drugs on psychiatric meds? Thanks!
>
> James here....
>
> The PDR or perscribing insert ( ask for it from your Rx) will generally will mention alcohol use with meds. other illicit drugs are da facto contraindicated. If you could be more specific as to which meds and illicit drugs you need info on I'll give you the straight dope as I see it. However, actual mileage may vary.
>
> j I'm looking for specific websites giving info on effects of marijuana use on absorption/utilization of various meds. I need concrete info that I can use professionally to show to my clients. Thank you!
Posted by Carol on October 31, 1999, at 11:34:04
In reply to Re: psych meds and substance abuse, posted by saint james on October 31, 1999, at 6:29:45
> James here....
>
> The PDR or perscribing insert ( ask for it from your Rx) will generally will mention alcohol use with meds.
>
> j
James--I've had difficulty getting straight answers on this. inserts and Rx's just say, "Don't use alcohol", but never will say why. I mean, I don't want to get drunk every night, but if I take 400mgs. Wellbutrin/day, and then have 3 or 4 beers over the course of a long evening out, will I fry my brain or something? Anybody know the consequences?
Posted by Elizabeth on October 31, 1999, at 13:04:38
In reply to Re: psych meds and substance abuse (to saint james, posted by Carol on October 31, 1999, at 11:34:04
> James--I've had difficulty getting straight answers on this. inserts and Rx's just say, "Don't use alcohol", but never will say why. I mean, I don't want to get drunk every night, but if I take 400mgs. Wellbutrin/day, and then have 3 or 4 beers over the course of a long evening out, will I fry my brain or something? Anybody know the consequences?
A problem with the PDR (two sites that have many of the monographs online are rxlist.com and rxmed.com - don't know how up-to-date they are, though; sometimes the web site for the pharmaceutical company will include the monograph) is that the monographs are written by the drug companies. They tend to do a lot of CYAing. The seemingly universal "avoid alcohol" warnings are an example. (They never include anything on interactions with illegal drugs, even some really dangerous ones (e.g., MAOI + MDMA).)
That said, my general impression has been that moderate alcohol use is fine with most antidepressants. (Ask your doctor what counts as "moderation;" I've never been clear on this.) Some people find that alcohol makes them sick when they are on antidepressants. Others say that it takes less to get them drunk. My experience on Nardil was that the alcohol actually had less effect than it ordinarily would have. (Maybe because most of the effect alcohol has on me is sedation, while Nardil made me more alert.) With other antidepressants I've noticed little or no difference.
A particular concern with Wellbutrin might be that rebound effects from alcohol could lower the seizure threshhold, always something to watch out for with Wellbutrin.
Posted by saint james on October 31, 1999, at 20:26:08
In reply to Re: psych meds and substance abuse (to saint james, posted by Elizabeth on October 31, 1999, at 13:04:38
> > James--I've had difficulty getting straight answers on this. inserts and Rx's just say, "Don't use alcohol", but never will say why. I mean, I don't want to get drunk every night, but if I take 400mgs. Wellbutrin/day, and then have 3 or 4 beers over the course of a long evening out, will I fry my brain or something? Anybody know the consequences?
>James here....
generally the "avoid alcohol" has to do with most AD's being sedating, and alcohol makes this worse.
probably alcohol makes AD's less effective, but a few drinks a week is not going to hurt. The Rx always puts "aviod alcohol" stickers on anything thing that is sedating, like antihistamines, ect.
To be safe, do ask you doc or Rx if there is a specific problem or is it just the sedation issue.
Have a glass of wine, or whatever, at home first to see if sedation increases.j
Posted by LORI on November 1, 1999, at 6:11:18
In reply to Re: psych meds and substance abuse (to saint james, posted by saint james on October 31, 1999, at 20:26:08
> > > James--I've had difficulty getting straight answers on this. inserts and Rx's just say, "Don't use alcohol", but never will say why. I mean, I don't want to get drunk every night, but if I take 400mgs. Wellbutrin/day, and then have 3 or 4 beers over the course of a long evening out, will I fry my brain or something? Anybody know the consequences?
