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Am I a dead woman? or what?

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Initial post: Mar 26, 2009 4:38:34 PM PDT
I would like to report that the medications they have been giving me --they have changed at least twice before I left.

Now I've been prescribed:

Seroquel/(Quetiapine Fumarate) 25mg

Lamotrigine/(generic for Lamictal 25m tablet GSK) 50mg

Zyprexa/(Olanzapine) 5mg

RPH: Mai Tran

Please, can anyone tell me if this pill-popping cocktail is at all dangerous?

I would like to note that in the hospital they were giving me the olanzapine described from the web-link below:

"The olanzapine orally disintegrating tablet (Zyprexa Zydis) may contain phenylalanine. Talk to your doctor before using this form of olanzapine if you have phenylketonuria (PKU)."(1)

But wasn't phenylalanine the drug that they recalled all those cough-syrups about? And if so, why are they distributing it at the hospital all willy-nilly?

The Zyprexa (Olanzapine) I am taking now is white and round and has LILLY 4115 on it.


In reply to an earlier post on Mar 26, 2009 7:02:14 PM PDT
phenylalanine is an amino acid- not a drug. Any product (medication, food, or beverages) must have a warning on it for those who have PKU- a metabolic disease in which this substance would be harmful to them. If you don't have PKU, then phenylanine is not an issue.

As far as your drug regimen you should review this with your prescribing physician; and you can always get a second opinion.

Posted on Mar 29, 2009 5:26:03 PM PDT
Great Cook says:
You might want to go to the Library, and check out the PDR to find out exactly what your taking? But Why don't you ask your Dr. and be prepared to write down what He/She said.

Posted on Mar 29, 2009 5:59:39 PM PDT
Ozeal says:
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Posted on Apr 2, 2009 9:38:46 AM PDT
Your suspicions (not about being "dead" but about being careful with combinations of drugs like these) are correct. The other commentors are right in suggesting that you become informed, via the PDR (and Merck's Manual) and your primary care physician, and getting second (and third!) opinions. Taking vitamins when you are on medications like these can be helpful -- check with a nutritionist to see which ones you should have.

Also see details about side effects and combinations of psychiatric meds at and These drugs do help some people but it should be within the client's control and choice. Too often they prescribe mind-numbing chemicals to clients, especially children and women, just to keep them quiet.


Posted on Apr 2, 2009 9:46:21 AM PDT
The cough medicines which were recalled for phenylpropylamine (PPA) not phenylalanine

Posted on Apr 3, 2009 9:29:02 AM PDT
penny layne says:
phenylalanine is what is in aspartame, a sweetener. read a diet coke says the same thing. lol.

Posted on Apr 6, 2009 8:27:04 PM PDT
Athas says:
I would be interested in knowing what your diagnosis is if you don't mind sharing it with us. I have been prescribed all of these drugs at various times except for the Mai Tran, but never at the same time, and after looking up the side-effects I refused to take them. These are seriously heavy drugs that can have horrendous side-effects. Two of them are anti-psychotics and I believe the other one is a mood stabilizer. I'm not a doctor but this is a very unusual cocktail to prescribe unless you are just completely out of control without them. I've been diagnosed with Bipolar II, a very mild form of Bipolar I. These drugs have been prescribed for me for various reasons; mostly for agitation and anxiety. But I don't buy my diagnosis. I think I just have Depression. And doctors get frustrated because I'm not getting any better so they start grasping at straws hoping something will have an effect on me. Again I'm really curious about your diagnosis. It's possible that you may actually need these medications but I cant tell unless I know your diagnosis. This combination of drugs is not actually dangerous in itself and the side-effects are only potential side-effects. But if you don't actually need to be on the drugs then you shouldn't take them. But, and I can't emphasize this enough DO NOT STOP TAKING THESE DRUGS WITHOUT SEEING YOUR DOCTOR FIRST.

