Out of Hospital + Drug Interactions

I was in the hospital from December 2 – 14 for psychiatric treatment on a youth ward. For the most part the doctor left my medications alone in order to acutely treat what I was dealing with at the time, but he did add L-Tryptophan (1000mg nightly) to help me sleep better. Sadly, he forgot to write me a prescription for it when I left the hospital, and I’m not seeing my psychiatrist or my doctor until the New Year, so it’s going to have to wait a few weeks. I’m sleeping okay without it but I think it helped a bit, and I’ll take anything that helps with few to no side effects.
While out of the hospital on a pass one day I went to see my dermatologist, who agreed that I still had a lot of room for improvement with my acne situation. He told me to stop using the PanOxyl soap and to switch to Clindoxyl (Clindamycin and Benzoyl Peroxide) cream. The soap was sort of a hassle anyway – traces of it would remain on my skin after I showered and would bleach all my towels.
He also switched my oral antibiotic from Minocin (Minocycline) to Erythromycin, because he thought it might be more effective. I’d been on Minocin for over a year without seeing any definite improvement, so I was fine with changing that around.
When I got back to the hospital later in the day, I informed them of the medication changes and they started me on my first dose of Erythromycin. However, the next day the ward pharmacist came up to speak with me – she had noticed an interaction that my dermatologist seems to have overlooked: Erythromycin increases the effect of Imovane by an unknown amount (she said by at least 50%). They immediately lowered my dose of Imovane/Immovane (Rhovane) (Zopiclone) to 15mg but I didn’t sleep well that night or the night after, so they raised it by one pill to 22.5mg. That means that for one night, I was on the equivalent of 8 pills, or 60mg of Imovane. It seems strange to me that I don’t recall falling asleep any faster than usual that night, and I was not particularly groggy or “hungover” the morning after. It’s possible that, like most other medications, the Zopiclone actually has little effect on me, and I can weather it like a house made out of bricks. Who knows.

Medications I’ve Been On (An Incomplete List)

I’ve certainly been on a number of other medications that I’m not currently taking, either because they weren’t working and have been phased out or replaced by another medication or group of medications, because they formed poor habits, because they were no longer needed, or they created too many adverse side effects. Let’s see if we can’t make a list of them…

