Too many Meds?

About 5 years back, my wife (now age 39) was diagnosed with severe sleep apnea. She had surgery to help relieve the problem, but still wears a cpap at night. Three years ago she was diagnosed with severe bipolar disorder (but has been treated for depression for 10 years) and 2 weeks ago she was found to be anemic. What gives?

She takes at least 10 different meds each day. Can the number of meds she's taking cause the anemia? It seems like whenever she goes to the doctor, she has a blood test then comes home with another new prescription. Nothing is ever treated by a specialist, only her regular doc.

Bless her heart, much of this she can't control, but she has really become difficult to live with lately. She has stopped doing housework, gets mad all the time, cusses a lot, cries a lot, drinks about two 2 liter diet pepsi's a day and last night, she went to bed at 12:30 am and slept until 5pm. (no alcohol) Any thoughts or advice that she could take to her doctor?

 

The behavior is from the bipolar disorder. What is she on for that? Depakote/Depekene (Valproic Acid) is usually the first drug of choice. Lithium works well for some but can be rough on the kidneys. If she is on one of these, has she had a blood level drawn? Depakote is worthless unless her level is between 50-100 (some docs allow it up to 125.) If a general MD is taking care of the bipolar disorder and she is still having symptoms like this, she needs to see a psychiatrist.

I don't know what other meds she is on, but neither Depakote or Lithium is known to cause GI bleeds. She needs to have a stool card for occult blood done to see if that's where she is losing blood. Anemia can also come from heavy periods or just not eating anough food with iron. Encourage green leafy veggies like spinach and lean meats for iron and protein.

But no, as a general rule- taking a lot of medications will not cause anemia unless one of them is causing a GI bleed.

Get her to a shrink ASAP. Bipolar disorder is one of the easiest psychiatric disorders to control if treated properly. Once that is under control, she will be able to focus more clearly on the anemia.

 

Sound good Fred. :xyzthumbs

 

Fred, thanks for the info. I think I will be calling her doc. The wife can't seem to get him to recommend more of an indepth treatment.

Here is a partial list of the meds she is taking: seroquel, aciphex, lithobid, levaquin, alprazolan, hemocyte, effexor, temazepam, welbutrin.

I am wondering if the combination of meds are causing some of the problems. It can't be good for anyone to be taking this many meds. It seems they are treating symptoms while not solving the problem and maybe making things worse. Thanks again.

 

Aciphex is to help control acid reflux- she probably needs to stay on that one
Levaquin is a high powered antibiotic and should be time limited- 10-14 days.
Hemocyte is for the anemia.

If her bipolar disorder could be controlled, she could come off many of these...

Lithobid is a time released Lithium. Have they done a lithium level? Lithium needs to be between 0.5 and 1.5 mEq/dl. Some docs don't like it over 1.2. Lithium is hard to manage and the newest way of thinking is the Depakote I mentioned above. IT WORKS WONDERS! It's actually a seizure medication and was found to have a mood stabilizing effect on people that take it. The only real side effect is a fine hand tremor it gives a lot of people, but doesn't do the kidneys any damage like the Lithium can.

Seroquel is an antipsychotic used to keep people calm. Until her mood is better under control, she may need this.

Temazepam? Why the heck is she on Restoril? It's an old, out of date sleeping pill that can be dangerous, is very addictive and usually only works on the patient for a few weeks until they start waking up after 4 or 5 hours. There are SEVERAL newer, safer sleeping pills like Lunista and Ambien.

Effexor and Wellbutrin are both anti-depressants- why 2 of them?

Aprazolam? Xanax on top of it all?

Homer, I'm no doctor and don't claim to be, but if this was someone in my family, I'd let the MD deal with medical concerns (the anemia and acid reflux) but I'd ask around for a good psychiatrist or ask your MD to suggest one. But anyone on SIX psych meds needs to be evaluated by a psychiatrist.

 

Fred, advice taken. We will be on the phone in the morning to try to get a referral to a psychiatrist. In the past, her doc has not been willing to give the referral. He seems to think he can treat and prescribe the same things as the psychiatrist. I'll push for it this time as well as explanation on all these meds. Thanks for your help.

 

even if he wont refer you somewhere else, can you find a psychiatrist on your own?

 

if it were an uncomplicated case of depression or an anxiety disorder, maybe a family doc could handle it and many do- and handle it very well. But if someone is on SIX psych meds and their bipolar disorder is not under control and the patient's mood is unstable, they need a specialist.

Good luck and I think you're a good man for sticking by her side.

BTW- When you see the psychiatrist, take an up to date medication list and a copy of any recent Lithium levels that may have been drawn. She may need you as an advocate to go with her to her appointment with the family doc. Many bipolar folks don't reconize the severity of their symptoms and some actually like the mania it can bring about.