Posted on Oct 14, 2009 6:37:39 PM PDT
Montana says:
The anti-psychotic drugs are generally dopamine-blocking drugs, and can cause lifelong side effects, especially movement disorders like tardive dyskinesia, which is the involuntary movement of, typically, the lips, tongue, etc. There is always tardive dystonia, which can be a sustained involuntary movement of other body parts like, the neck, the back, etc. The third type of problem is more of a sensory problem and is called tardive akathisia. People feel an intense restlessness, sometimes in general, and sometimes localized to the legs. It is nearly unbearable, and patients try and walk or make other movements to make the symptoms lessen. The newer antipsychotics have lesser incidences of these side effects, but hopes that they would not cause them at all were dashed. The word tardive refers to the fact that these symptoms often come on when the drug is discontinued or when the dose is lessened. It is because of these problems, that these drugs are typically not given unless one has a serious disorder that cannot be treated by other means. For example, psychosis due to schizophrenia. It is perhaps fashionable in psychiatry these days, to use these drugs for other disorders that aren't so serious. I don't agree with this, but there are obviously well-respected doctors who do. I would discuss any fears of yours with your own doctor. Only you and he or her know whether the risks of this type of treatment or worth the potential benefit to you.

Posted on Oct 15, 2009 2:37:07 PM PDT
Pharmacists are excellent resources in discovery drug interplay dangers. I'd make sure my pharmacist is aware of all my meds, when I take them, and my concern about interactions. If I don't feel comfortable with his/her knowledge, I'd find a new pharmacist.

Posted on Oct 28, 2009 1:04:40 PM PDT
KM says:
I would be very concerned if you are more comfortable speaking with people on about the drugs you are being prescribed than you are with speaking to the physician who prescribed them or a pharmacist. All drugs are DRUGS- they will have effects and side effects, sometimes long-term. Most of the time you are not going to be prescribed them unless someone feels that the benefits for you outweigh the risks, but only you can tell them whether you feel that the benefits outweigh the risks. Speak to the physician, a nurse (preferably advanced practice nurse such as a nurse practitioner), or a pharmacist ASAP if you are concerned. Good luck!

Posted on Nov 3, 2009 1:54:27 AM PST
maxbatista says:
I am a psychopharmacologist. Amen to 'KM's' post.
Do you remember the robot on the Sci Fi show from the 60's that would spaz out arms and circuits akimbo screaming, "Danger, Danger!!".
That's what this situation reminds me of. If you were my daughter or mother (I like them both), I would try my darndest to get you to get plenty of
info, but only from people who you can sue. Seriously.
This is a terrible and bad and crummy place to get advice on specific issues like the one you brought up. I can't stress that enough. They just started
studying this, and the pilot results (it's a Mass General study looking at patients who sought internet info vs. those who didn't) showed that getting
anectodtal info is, in essence, a bad idea when you following outcomes.
No one can possibly give you advise without sloshing around in your detailed history. This takes some number of hours (at minimum).
I'd seek out a 2nd/3rd opinion from a competent clinician, preferably board certified, and approach the consultation with no preconceived notion of
what you'd prefer to hear. The big trick that science hangs it's hat on is basically that a researcher tries to prove themselves wrong. It's the only way to get rid
of the whole bias magilla.
For the record, the medications you mentioned are at micro-doses. Zyprexa or Zydis, is usually dosed at 10 to 20 or 25 mg. per day. It is used to help organize thoughts, and to enhance filtration of stimuli - brain glue is a pretty accurate handle. It is pretty effective at reducing anxiety, and can have some mood stabilizing and mood enhancing effect (some of these indications are pending announcements). If anxiety rises to a high enough level, reality testing goes out the window. This is why it is effective in inivdiulas who are profoundly altered (though at much higher doses usually).
Lamictal is a mood stabilizer, and is probably the stabilizer with the most effective mood enhancing punch. It requires a slow/gradual titration. Usually 200 - 250 mg. is where it works best.
Seroquel is somewhat similar to Zyprexa - it can be used as a medication to reduce anxiety/agitation, to reduce fragmenttion, and to help with sleep - in this way, it is similar to Zyprexa - it is frequently a go to medication at super low doses (i.e. - 25 to 50 mg.) to assist with sleep. It has some advantages over other sleeping aids (minor tranquilizers such as diazepam, Restoril, ect.), becaluse it will not induce tolerance, ad it will not cross tolerate with alcohol. (SORRY I AM OUT OF JUICE, AND AM COMING TO AN ABRUPT end here, spell checker be damned - this is going to have a gajillion typos).
These three meds are somewhat frequently paired, at least early on in treatment. Usually the goal is to have a patient on fewer medications, so that it is not unusual to treat with several agents eary, and to later wean down to oone medication. If a patient is able to remain well and be on no medications, this would be the ideal outcome.
Lastly, the equation one runs when considering any treatment is something like:
Problem (anxiety/depression/fragmented thinking/insomnia/... whatever = X
Benefit/ improvement from medication = Y
Risk of side effect = Z
if y

In reply to an earlier post on Nov 5, 2009 8:27:02 AM PST
Phenylalanine is an amino acid found in many proteins. I believe you have it confused with pseudoephedrine, which used to be cough syrups and cold medications. Pseudoephedrine is no longer used cold medications because it is the major ingredient used in the home manufacture of crystal meth.