> >
>
> James here....
>
> generally the "avoid alcohol" has to do with most AD's being sedating, and alcohol makes this worse.
> probably alcohol makes AD's less effective, but a few drinks a week is not going to hurt. The Rx always puts "aviod alcohol" stickers on anything thing that is sedating, like antihistamines, ect.
> To be safe, do ask you doc or Rx if there is a specific problem or is it just the sedation issue.
> Have a glass of wine, or whatever, at home first to see if sedation increases.
>
> j
All I know for sure is that alcohol is a depressant in any amount. It makes no logical sense to take a antidepressant and then take a depressant! In any amount.
Posted by Noa on November 1, 1999, at 7:01:58
In reply to Re: psych meds and substance abuse (to saint james, posted by LORI on November 1, 1999, at 6:11:18
I don't think it is just the sedating ADs that one needs to be cautious about. I think some of the ADs affect the ability of the liver to metabolize substances, like alcohol, so the effect of the alcohol can be more pronounced, even if one is taking a so-called "activating" AD, rather than a sedating one.
Posted by Bob on November 1, 1999, at 7:59:56
In reply to Re: alochol and ADs, posted by Noa on November 1, 1999, at 7:01:58
> ... I think some of the ADs affect the ability of the liver to metabolize substances, like alcohol....
This has always been one of those little nagging voices in the back of my head ... many of us here are on three, four, five or more meds ... what is the cumulative impact on the liver and related organs? That's probably the main reason why I refrain from self-medicating, and also cutting back on refined sugars (gotta get those extra Halloween candies OUT of the apartment!), caffeine and such.
Bob
Posted by Racer on November 1, 1999, at 13:03:44
In reply to Re: liver function, posted by Bob on November 1, 1999, at 7:59:56
(gotta get those extra Halloween candies OUT of the apartment!), caffeine and such.
>
> BobTrick or treat!
Send them over here to me! I need some sweetening up!
(Yep, my blood sugar is about 60 today... Started at 42, then went all the way up to 58 after breakfast... Yep, normal is about 100... Yeah, it's a little low...)
Posted by Deb R on November 1, 1999, at 20:00:10
In reply to Re: liver function, posted by Bob on November 1, 1999, at 7:59:56
>many of us here are on three, four, five or more >meds ... what is the cumulative impact on the >liver and related organs?Hey Bob
This is something that is on my mind a lot with Mum - her liver and kidneys have been affected by many years of taking anti-psychotics. Liver function in particular is a concern for me. If Mum was off all drugs would the liver cleanse itself back to 'normal' or would it stay as it is, at that same level of reduced function?
If anyone knows the answer please let me know. Thanks!Deb.
Posted by saint james on November 1, 1999, at 21:42:27
In reply to Re: liver function - a question...., posted by Deb R on November 1, 1999, at 20:00:10
>
> >many of us here are on three, four, five or more >meds ... what is the cumulative impact on the >liver and related organs?
>
> Hey Bob
> This is something that is on my mind a lot with Mum - her liver and kidneys have been affected by many years of taking anti-psychotics. Liver function in particular is a concern for me. If Mum was off all drugs would the liver cleanse itself back to 'normal' or would it stay as it is, at that same level of reduced function?
> If anyone knows the answer please let me know. Thanks!
>
> Deb.James here....
Generally the liver will regenerate to some degree
if the damage is not
Posted by Bob on November 3, 1999, at 14:47:46
In reply to Re: liver function - a question...., posted by saint james on November 1, 1999, at 21:42:27
> James here....
