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BrittleBones 09-28-2006 11:44 AM

Methadone & Anti-Depressents & Heart Problems
I am bringing up this subject because it is currently in the news but for me, more importantly, because it could be an issue for me. As many of you may be aware, the son of Anna Nicole Smith was recently found dead and the most recent toxicology report has found that a combination of two anti depressents, Lexapro & ????, and Methadone, resulted in a cardiac event which ended his life. Two weeks ago I had a mild heart attack. My ekg showed very similar findings as those found in Daniel Smith's autopsy.

I take 120mg of Methadone, Prozac, Wellbutrin and Trazadone daily. That's 3 antidepressents and Methadone. I realize that the antidepressents I take aren't the ones that he took, but I believe that the theory is the same. I heard a coroner on t.v. this morning say that he believes that the methadone is what caused the body to not be able to process the anti-depressents through the liver in the normal time, thus letting it build up in his system. The cumulative effect of the anti-depressents apparently is what killed him.

I spent this past Monday and Tuesday in a major heart center hospital undergoing a heart catherization to check for blockages in my arteries. The doctor did not find any. The results of my ekg showed a definate heart event and I had severe chest pains, sweating, hard time breathing, etc.

I will be seeing my cardiologist first thing Monday morning to discuss what could have caused this attack. But now I'm very worried that it could be this combination of anti-depressents and methadone.

So, my question: Has anyone else who takes methadone and anti-depressents ever had any heart problems or heart symptoms? It's just a coincidence that all of this happened while the press is concentrating on the death of Daniel Smith, but in a way, I'm glad it brought this to my attention. Any comments? Thanks in advance - KathyMac

cpapp31 09-28-2006 01:19 PM

Re: Methadone & Anti-Depressents & Heart Problems
Hi Kathy!

Hmmmm, makes you wonder if these doctors really know what they are doing. Be very careful, the whole thing makes me worry.

Take care,

slipperyslope 09-29-2006 03:44 PM

Re: Methadone & Anti-Depressents & Heart Problems
KathyMac, The verdict isn't out yet on the methadone in his system. I have been following the case and a few articles say he had traces of methadone in his symptoms, and other articles say they didn't find any methadone so who know's really.

I think its a lot of gossip and talk at this point, and we really don't know what he died from yet, so I wouldn't get to worried about it. until we know for sure, He was a new patient to AD'S so that could have also been a cause You have been on Methadone for a long time now Right, and you know how to take your medication properly so I wouldn't get to worked up yet. I would talk to your Dr about it if your really worried or the pharmicist might also have an idea. I can't imagine your Dr would prescribe you medications if they didn't " go" together and could kill you.

Plus the fact you check in with your Dr regulary I am sure he would of let you know by now if there was a danger mixing the meds together that your on.

Good luck and I hope your doing okay these days. I am sorry you had a Heart attack, that is scary. my hubby had one when he was 38, but he had clogged arteries. I always thought the reason people have them is because there arteries are clogged. Since your's aren't I wonder how that happened. what did the Dr's say, can people really have a MI with clean arteries???? Did they add asprin to your list of meds? or blood thinners since you had one?

ugh you poor thing, this is not what you needed. I am sorry this happened to you.

Shoreline 10-02-2006 07:20 AM

Re: Methadone & Anti-Depressents & Heart Problems
Hi SS, I saw the coronor on TV this morning talking about what they found, It was lexapro, another SSRI and methadone. THe coronor was basically talking about combined respirtory effets of all the meds he was taking. It's not that there is a specific drug interactions, but something is very fishy about the story of using meth for back pain as a front line drug rather than long term use to treat CP. Meth is dangerous for opiate naive people, because it doesn't produced the imediate high or sense of well being that other opiates do. So they take more and ore with each dose thinking they just haven't taking enough. Thery don't consider the half life and the remaining meth in their system. Without the high to let them know they are wasted enough, the last dose that should do the trick is the one that puts them to sleep for good. Meth has been used saely by thousands and thousands of CPpatients that do follow their docs instructions and do take meth with antidepressants to help treat the depression and pain.

If you take any other pain med, you get relief in 30-40 minutes, meth slowly builds in your sytem and if you take more than prescribed thinking it's safe to take more because the first dose didn't cause harm, when you take the second dose 4 hours later, half the first dose is still working, and so on and so on for 20-30 hours. So someone isn't just taking one or two extra pills at each dose, it's the acumulated serum level from the previous doses that causes tragedies like this.

Abusing meth is extremely dangerous and won't produce the feeling that someone may get from other pain meds. If someone uses meth to try to produce those same warm fuzzy feelings, likely they are causing respirtory supression which is dificult to reverse even with Narcan. Narcan has to be repeateldly given to prevent the patient from slipping back under because the narcan wears off long before the meth does.

Honestly, someone that likely had no buisness taking meth, had no information and the wrong expectations and then exceeeds the prescribed dosage, doesn't make meth any more dangerous than abusing any other med. The outcome of drug abuse is pretty clear so I don't really understand the shock involved when someone actually dies from it. It didn't make him high like he wanted , so he took more and more trying to capture that feeling and by the time he did feel high, it was too late.
If someone is taking it as prescribed and adjusted the dose slowly upwards to manage their pain allowing time to acomadate to the dose and half life, you really have nothing to fear after being on the same dose for months or years. If your doc doubled your dose overnight, that would beconcerning how it would effect you by day 3 or 4, but hoopefully our docs know enough about the meds they prescribe not to do something so reckless.