People with PKU have a genetic disorder in which their bodies cannot use the phylalanine in their diets. If children with PKU eat more than a minimal amount of phyalanine, they become mentally retarded. Adults with PKU can often eat more phylalanine without problems, but they must check with their doctor to find out just how much they can eat without developing other problems

Posted on Nov 18, 2009 11:40:44 PM PST
Luckygirl says:
Hi there,
I just noticed this thread and became alarmed.
I am a Psychiatry resident physician and just want to reassure you on a number of issues.
1. The Psychopharmacologist (maxbatista) is correct. This is the very last place you want to receive help from anyone concerning your medications. You need to talk to people who have had 4 to 10 years of formal educational training, then more years of clinical practice, to assess what these drugs might be doing to you.

2. We don't know what your diagnosis is here. You shouldn't tell us either. For you to be taking drugs such as those mentioned, you should be regularly seeing one Psychiatrist who has your full medical records, has full disclosure of your medical history and life in general, and who knows ALL the medications you are taking. If you want to get a second opinion, that is encouraged, but, again, you have to tell them everything: provide your medical records, disclose your entire medical history and life circumstances, and provide information on all the medications that you are taking. You shouldn't doctor-shop because you might kill yourself if you omit critical information.
3. Doctors and pharmacists are not evil people who give medications to children and women "just to keep them quiet." Rarely is it the case that medications are the first step in improving someone's life in Psychiatry - they are used as a very last resort, ESPECIALLY when it comes to treating children. We actually care very deeply about our clients, and want to see their health improve. We lose sleep over our clients and cry over their conditions. It still hurts us to see others in physical or mental pain.
We hear and answer concerns that clients have over their medications every single day, and have regular classes and conferences to stay up to date on the latest research findings.
If you feel that you would like to come off your medications, or have your concerns answered, all you have to do is explain to your Psychiatrist that you are scared and would like some time given to your concerns.

Thank you.

In reply to an earlier post on Nov 20, 2009 6:59:40 AM PST
K. Allsop says:
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In reply to an earlier post on Nov 20, 2009 9:20:38 AM PST
Last edited by the author on Nov 20, 2009 9:51:05 AM PST
S. zelei says:
Didn't she say she recently left the hospital?! Let's not just assume she is given a mood stabilizers and atypical antipsychotics without a good reason! And since she might very well need these drugs at this time as much as a cancer patient needs chemo, let's not assume she'll have every possible side effect known to man. Especially ones that are much more common and severe from drugs she's not even actually prescribed! People do survive and thrive on less-than-pleasant, but life saving, drug regimens - focus on the positive.

Ms Cincotta, get a second - and third and fourth and fifth if you feel it's necessary and you can - opinion from doctors. Or psychiatric nurse practitioners - I find that NP's often take more time to and are better at answering questions than doctors tend to. Here (and anywhere on internet forums) mostly what you're getting is a sample of public opinion and attitudes about modern psychiatry. And people will start telling you their personal experiences, which you have no way of fact-checking or putting into context, but that are hard to not be influenced by. (It's human nature to listen more to personal anecdotes than statistics, research results etc.) But NO ONE on an internet forum anywhere will have more accurate information on drug interactions than a decent psychiatrist, psychiatric nurse practitioner, or pharmacist.

Edit - I just saw Luckygirl's post. She and maxbatista know what they are talking about. Don't listen to anyone else here, including me!

In reply to an earlier post on Nov 21, 2009 7:03:11 PM PST
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Posted on Nov 22, 2009 9:45:46 PM PST
P. Vaughn says:
My husband has a bi-polar disorder and has taken the similar combination of drugs. Your dose of Seroquel is tiny, he's taken 300 mg before, as well as the dose for Zyprexa, he's taken 25 mg. Right now he's on Depakote (mood stabilizer, you could relate this one to the Lamictal), Risperidone (antipsychotic) and Zyprexa. There is a treatment options list the doctor goes by, if you do not respond to step one and then to step two, they keep moving up and trying different combinations and different numbers of meds in each combinations. The drugs you're on right now are considered step 3 in treatment and are the right combination, plus they are pretty small doses, so I wouldn't worry about it.