> Generally the liver will regenerate to some degree
> if the damage is not... yes ... "is not..." ... what? ;^)
Well, Deb, the last time I studied any Bio was, I believe, prior to the Knack hitting it big, but my therapist is into Yoga, and organic vegetarian nutrition and all that other alternative med stuff, and while waiting one day I was reading a book of hers on "natural" ways to imporving your health -- like "liver cleanses" and "colon cleanses" and the like, and what order to do them in. The prevalence of the word "enema" in all of these recipes had me turning the pages pretty quickly, tho. Maybe someone else out there who is more enlightened (and less frightened!) about this topic can respond ....
Bob
Posted by Phil on November 3, 1999, at 17:14:24
In reply to Re: liver function - a question...., posted by Bob on November 3, 1999, at 14:47:46
> > James here....
> > Generally the liver will regenerate to some degree
> > if the damage is not
>
> ... yes ... "is not..." ... what? ;^)
>
> Bob,We've got a lot of 'colon cleansers' here in Austin-"Where the men shave their legs and the wimmin don't". And Matt M. plays the bongos nekkid!
Seriously though, I'd love to hear more info on liver function related to all these drugs.Phil
Posted by allison on November 3, 1999, at 17:43:04
In reply to Re: liver function - a question...., posted by Deb R on November 1, 1999, at 20:00:10
From my experience with my mother's cirrhosis, liver function is not the easiest thing to determine or predict.
They can tell if it's distended or enlarged. They can tell how it's scarred. They can measure its function (my mother qualified for a transplant).
However, if it stops working (and I am by deduction assuming here that this can include reduced function but I may be wrong and invite others to join in here), they CANNOT tell you WHETHER OR WHEN a liver will start functioning again.
There were several times when my mother was hospitalized that I waited several days for doctors to see if her liver would begin to work again. If it doesn't, it can be a gruesome death for the survivors to endure. Of course, one is already yellow, but then turns an ochre green as toxins build up in the system. Then other organs fail (kidneys, lungs, heart). But this takes several days as I understand it.
Yes, the liver can regenerate itself (my mother always used this excuse to keep drinking), but only to a point. Then liver function decreases and doctors add drugs to help it compensate. That said, I've read that milkthistle (or something like that, it's been a while and I think I've kind of blocked it out) helps liver function.
As I've said before, prescription doses can be a problem too, because it's hard to predict liver function and how well the body is eliminating drugs, so there is always a risk of dangerous buildup. This is where the doctors failed my mother.
Posted by torchgrl on November 3, 1999, at 17:57:07
In reply to Re: liver function - a question...., posted by allison on November 3, 1999, at 17:43:04
milkthistle is definitely supposed to be good for liver function--I'm pretty sure there are a few other homeopathic remedies that are also purported to be helpful, my brain just doesn't have enough storage space to be able to tell you which ones. It's definitely worth doing some research on, though.
Posted by Deb R on November 3, 1999, at 22:47:08
In reply to Re: liver function - a question...., posted by torchgrl on November 3, 1999, at 17:57:07
Firstly, sorry to have gotten so far away from your original thread Lori...
Have found a book (in my own bookshelf I am ashamed to say) called The Liver Cleansing Diet by Dr Sandra Cabot, think its an Aussie publication. Anyway, will finally read it properly, then check out natural remedies such as mentioned by allison and torchgrl.
I still believe that the first step for Mum should be a break from all drugs, I just cant get my head past the thought that I might lose her and I can do something about it. Allison, bless you and thank you for sharing what must be painful memories for you....thanks to you all.
Lori, I hope you find the answers to your original thread question...good luck...
Deb.
Posted by JohnL on November 4, 1999, at 3:28:20
In reply to Re: liver function - a question...., posted by torchgrl on November 3, 1999, at 17:57:07
> milkthistle is definitely supposed to be good for liver function--I'm pretty sure there are a few other homeopathic remedies that are also purported to be helpful, my brain just doesn't have enough storage space to be able to tell you which ones. It's definitely worth doing some research on, though.
