http://www.child-autism-parent-cafe.com/autism-medication.html
When taking part in drug therapies for any disease, disorder or physiological condition it is important to know and understand any interactions and nutritional deficiencies that can be caused by the aforementioned drugs. The following information is searched via www.drugdigest.com
Via the list previously provided:
Amphetamine/Detroamphetamine: a stimulant commonly prescribed for ADHD creates the following symptoms:
Side effects that you should report to your doctor or health care professional as soon as possible:
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- anxiety, nervousness
- changes in mood or behavior
- chest pain
- fast, irregular heartbeat
- fever, or hot, dry skin
- high blood pressure
- muscle twitching
- uncontrollable head, mouth, neck, arm, or leg movements
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
- difficulty sleeping
- dizziness or light headedness
- headache
- nausea, vomiting
- stomach cramps
- weight loss
Clomipramine: a tri-cyclic antidepressant m/c prescribed for obsessive compulsive disorder has the following side effects:
Side effects that you should report to your doctor or health care professional as soon as possible:
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- breast enlargement, milk
- breathing problems
- confusion, hallucinations
- fast, irregular heartbeat
- fever with increased sweating
- muscle stiffness, spasms
- pain or difficulty passing urine, loss of bladder control
- seizures
- suicidal thoughts or other mood changes
- swelling of the testicles
- tingling, pain, or numbness in the feet or hands
- yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
- change in sex drive or performance
- constipation, or diarrhea
- nausea, vomiting
- weight gain or loss
The list can go on and on, let's take a case example:
A 13 year old boy with autism that still wets the bed can commonly be found to be on the following medications:
Adderal, Anafranil, Tofranil, Hadol and Lithium citrate
Look at the interactions!!
SELECTED SYMPATHOMIMETICS/TRICYCLIC COMPOUNDS
amphetamine-dextroamphetamine Oral and imipramine HCl Oral may interact based on the potential interaction between SELECTED SYMPATHOMIMETICS and TRICYCLIC COMPOUNDS.
SELECTED SYMPATHOMIMETICS/TRICYCLIC COMPOUNDS
amphetamine-dextroamphetamine Oral and clomipramine Oral may interact based on the potential interaction between SELECTED SYMPATHOMIMETICS and TRICYCLIC COMPOUNDS.
Moderate Interaction
HALOPERIDOL/LITHIUM
haloperidol lactate Oral and lithium citrate Oral may interact based on the potential interaction between HALOPERIDOL and LITHIUM.
Selected Sympathomimetics/Tricyclic Compounds
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
MONOGRAPH TITLE: Selected Sympathomimetics/Tricyclic Compounds
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Unknown. However, it is speculated that direct-acting sympathomimetic amines have an enhanced effect due to tricyclic blockage of norepinephrine reuptake. Indirect-acting sympathomimetics would have decreased activity due to tricyclic blockage of their uptake into the adrenergic neuron.
CLINICAL EFFECTS: Increased effect of direct acting sympathomimetics. Decreased effect of indirect acting sympathomimetics. Mixed acting sympathomimetics will show effects based on the predominance of either direct or indirect activity.
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Consider avoiding the concurrent use of direct-acting sympathomimetics and tricyclic compounds. If concurrent use of direct-acting sympathomimetics and tricyclic compounds is warranted, the initial dose of the sympathomimetic should be lowered and the patient should be monitored for adverse cardiovascular effects. Use of tricyclic compounds and other sympathomimetics should be approached with caution.
DISCUSSION: Epinephrine and other direct-acting sympathomimetic amines exert enhanced cardiovascular effects (e.g., arrhythmias, hypertension, and tachycardia) in individuals concurrently receiving or previously treated with tricyclic antidepressants.
Other direct and mixed acting sympathomimetic amines have also been reported to interact with tricyclic antidepressants. These include norepinephrine, phenylephrine, dopamine, and methoxamine. The pressor effects of the indirect-acting sympathomimetic amines (i.e., amphetamines, ephedrine, methylphenidate, pseudoephedrine, and tyramine) are antagonized by tricyclic antidepressants. Protriptyline, amitriptyline, and desipramine have also been reported to interact with direct-acting sympathomimetics.
Similarity between cyclobenzaprine and the tricyclic antidepressants consideration of tricyclic antidepressant interactions for cyclobenzaprine.
REFERENCES:
1.Boakes AJ, Laurence DR, Teoh PC, Barar FS, Benedikter LT, Prichard BN. Interactions between sympathomimetic amines and antidepressant agents in man. Br Med J 1973 Feb 10;1(5849):311-5.
2.Ghose K. Sympathomimetic amines and tricyclic antidepressant drugs. Neuropharmacology 1980 Dec;19(12):1251-4.