Posted on Nov 22, 2009 9:51:49 PM PST
P. Vaughn says:
And if you have a diagnosed psychiatric disorder, and have ended up in the emergency room / psyc clinic before, PLEASE do not listen to all these naturopaths suggesting gluten free diets and "non-western" medications. Yes, there are side effects from the medicine that you're on right now, but it's better than ending up committing suicide or ending up on the streets/ in trouble with the law. I have seen what a mental illness can do to a person and everyone around them when they are not on any type of treatment. I would also suggest seeing a therapist. And once again, your doses are tiny compared to what other people take. I suggest joining a forum or a chat on the topic.

Posted on Dec 7, 2009 10:07:23 AM PST
P. L. Dwyer says:
I think both sides have a point here. As a chiropractor practicing for 23 years, I've seen some of my patients get sucked into the "Mental Illness" model and become toxic, confused, drugged, obese, diabetic, hypertensive, twitching zombies in situations where a career change, divorce, and/or move away from a toxic family would be much more productive. It's not in my scope of practice to take them off their medications, so I can only support them with pain relief, mitigate the toxicity as much as possible with nutritional supplements, and give them lots of positive feedback when they stop looking to the drugs to "fix" them. I've seen a few of them come out the other side, refuse to keep taking the medications, and come "back to life" once they decided to take the locus of control back.

On the other hand, I've seen some patients who come to me hoping that I can provide a non-drug alternative for serious mental illness; some of them become quite angry when I encourage them to go to a different psychiatrist because they probably need to be on meds for the rest of their lives. I've had a couple of those come back years later and thank me for telling them what none of the other "alternative" doctors would. Some of them refuse, and go on to live with their illness for many years, choosing the suffering of the illness in preference to the suffering caused by the medications; and who am I to judge that choice just because their mentally ill behaviors make me uncomfortable?

And that brings me to another observation, which is that clinicians (such as luckygirl, maxbatista, and myself) tend to underestimate the severity of the harm done by our treatments. I think this is increasingly the case in the insane pharmaceutical marketing environment where prescribing patterns are determined by what is "fashionable", as fashionmavenneurologist says, rather than by what is clinically proven and humanitarianly defensible.

For a really good presentation of the anti-medicalization perspective, may I suggest Thomas Szasz' book, "The Myth of Mental Illness". The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (Revised Edition)
He takes an extreme position, which is indefensible when you get to schizophrenic psychosis and classical bipolar disorders, for example, but he also makes a broadly valid case against medicalization of all emotional and spiritual distress.

Posted on Dec 8, 2009 9:07:15 PM PST
Erika says:
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In reply to an earlier post on Dec 10, 2009 12:45:26 PM PST
despinne says:
Phenylketonuria (PKU) is a disease that can be exacerbated by taking something with phenylalanine in it. If you had PKU, you would know it by now, because every newborn in the USA is tested for it. It is a dietary problem. Start reading labels and you will see the same sort of warning on many foods and medications. Olanzapine is for short-term treatment of agitation caused by schizophrenia or bipolar disorder. It may also be used for other conditions as determined by your doctor. Why not talk to your doctor, or else your local pharmacist, who can help you understand your treatment better?

In reply to an earlier post on Dec 10, 2009 12:48:58 PM PST
despinne says:
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In reply to an earlier post on Feb 28, 2010 7:23:44 PM PST
LTSpike says:
Am I a dead woman? or what? "

You are if you're putting this much trust in anonymous internet forum posters for something this important!!
Your reply to LTSpike's post:
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Posted on Mar 1, 2010 1:27:51 AM PST
Lessfatman says:
On this site (as on other sites as well) there are people responding who know nothing about drugs or diseases, who have no formal schooling or responsibility but a lot of opinions and beliefs.

If you do not trust your prescribing MD, tell him about the problem and ask politely to be referred to another one. It is a good idea to have the next one informed about with your situation is, what has not worked and why the line of treatment has been chosen.

If you are not really in bad mental health, but just bored, you can start playing around with all possible kinds of 'healing' games. You might find people there who can make you feel normal...because they are not! Just note that ingesting stuff that nobody knows what's been put in it is generally a bad idea.

But basically, if you do not have enough trust in you doctor and you prefer the opinions of laypeople, get another doctor.
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