Discussions that mention zoloft

Pain Management board

Hi, I'm hoping a health professional on here can help. My mother has debilitating chronic pain (degenerative arthritis and other problems, many stemming from a severe head & upper-body beating in 1979), as well as a history of PTSD, depression, terrible eczema, and other health problems. She is taking:

Norco 10/325 - 2-6/day
MS Contin - 60 mg twice/day
Zoloft - 150mg/day
Verapamil - 240 mg twice/day
Loratadine - 10 mg/day
Neurontin - 300 mg 2-3 times/day
And as needed: Cipro, Imitrex, Xanax, Clobetisol.

She's allergic to: Valium, ibuprofen, codeine, dyazine, penicillin, and sulfa.

She drinks a lot of diet soda and grapefruit juice.

I feel like many of her problems may be cause by her drugs, especially given a history of allergies and a relatively poor diet.

Any advice is VERY much appreciated, thanks!
Linda is so right about drugs and how they effect our seniors. She's right on the money and it's very posible that your mother may not even be aware of some of the side effects she's experienced
I did happen to check her meds on the Grapfruit juice drug interaction site and found mild interactions with these meds but discontinuation was not deemed neccesarry.

alprazolam (Xanax®)

Eight healthy male volunteers were given a single dose of alprazolam 0.8 mg after 10 days of drinking either water or single-strength GJ (200 mL three times daily). The mean AUC (a measure of drug bioavailability) was increased by 12% with GJ (slightly higher in smokers, at 17%) and Cmax (peak serum concentration) was increased by 7.2%. In a related multiple dose study, 11 patients with anxiety disorders (1 male, 10 female) receiving alprazolam 0.8-2.4 mg/day, were given single-strength GJ 200 mL three times daily for 7 days. Plasma concentrations were increased from baseline by a mean of 15% during GJ consumption.

verapamil (Isoptin®, Calan®)

A recent report showed that co-administration of GJ with verapamil, a non-dihydropyridine calcium channel blocker, led to increased verapamil AUC and serum concentrations. In a crossover study of 24 volunteers, verapamil and norverapamil AUCs were increased 43% and 28%, while the Cmax of verapamil and norverapamil were increased 60% and 32%. Four subjects in the GJ-verapamil phase had a PR interval prolongation to greater than 0.24 seconds. While the interaction was significant, the effect was of a lower magnitude than seen with other calcium channel blockers.

sertraline (Zoloft®)

Six older patients (age 63-74) being treated with sertraline for depression took their usual sertraline (range: 50-75 mg/day) dose as a single dose in the morning daily for 1 week, avoid GJ, grapefruit, alcohol, caffeine, and cola beverages. In the second week, the patients took their same sertraline doses with 240 mL single strength GJ. One patient was excluded from analysis due to non-compliance. GJ consumption significantly increased the mean trough (Cmin, drawn approximately 30 minutes prior to the dose being given) sertraline concentration by 47%

Although a 10 - 15% increase or decrease may be unfelt by a healthy young person it can be the difference between theraputic dose and loss of efficacy and exagerated side effects in the elderly.

Opiates are unconfirmed other than methadone and I wouldn't feel comfy recomending GJ to people to increase their serum level, as it may raise it, it may also interact with another medication in a negative way. The increases and decreses in serum level are unpredictable.

I have used GJ when I first started meth with a doc that didn't use BT meds, A half a grapefruit would literally make me break into a sweat. . It's not something I recomend and a little off topic.

Any side effect can be exagerated in the elderly population and my fear is mulltiple docs throwing meds at here with the belief that there would be no negative side effects, But if they are unaware of the other medication taken, nobody is looking at drug interactions and relying on an elderly persons abilty to distinguish normal feelings like needing an afternoon nap and increased serum levels created by drug or food interactions.

Several meds are strong CNS depressants and The elderly are more prone to amplified effects of all these meds especially when combined. Morphine, Hydrocodone,. Xanax and Neurontin are all CNS depressants and can couse drowsinesss, if she drives she needs to undertsand that driving on these meds can land her in jail for DUI or DWI. These meds can certainly effect her ability to concentrate and rememeber. She would be subject to the same DUI or DWI laws in her state than anyone drinking and driving would be would be.

I can't out do linda's post. She's on the money and your mom most likely needs a second set of eyes to report side effects she may be unaware of.
Good luck, Dave