I used to read a book called "Healing Power of Herbs". This post spiked my curiosity. I dusted off the book and checked out liver function topics.
The book is written by an MD. It has a scientific/technical slant. In addition to traditional folklore, it includes molecular diagrams, pharmacology, and hundreds of footnotes of related scientific/clinical studies.
I was so impressed with what I read about milk thistle I wanted to quote it all here. But it would have been much too long. So I'll summarize.
Milk Thistle's active ingredient is used in several European prescription drugs for hepatic conditions. It's benefits for liver protection and rejuvenation are scientifically proven. Lots of scientific support. It has even completely reversed liver damage. In one study the liver-poisoning effects of deadly mushrooms were completely neutralized by taking milk thistle prior to ingesting the mushrooms. To make a long story short, milk thistle is indeed a liver protector and a liver rebuilder and it's a primary ingredient in hepatic prescription meds and the scientific evidence is abundant.
A close second is Dandelion. Other herbs with noted liver rejuvenation function are panax ginseng, gotu kola, and a couple others I've never heard of. But milk thistle and dandelion seem to be the heavy hitters on this topic. Like I said, the clinical evidence for milk thistle's liver healing power is impressive. It is way beyond folklore or placebo effect stuff. Very impressive.
Posted by PL on November 4, 1999, at 8:24:01
In reply to Re: liver function - milk thistle & others., posted by JohnL on November 4, 1999, at 3:28:20
I have read that besides milk thistle, Glutathione was very helpful.
Posted by Bob on November 4, 1999, at 9:06:27
In reply to Re: liver function - milk thistle & others., posted by PL on November 4, 1999, at 8:24:01
I don't know if all this liver talk is so off topic -- I mean, if you're going to self-medicate with what readily available out there in the recreational drug market, it seems to me that most of the more common self-meds hit the liver pretty hard. Maybe there's even some potential for a new type of bar here -- where all the drinks (or other refreshments) served come with a homeopathic "chaser" of something to fend off any damage done. (Damn! Wish I had the capital to do this ... I'm sure it'd be a hit down in SoHo or the Village .... ;^)
Bob
Posted by saint james on November 5, 1999, at 18:36:19
In reply to Re: liver function - a question...., posted by Bob on November 3, 1999, at 14:47:46
> > James here....
> > Generally the liver will regenerate to some degree
> > if the damage is not
>
> ... yes ... "is not..." ... what? ;^)
>James here....
So bad that your liver is dried up hard prune, hard as a rock, maybe with cirrhosis. A liver biopsy would give a better idea of damage.
tests are good at telling how bad it is but the question of "will it get better" is up to "doctor time" and you have to just wait and see be cause "doctor time" doesn't give consults.The best thing to do is avoid all but the very necessary meds, eat well, lots on nutrients, exercise, no ethanol (unless you have a death wish) avoid stress.
The answers are not ez, in the 1980's I got very sick with what the doc's best guess was non a/nonB hepatitis (now hep C) there was not test for hep C then. I lived in a cold sweat for several years, liver function tests returned to normal slowly over 12 months but I was told this in no way ment I did not have hep C. I might be fine, I might progress to chronic, be very sick for the rest of my life or slowly die. Lots of cold sweats for several years. Middle 1990's (and after much tap dancing with my HMO) I had a Hep C test, and every hep A, B, and C antibody/antigen test known to man, which were all negative. Since these were negative there was no reason to test for hep d and e. Whew. I still get a function test once a year, and all is perfect. their best guess is that I had a "virus of unknown origin" I can appreciate the frustration the poster has because for many years b4 the hep c test was out all they could do is draw blood and tell me Ok today but answer no questions about tomorrow. Now they say that as my live has not so much as burped
in almost 20 years whatever I had was self limiting; that I am cured. Such is the limit of medicine today that I had to wait 10 yrs to know if I had it and 5 more to get a clean bill of health.j
This is the end of the thread.
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