WebMD Ask the Pharmacist

Depression, Anxiety, and More: Ask the Pharmacist

Pharmacist Maria Marzella Sulli, PharmD, answers questions about depression, anxiety, and more.

Question:

I am taking lithium oral, and everything I drink tastes like salt. What do you think? Do a lot of people have this experience?

Answer:

It is possible that lithium can alter your ability to taste. If you are having any unusual side effects that are bothersome, you should talk to your health care professional.

Question:

I took my Adderall today. Later on I'll want a beer. Is it safe to drink a few beers with my medication still in my system?

Answer:

It is best to avoid alcohol when taking a medication like Adderall. But on occasion, it is probably safe to have one beer. You would really need to discuss it with your doctor or pharmacist who knows you and all your other medications and health conditions, and can determine if drinking alcohol is safe for you.

Question:

Can I take Tylenol PM with Lexapro?

Answer:

There are no significant drug interactions reported between Lexapro and Tylenol PM. But keep in mind that Lexapro can cause drowsiness as a side effect. If you combine it with another medication that can cause drowsiness, like Tylenol PM, you may become extra drowsy. So you may experience a kind of hangover effect the next morning if you also take a Tylenol PM.

If you have had difficulty sleeping for longer than two weeks, you should talk to your health care professional.

Question:

How long are medicines good for? I still have some lorazepam from a few years back. Is it still good?

Answer:

Most medications are good for about a year after you get them from the pharmacy, that is, if they are stored properly away from direct heat or light, and in a cool, dry place. I do not recommend keeping medication longer than a year because passing time increases the likelihood that mistakes can be made while taking it. If you haven’t used the lorazapam in years, most likely you don't need it. So I would recommend discarding it.

The best way to dispose of medication is through a local drug take-back program. Or mix the pills with an undesirable substance -- like kitty litter or used coffee grounds -- wrap it all up, and throw it away. Flushing medications down the toilet is not recommended.

Question:

I forgot to take my Effexor this morning. Can I take it at night along with Lunesta?

Answer:

There are no significant interactions between these two medications. For some people, Effexor can actually cause drowsiness. But for others, it can sometimes make it difficult to sleep. If it does not affect you in this way, you can take it at night.

In general, if you take a medication every morning and forget for more than 12 hours, it is best to just skip the dose and return to your normal schedule the next morning. You do not want to take extra doses too close together.

Question:

How does taking Xanax and eating grapefruit affect the body?

Answer:

Grapefruit juice contains a substance that slows down your body’s ability to metabolize the Xanax and get it out of your system. So you could have a more pronounced or prolonged reaction from the Xanax. It is best to avoid grapefruit products when taking a medication like Xanax, so you do not get enhanced side effects.

Question:

My husband is bipolar and is currently taking Zyprexa 20 mg. It is a very expensive drug ($172 a month with insurance). But the doctor says it's working. He has been out of work for over a year. Is there any program that can help us with the cost?

Answer:

Oftentimes, when a medication is not available as a generic, the manufacturer has programs that can help defray the cost of a medication. Lilly Cares is a program that the makers of Zyprexa offer for eligible patients. You can find more information on this program by visiting www.lillycares.com/Pages/index.aspx.

Question:

Is there a generic form of Lexapro?

Answer:

There is currently no generic version of Lexapro available. It is only available as a brand name product. If you are having difficulty paying for your medication, you should talk to your doctor or pharmacist. They can usually help you find an acceptable alternative that is available as a generic product and can save you money.

Question:

Are there any interactions between Wellbutrin XL and Mucinex DM? My doctor switched me to the Wellbutrin a couple of months ago. Now I have one of those glorious summer colds and my usual form of self-medication is Mucinex DM.

Answer:

There are no significantly dangerous interactions between Wellbutrin and Mucinex DM. You can take the two medications together safely. You should always ask your pharmacist before taking any over-the-counter medication to ensure it is safe and the best choice for you and your symptoms.

Question:

Can you safely take Mobic for arthritis pain if you are taking Cymbalta for depression and verapamil for blood pressure?

Answer:

Mobic can be taken safely with those two medications. There are no significant interactions between the medications you listed. Mobic is an anti-inflammatory medication and does have a slight tendency to raise blood pressure when taken regularly. So it is important to watch your blood pressure while you are taking it. I am sure your doctor will be monitoring for that.

Also, to avoid dangerous drug interactions, it's always important to have all your prescriptions filled at the same pharmacy so the pharmacist has access to all the information he or she needs to take the best care of you. Also, new prescriptions will be screened against all the other medications you are taking to ensure there are no problems.

Question:

My wife is taking Effexor XR 75 mg. Is there a lower dosage available?

Answer:

Yes. Effexor XR is also available as a 37.5 mg capsule and a 50 mg capsule.

Question:

I was prescribed Prozac for depression. I have only been taking it for three weeks. I have had sleeping problems and muscle aches and fatigue over the last few days. Are these possible side effects from the Prozac?

Answer:

It is possible. If you are experiencing bothersome or severe side effects from a medication you are taking, you should consult your health care professional.

