Posted by Lonely on January 31, 2005, at 19:31:30
In reply to Re: Dextromethorphan+Lamictal+Wellbutrin = Interact? » Lonely, posted by Larry Hoover on January 31, 2005, at 19:16:21
Thanks, Lar. What you've said is helpful and makes sense.
One thing I forgot to mention was that he started to get better over 2 weeks ago and then began his Copaxone injections for multiple sclerosis. It was 2 days later that he definitely got worse and the real choking began. I took him off Copaxone after 5 injections - he can go back when he gets well.
I guess I haven't used the "magic word" here enough with doctors
- C - H - O - K - I - N - G They ignore the coughing part.Also just learned this afternoon he's not bipolar (!!!) but per psychiatric med school prof he's (for billing purposes) Mood Disorder, NOS. I'll write more about that in a different post.
Again, thanks for coming to our rescue!
> > After going to an ENT who acted like nothing was wrong and telling his neurologist who ignored my question, we gave him Allegra which dried him out, 4 days of decreasing Aristocort (now he has hypoglycemia) and finally, today, added an over-the-counter Dextromethorphan with guifenesin which did ease the coughing but left him with what he described as the bad side of being drugged but none of the pleasant side effects. He's pretty agitated and hyper.
> >
> > Okay, the question is and I haven't been able to find this on the net ... does the ingredient in the cough med - Dextromethorphan - interact w/Lamictal and/or Wellbutrin?
>
> Yes. Wellbutrin inhibits the destruction of dextromethorphan. The result is akin to overdose, even though normal therapeutic doses are taken.
>
> > His agitation and choking and the lack of interest from doctors is driving me crazy. Will the cough drug aggrevate the bipolar?
>
> No, I don't believe so. The disinterest or lack of communication with your treating physicians is most alarming, though. You shouldn't be in the position of having to guess at treatments.
>
> If you have an internist, I'd suggest you try and get a general assessment of his condition. Prolonged coughing is not a good thing.
>
> > Also, is coughing and choking typical of a bipolar 2? I sure haven't heard of such a thing.
>
> No, it's not related to a mood disorder.
>
> > Ironically, when he was on Trileptal, and was coughing from previously using ACE inhibitors, he got better re the coughing. So, I'm wondering if there is a "brain" or "neurological" component to all of this?
>
> I doubt it. The response to the steroid and antihistamine suggest a sensitivity reaction of some sort. It could even be the Lamictal that is triggering this, despite having been on it for a period of time. Delayed sensitivity reactions are not unheard of, but I think a doctor should be involved in sorting this out with you. I hope there is another one you can find who will work through this with you.
>
> Good luck,
> Lar
>
>
>
poster:Lonely
thread:450411
URL: http://www.dr-bob.org/babble/20050128/msgs/450751.html