Drug interaction question

[Meghen]

I work at a group home. Out of curiosity, I began checking the client's prescribed medications in the drug interaction search engine. One interaction that worried me was a major drug-drug interaction between Effexor XR (SRI) and Adderall (amphetamine) The management instructions advised, "In general, amphetamines should not be combined with serotonin reuptake inhibitors." Is this something to worry about? If it were dangerous to the client in any way, I assume the perscribing Dr. would not have prescribed it. However, Dr.'s are not perfect, some are even careless. Should this be brought to someone's attention?

[zippysgoddess]

I checked out what you are talking about, this reaction can generally be avoided as long as the patient is closely monitored while using these meds. IE: Most docs will not prescribe these together for someone who is taking meds on their own at home, however if they are in a hospital, or personal care setting, where someone is always on duty to watch them, they will prescribe them together. Careful monitoring of the dosaged can also help this reaction be avoided, I would say if the patient is showing no unusual symptoms, then there shouldn't be a problem, however it would probably be smart for you to alert others who work in your care home to the potential for this reaction, so they know what to watch for, and when to seek emergency medical attention for this person.

verwon@gmail.com

My information is not guaranteed correct. I do not get them right all the time, but I do enjoy the hunt~

[Meghen]

Thanks for responding. I read that worst-case scenario, this interaction could cause "serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors." I'm not sure I understand this explanation, but could this hyperstimulation of the receptors be happening gradually, with no immediate visible side effects?

[tool8er]

Serotonin syndrome can occur I assume. I would more likely be worried about the synergistic increase in circulating NE and its ramifications.

quote:Originally posted by Meghen

Thanks for responding. I read that worst-case scenario, this interaction could cause "serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors." I'm not sure I understand this explanation, but could this hyperstimulation of the receptors be happening gradually, with no immediate visible side effects?

T. Blando, BS, RRT, PharmD Candidate