Prozac (Fluoxetine): Max. dose of 80mg for Major Depressive Disorder. Stopped taking it because it wasn’t working; it was replaced by Zoloft (Sertraline).
Celexa (Citalopram): Max. dose unknown for Major Depressive Disorder. Stopped taking it because it wasn’t working; it was replaced by Prozac (Fluoxetine).
Chloral Hydrate:  Max. dose 20mL for Insomnia. Stopped taking it because I was developing a habit and tolerance; it was replaced by a series of benzodiazepines.
Motilium (Domperidone): Max. dose 60mg for nausea and vomiting related to an Eating Disorder. I stopped taking it because I didn’t need it anymore. Also, it was making me lactate.
Klonopin (Clonazepam): Max. dose 4mg for anxiety. Stopped taking it because it wasn’t working very well and is habit-forming.
Valium (Diazepam), Ativan (Lorazepam): Max. dose unknown for anxiety. They were taken short-term during a hospital admission. I stopped taking these medications because they’re habit-forming.
Elavil (Amitriptyline): Max. dose 150mg for Insomnia. I stopped using it because it wasn’t working and it was replaced by Chloral Hydrate.
Seroquel (Quetiapine Fumarate): Max. dose 650mg for anxiety and Insomnia. Stopped using it because it wasn’t working.
Desyrel (Trazodone): Max. dose unknown for anxiety. Stopped using it because it wasn’t working.
Neurontin (Gabapentin): Max. dose 1200mg for anxiety. Stopped using it because it wasn’t working. No replacement.
Loxapac (Loxapine): Max. dose 40mg for agitation. Stopped taking it because it was causing emotional deadness and insensitivity.
Zyprexa Zydis (Olanzapine): Max. dose 30mg for anxiety. Stopped taking it because it wasn’t working.
Buspar (Buspirone): Max. dose unknown for anxiety. Stopped taking it because it wasn’t working.
PanOxyl (Benzoyl Peroxide): Came in soap format. Max. dose one use per day. Stopped taking it because it wasn’t working; it was replaced by Clindoxyl (Clindamycin and Benzoyl Peroxide).
Eltroxin (Levothyroxine): Max. dose 0.05mg for low energy and mood related to Major Depressive Disorder. Stopped using it because it wasn’t working; it was replaced by Strattera (Atomoxetine).
Minocin (Minocycline): Max. dose 200mg for acne. Stopped taking it because my doctor thought another medication might work better in my case. We replaced it with Erythromycin.
Strattera (Atomoxetine): Max. dose 75mg for low energy and mood related to Major Depressive Disorder. Stopped taking it because it wasn’t working. It was replaced by Ritalin (Methylphenidate).
Zoloft (Sertraline): Max. dose 300mg for Major Depressive Disorder. I stopped taking it because my doctor didn’t think it was helping me (I agreed); we tapered off by 50mg per week and replaced it with Effexor (Venlafaxine).
Advil (Ibuprofen): Max. dose 1600mg for chronic wrist pain. I stopped taking it regularly after having a successful wrist ganglion excision in September 2009, which reduced the chronic pain.
Calcium + Vitamin D: Max. dose 500mg Calcium and 125IU Vitamin D for bone health. I currently take this medication.
Clindoxyl (Clindamycin and Benzoyl Peroxide): Max. dose one application nightly for acne. I currently take this medication.
Delatestryl (Testosterone Enanthate): Max. dose 100mg intramuscular once weekly for low testosterone. I lowered my dose to 60mg once weekly to counter some side effects I was experiencing. I currently take this medication.
Effexor (Venlafaxine): Max. dose 187.5mg for Major Depressive Disorder. I currently take this medication.
Erythromycin: Max. dose 333mg morning and evening (total 666mg daily) for acne. I currently take this medication.
Imovane/Immovane (Rhovane) (Zopiclone): Max. dose 30mg for Insomnia. I lowered my dose to 22.5mg after starting to take Erythromycin because Erythromycin increases the effect of Imovane by an unknown amount. I am currently taking this medication.
L-Tryptophan: Max. dose 1000mg for Insomnia. I am currently taking this medication.
Losec (Omeprazole): Max. dose 20mg for acid reflux. I am currently taking this medication.
Melatonin: Max. dose 3mg for Insomnia. I am currently taking this medication.
Multivitamin: Max. dose 1 daily for overall health. I am currently taking this medication.
Risperidal (Risperidone): Max. dose 4mg for Tourrette Syndrome. My doctor lowered it to 2.5mg because above that dose, I experience negative side effects, including emotional deadness and insensitivity, and bradykinesia (facial motionlessness). I am currently taking this medication.
Ritalin (Methylphenidate): Max. dose 40mg for low energy and mood related to Major Depressive Disorder. I stopped taking it because it wasn’t working. It was replaced by Dexedrine (Dextroamphetamine).
Salmon Oil: Max. dose 1000mg in the morning, at dinnertime and at night (total 3000mg daily) for high cholesterol. I am currently taking this medication.
Vitamin C: Max. dose 500mg for overall health. I am currently taking this medication.
Dexedrine (Dextroamphetamine): Max. dose 20mg for low energy and mood related to Major Depressive Disorder. I am currently taking this medication.
Thorazine (Chlorpromazine): Max. dose unknown for anxiety. I stopped taking this medication because it wasn’t working.
Vicodin (Hydrocodone and Paracetamol): Max. dose 40/4000mg per day for post-surgical pain. I stopped taking this medication because I was no longer in severe pain. It was replaced by Advil (Ibuprofen).
Percocet (Hydrocodone and Acetaminophen): Max. dose unknown for severe acute ankle pain. I stopped taking this medication because I was no longer in severe pan; it was replaced by extra-strength Advil (Ibuprofen).

To be continued…