Question:

Does Sronyx for birth control interact with Strattera for ADHD?

Answer:

No. There are no dangerous interactions between birth control pills and Strattera. The medications may be taken together safely. Always tell your health care professionals about all the medications you are taking so they can take the best care of you.

Question:

What class is the drug Zoloft in?

Answer:

Zoloft is a member of the class of medications known as selective serotonin reuptake inhibitors.

Question:

I have been taking 30 mg Cymbalta and 300 mg Wellbutrin XL since October 2009. In the last three to four weeks, I have been so sleepy all the time. I have also had "brain zaps" like people experience when withdrawing from certain antidepressants. This is frustrating because I'm not withdrawing from either medication. I take both daily as prescribed. But I don't know what is causing these zaps and the sleepiness. Any suggestions?

Answer:

I suggest you talk to your health care professional. Anytime you are experiencing new symptoms or side effects it is important to report them immediately to your doctor.

Question:

Can a 20 mg Prozac capsule be opened and added to water to swallow?

Answer:

Yes. If you have difficulty swallowing the capsule whole, the capsule can be opened and the contents sprinkled on a soft food -- such as pudding or applesauce -- and swallowed.

Question:

Is clonidine in the same class as benzodiazepine?

Answer:

No. Clonidine is not a benzodiazepine. Clonidine belongs to a class of medications known as alpha agonists. They work in the central nervous system but are not benzodiazepines.

Question:

My daughter just began taking lithium for her bipolar disorder. She is starting at 300 mg. Last night she took her night and morning dose together by accident. Will she be all right? What should I do? What side effects should I watch for?

Answer:

Whenever someone accidentally takes more of a medication than they should, you should contact your doctor or pharmacist, or call the poison control center. You can access your local poison control center by calling 800-222-1222.

Question:

I have been taking brand name Effexor for the last four years. This week my pharmacy substituted a generic for the Effexor. Today I'm feeling anxious and jittery. Can there be a change from the brand name to the generic? Thank you.

Answer:

If you feel different on your medication, you need to contact your health care professional. Generic Effexor contains the same active ingredients as the brand name. So you should not feel any different. But it is best to check with your health care provider.

Question:

Can Abilify, Strattera, Celexa, or bupropion cause muscle twitches at night when you go to bed?

Answer:

There are many possible causes of muscle twitches at night, especially when taking a combination of medications like these, which can affect your nervous system. If this symptom is new or bothersome, you should consult your physician.

Question:

What side effects could occur from suddenly stopping Lexapro?

Answer:

Suddenly stopping a medication like Lexapro can cause withdrawal effects, which can lead to symptoms such as tiredness, agitation, confusion, or a burning sensation. If you are experiencing any of these symptoms, or any other bothersome symptoms, you should contact your doctor.

Question:

My daughter is currently taking Geodon, trazadone, and propranolol. Is it safe to give her Zantac for occasional heartburn? We have ruled out any issues causing this from her current meds.

Answer:

Yes. It would be safe to use Zantac with the medications your daughter is taking.

Question:

I am taking Wellbutrin SR 150 mg, twice a day. I have started suffering from blurred vision, and I was wondering if that could be a side effect.

Answer:

It could be a side effect or something new and different happening. I suggest you consult your doctor for an examination.

Question:

Does Effexor XR add to hot flashes or relieve them?

Answer:

Effexor is used to treat hot flashes in women who do not want to undergo hormone replacement therapy, although it does not work for everyone.

Question:

I was prescribed lorazepam by my doctor to help ease my anxiety. I'm taking 5 mg, and I'm scared to death that it may be addictive. Is it highly addictive?

Answer:

Benzodiazepines, like lorazepam, can be addictive. So it is very important to use them only as directed. Never take one if you do not have anxiety, and never take more than your prescribed dosage.

Question:

What time of day is best to take Celexa?

Answer:

The best time of day to take Celexa is the time of day you are most likely to remember to take it. Other than that, there is no special time of day that is best. It can also be taken with or without food, so find the time that is best for you and take it at that same time each day.

Question:

If a person is taking Klonopin but cannot afford the prescription, which prescription is better to request from the doctor as a replacement: Lexapro or Pristiq?

Answer:

Neither Lexapro nor Pristiq is in the same class as Klonopin. You would need to talk to your health care professional to determine which medication would be best for you.

Question:

My 89-year-old mother has been taking Paxil for some time. Recently, she was prescribed Namenda and pimozide for an uncontrollable twitch on her right side. The twitching has stopped, but she has become confused and lethargic. Is it safe to take these drugs together?

Answer:

It is safe to take these medications together. But if she is having bad side effects from the combination, you should discuss it with her doctor. At 89 years old, her body uses medications differently than a younger person and she is much more susceptible to side effects and toxicities.

Question:

I took phentermine in the morning and Xanax in the evening. I also had a glass of wine. Could this be what is making me feel nauseous right now?

Answer:

It could be. It is not advisable to combine alcohol with either phentermine or Xanax.

Question:

Is there a generic form of Celexa available?

Answer:

Yes. Celexa is available as a generic, called citalopram. It is readily available in pharmacies.

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