"One pill makes you larger, and one pill makes you small..."

July 4, 2009 6:56 AM

I'm beginning to feel like I am taking too many pills. Should I be?....I know YANMD/YANAD.

I've been on Vyvanse for about a year, birth control (quasense) and have just started on Zoloft. I also use a prescription shampoo and a prescription scalp solution for skin issues. My GP also believes I have Gilbert's syndrome.

I've seen conflicting articles on if it is okay to take Vyvanse and Zoloft together and feel like now there is just too many chemicals in the mix.

Also, the zoloft is making me clench my jaw (happened when I started the vyvanse too). I am fairly certain it will resolve itself as my body gets used to the new medicine, but in the meantime, my jaw is so sore and I have a massive headache from clenching my jaw. I would love to take a tylenol or something as I have spent the last 24 hours in tremendous pain (I can still function, but it is like trying to work/drive/cook while someone is driving thumbtacks into the back of your head), but I have also seen scary articles on taking vyvanse/aspirin & zoloft/aspirin & having GS/aspirin.

I'm going to call the doctor in the morning re the teeth clenching/headaches.

But I am hoping maybe someone else here has gone through a similar experience and could share their peals of wisdom:

Am I being paranoid about too many drugs in my body?

posted by anonymous to health & fitness (10 comments total)

Talk to your doctor, of course. I took dozens of medications for years, 9 just for asthma...it's certainly not unheard of to be on lots of pills. I don't take them anymore, but I have a medical condition that precludes the use of most painkillers. I would play it safe and not take one until you can reach a doctor or nurse and talk about it. I have TMJ which causes similar jaw pain and when I have an issue I alternate ice and a heating pad. If this sort of thing continues, you might want to see an orthodonist who can prescribe various appliances that can prevent jaw pain from clenching (I only get jaw pain if I don't wear mine).

Hope you feel better!
posted by melissam at 7:07 AM on July 4, 2009

This happened to me once. I typed a long personal anecdote, but decided to delete it because it's so easily summed up by ONE SHORT ANSWER: GET A SECOND OPINION, or two, or three. Your doc may be right; but the peace of mind you will get from having the opinion echoed may help you. On the other hand, a different doc may have a different strategy that may work better for you.
posted by bunnycup at 7:34 AM on July 4, 2009

seconding the advice to get a second opinion.

i went through something similar, mostly because i was on 1 or 2 prescriptions to fix "old problems" and i didn't need to be on them anymore. see if you can get a second opinion and you might be able to minimize the number of prescriptions.
posted by gursky at 7:54 AM on July 4, 2009

If the risk is just for those drugs and aspirin, couldn't you still take a non-aspirin pain reliever (like tylenol or ibuprofen)? I would call you pharmacist and ask about possible interactions and what OTC pain meds you might be able to take. If your pharmacist can't/doesn't want to say, you should talk to your doctor.
posted by ishotjr at 7:55 AM on July 4, 2009

Thirding a second opinion. The sheer value of second opinions are greatly underappreciated. But do what you can to read reviews (ratemds.com, etc) to make sure you get a doctor who will listen to you and be attentive to your history, since he doesn't have the benefit of having been your doctor for months/years.
posted by crapmatic at 10:12 AM on July 4, 2009

Yes,of course you should discuss with your Dr or a pharmacist re: interactions--the latter if your primary concern is interactions. I doubt if several aspirin for pain is going to hurt you until you can speak to one or the other. If yhou are taking Vyvanse and zoloft you should be seeing a psychiatrist or psychopharmacologist--there is nothing wrong with taking the drugs in combination but dosing and patience, on the part of the physician and patient, is extremely important with these and similar drugs.
posted by rmhsinc at 10:50 AM on July 4, 2009

When you talk to your "2nd opinion" doctor, ask for liver enzyme tests! Having Gilbert's Syndrome in combination with certain drugs can be fatal:

Detoxification of certain drugs

The enzymes that are defective in GS (UGT1A1) are also responsible for some of the liver's ability to detoxify certain drugs. For example, Gilbert's syndrome is associated with severe diarrhea and neutropenia in patients who are treated with irinotecan, which is metabolized by UGT1A1.[7]

While paracetamol (acetaminophen or brand name Tylenol) is not metabolized by UGT1A1,[8] it is metabolized by one of the other enzymes also deficient in some people with GS.[9][10] A subset of people with GS may have an increased risk of paracetamol toxicity.[10][11]

Don't forget to check the drug interaction database. And at the very least, you could always forgo the birth control pills and use condoms with VCF spermacide films. I felt depressed and PMS-ey 24/7 and didn't feel right again until I quit.
posted by aquafortis at 10:50 AM on July 4, 2009

Your problem isn't that you're taking too many drugs, your problem is that your drugs aren't playing well together. Absolutely make sure that if you're taking more than one drug that they don't exacerbate any side effects of other drugs that you're on.

I'm on several drugs for various things and they all play together just fine and the worst side-effect that I notice is occasional dry mouth. Get a second opinion and find a combo of drugs that does what you need them to do without also causing secondary headaches (literally).
posted by grapefruitmoon at 12:32 PM on July 4, 2009

I used to work for pharmacologists. They specialize in understanding the action of drugs and can fine tune your prescriptions and their doses. The patients that would get referred to them were frequently on at least five different prescriptions including antidepressants. The pharmacologists would then advise the GP on any adjustments that should be made and if any drugs should be discontinued. See if you can get a referral to one.
posted by waterandrock at 1:45 PM on July 4, 2009

Agreeing with all of the above, but with one small caveat: I too have been on lots of medications at times with attendant anxieties associated; "Am I a hypochondriac? What am I doing to my body with all these pills?" etc etc.

If you are sick, and you need medicine to make it better, don't feel guilty about that. Don't feel weird, or that you seem so much sicker than everyone else, or that people may be judging you the way you might be judging yourself. Or that all those medicines can't be making you better because you're still so damned sick, and more and more.

I'm not saying that you're thinking all or even any of this, and a second opinion is definitely a great idea. But I've been in a similar place with different meds and the psychological tension I was putting myself through at the time about all the pills I was taking, was definitely a source of stress I could have done without, and I would hate to know anyone else was doing that to themselves. Best of luck, :)
posted by smoke at 5:39 PM on July 4, 2009