3.Svedmyr N. The influence of a tricyclic antidepressive agent (protriptyline) on some of the circulatory effects of noradrenaline and adrenaline in man. Life Sci 1968 Jan 1;7(1):77-84.
4.Bonaccorsi A, Garattini S. Effect of desipramine on directly or indirectly elicited catecholamine pressor responses in rats. J Pharm Pharmacol 1966 Jul;18(7):443-8.
5.Cairncross KD. On the peripheral pharmacology of amitriptyline. Arch Int Pharmacodyn Ther 1965 Apr;154(2):438-48.
6.Ghose K, Gifford LA, Turner P, Leighton M. Studies of the interaction of desmethylimipramine with tyramine in man after a single oral dose, and its correlation with plasma concentration. Br J Clin Pharmacol 1976 Apr; 3(2):334-7.
7.Jefferson JW. A review of the cardiovascular effects and toxicity of tricyclic antidepressants. Psychosom Med 1975 Mar-Apr;37(2):160-79.
8.Ragheb M. Drug interactions in psychiatric practice. Int Pharmacopsychiatry 1981;16(2):92-118.
9.Risch SC, Groom GP, Janowsky DS. Interfaces of psychopharmacology and cardiology--part one. J Clin Psychiatry 1981 Jan;42(1):23-34.
10.Maxwell RA, Keenan PD, Chaplin E, Roth B, Eckhardt SB. Molecular features affecting the potency of tricyclic antidepressants and structurally related compounds as inhibitors of the uptake of tritiated norepinephrine by rabbit aortic strips. J Pharmacol Exp Ther 1969 Apr;166(2):320-9.
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
MONOGRAPH TITLE: Haloperidol/Lithium
SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.
MECHANISM OF ACTION: Unknown.
CLINICAL EFFECTS: Extrapyramidal and neurotoxic effects have been reported.
PREDISPOSING FACTORS: Large doses of either drug, pre-existing brain damage, history of mania, history of drug-induced extrapyramidal symptoms or the existence of other disease states (e.g., infection, dehydration).
PATIENT MANAGEMENT: During the initiation of concurrent treatment with this drug combination, observe the patient closely for signs of neurotoxic or extrapyramidal effects.
DISCUSSION: Haloperidol and lithium have been used safely in the treatment of patients. However, numerous reports experiencing adverse effects during concurrent administration of these drugs have been reported. Signs and symptoms associated with concomitant use have included confusion, fever, lethargy, tremors, stupor, weakness, leukocytosis and increased blood urea nitrogen. Extrapyramidal effects, which in some cases were irreversible, and permanent brain damage have also been reported.
REFERENCES:
1.Cohen WJ, Cohen NH. Lithium carbonate, haloperidol, and irreversible brain damage. JAMA 1974 Dec 2;230(9):1283-7.
2.Thornton WE, Pray BJ. Lithium intoxication: a report of two cases. Can Psychiatr Assoc J 1975 Jun;20(4):281-2.
3.Loudon JB, Waring H. Toxic reactions to lithium and haloperidol. Lancet 1976 Nov 13;2(7994):1088.
4.Baastrup PC, Hollnagel P, Sorensen R, Schou M. Adverse reactions in treatment with lithium carbonate and haloperidol. JAMA 1976 Dec 6; 236(23):2645-6.
5.Juhl RP, Tsuang MT, Perry PJ. Concomitant administration of haloperidol and lithium carbonate in acute mania. Dis Nerv Syst 1977 Sep;38(9):675-6.
6.Thomas CJ. Brain damage with lithium/haloperidol. Br J Psychiatry 1979 May;134:552.
7.Biederman J, Lerner Y, Belmaker RH. Combination of lithium carbonate and haloperidol in schizo-affective disorder: a controlled study. Arch Gen Psychiatry 1979 Mar;36(3):327-33.
8.Thomas C, Tatham A, Jakubowski S. Lithium/haloperidol combinations and brain damage. Lancet 1982 Mar 13;1(8272):626.
9.Spring G, Frankel M. New data on lithium and haloperidol incompatibility. Am J Psychiatry 1981 Jun;138(6):818-21.
10.Addonizio G. Rapid induction of extrapyramidal side effects with combined use of lithium and neuroleptics. J Clin Psychopharmacol 1985 Oct; 5(5):296-8.
11.Goldney RD, Spence ND. Safety of the combination of lithium and neuroleptic drugs. Am J Psychiatry 1986 Jul;143(7):882-4.
12.Saran A, Addy O, Foliart RH, Schubert DS, Halaris A. Electroencephalographic changes and other indices of neurotoxicity with haloperidol-lithium therapy. Neuropsychobiology 1989;20(3):152-7.
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