However a 20 year old kid that's lived a party life, that doubles a prescribed dose and does it again and again if they didn't get the desired effect. It's pretty easy to predict the outcome when taken so wrecklessly, and prescribing meth to a 20 year old for incedental back painis wreckless. It's a very dangerous drug to self medicate with and I seriously doubt the antideprssants had a thing to do with what killed him, but we will never truly know how much he did take and in what time period that caused the OD.

It's as simple as self medicating is dangerous and stupid and meth doesn't produce the same effect he may have expected from previous opiate use. So he likely took more and more trying to find that warm fuzzy feeling. The build up he wasn't aware of overcame him when he was't expecting it. Sad, but there isn't an opiate that hasn't been abused or linked to a death by combined drug/drug or drug /alcohol interactions or simple ignorance regarding how the drug works.
Good luck and I wouldn't worry if you have been stable on a dose for months or years and don't plan on doubling your dose this weekend for a little extra fun.
Good luck, Dave

RetiredDirector 10-02-2006 02:07 PM

Re: Methadone & Anti-Depressents & Heart Problems
KathyMac: Hi and sorry to hear of your heart problems. As you probably remember, I also take Methadone, 180 mg per day. I also take Lexapro and Elavil. The death of Danial Smith has also caused me to think about the meds I take.

I think Dave (Shoreline) explained it quite well and reminded us that it is important to take your meds as directed by your doctor. I have an appointment with my doctor in about two weeks, and I intend to go over my medications with him, just to make sure all is OK with the meds and doseage I take.

Please let us know what your cardiologist has to say when you have your appointment.

donaeis 10-02-2006 06:57 PM

Re: Methadone & Anti-Depressents & Heart Problems
Methadone does not cause liver dysfunction, but is not processed well by the liver, causing a gradual increase in the system that stabilizes at 7 days. However, methadone has been associated with a number of deaths due to cardiac dysrhythmias, specifically the QTc interval that becomes prolonged. Some doctors are requiring all patients taking methadone for pain to have a baseline ECG and if the QTc is prolonged, will not prescribe methadone. Others already on the drug for an extended time are also being tested via ECG.
Methadone apparently causes a problem in the electrical conduction system of the heart rather than coronary artery spasm or plaques that dislodge.
It is interesting that apparently at least one of the two antidepressants was not being prescribed, and neither was methadone according to one news story.Two antidepressants in the same class can certainly cause issues for people, as well as taking non-prescribed drugs.

zoey1 10-03-2006 05:52 AM

Re: Methadone & Anti-Depressents & Heart Problems
From what i heard that not only does the opids take time to build up but the anti depressants in some cases take time to work as well.
Many already know not to take calcium with beta blockers it blocks the effects of beta blockers. But this issue is brought to the fore front because of the news.
If in doubt do not forget that your pharmasist may be a great reference for what meds interact with meds and or what should not be taken together.
Oh another one synthryiod should not be taken with beta blockers or calcium...
Yet many times folks just do not read the information in the pharmacy slip.

BrittleBones 10-03-2006 06:14 AM

Re: Methadone & Anti-Depressents & Heart Problems
Thanks everyone for your replies. I met with my cardiologist on Monday morning. The heart catherization didn't show any blocked arteries! As a matter of fact, the arteries that he thought were blocked when he examined my heart during my chemically induced stress-test the week before were probably a false reading due to "breast artifact". So now he is leaning to a pharmaceutical being the cause of the heart "event". He's even backing off calling it a heart attack now! And this after I've told all my family and friends that I had a heart attack and they were feeling so sorry for me and treating me so nicely!!!!:rolleyes: Right now the drug at the top of the list of suspects is the Procrit I take to help my body produce red blood cells. I'll be making an appointment with my hemotologist this week to discuss the continued use of this injectible drug. It has some serious cardiac side effects listed in its literature and I had this pain and sweating event the day after I took my Procrit shot. For now I've stopped taking it. Thanks again you guys for responding. I find it so incredible that I can drop into this forum with some of the most ***zare questions and folks never fail to give it their best shot as far as answering them. All the best - KathyMac:wave:

zoey1 10-03-2006 06:24 AM

Re: Methadone & Anti-Depressents & Heart Problems
i am so glad you got some answers and yes i am very grateful for here too.
I am also glad it was meds related and not another part of your body failing on you!
One of the super neat things about here is we have some good moments then go through days of crud and are reminded what we have never goes away. That the bad moments are part and parsal of what we are dealing with.
Glad you got in right away !!!

theweaver2 10-03-2006 03:45 PM

Re: Methadone & Anti-Depressents & Heart Problems
WOW.. these posts came at good time. I just saw my new pain doc and he has switched me from oxycontin to meth and said because of my 24/7 pain the meth should work better for me.

I do have irregular heart beats and hearing these things concern me. Although, the dose he prescribed is low 5 or 10 mg - havent picked up script yet. Using 1/2 to 1 tablet 3 times a day.

I know they want to add an antidepessant to the mix but he doesnt want to throw all of it at me at once.

My heart beats irregularly many days. I havehad it checked out and it happens in stressful situations, which is most everyday for me with my pain lol. They didnt even check my BP which seemed strange to me.

But it is a low dose and I shall see over thenext two weeks how it works for me.

He did say it was a tried and true opiate w/ few side effects Like someone mentioned here. If abused, a lot of meds can cause problems.

Again, I will research and be proactive.

Thanks for the infor guys.


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