Medicine led to suicide

Q. A family member took his life while on Cymbalta. He had never been depressed, but when he explained to his physician the suicidal thoughts he was having, the physician doubled his dose of Cymbalta, added Abilify and told him to come back in a week. He died by his own hand instead.

A. We are terribly sorry to learn about your loss. The Food and Drug Administration requires a highlighted warning for Cymbalta and similar drugs: “Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder and other psychiatric disorders. ... Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior.”

Q. I had a heart attack 10 years ago, when I was 62, and I have had several stents put in my arteries since then. My doctor has me on a bunch of medicine for blood pressure and heart: amlodipine 5 mg a.m. and p.m., hydrochlorothiazide 25 mg a.m., Toprol 25 mg p.m., simvastatin 40 mg p.m., isosorbide 10 mg a.m. and p.m., and ticlopidine 250 mg a.m. and p.m.

I’m weak, and I hardly ever feel well anymore. I am wondering if any of these drugs fight with each other.

A. In June, the FDA advised doctors to avoid prescribing more than 20 mg of simvastatin together with the blood pressure drug amlodipine. This combination makes muscle pain and weakness more likely.

Please get in touch with your doctor to find out if your dose of simvastatin can be adjusted, or if there is a different cholesterol-lowering drug that would be appropriate for you. Anyone taking simvastatin to lower cholesterol should check with a pharmacist about possible drug interactions with other medicines. The dose of simvastatin must be limited for people taking amiodarone, diltiazem, ranolazine and verapamil.

Q. I have to get up to pee a couple of times every night. I frequently have a very hard time falling back to sleep. I am reluctant to take a sleeping pill at 2 a.m. because it makes me groggy when I have to get up. Is there anything that won’t leave me spaced out?

A. The first thing you should do is investigate why you have to pee so frequently at night. Diuretics for blood pressure control can contribute to this problem, especially if taken late in the day. For men, an enlarged prostate may be the culprit; a urologist might have a solution.

Many sleeping pills, including over-the-counter products, may well cause a morning hangover effect if you take them after 2 or 3 a.m. You might ask your doctor about a short-acting prescription sleeping pill that is less likely to have that effect.

We are sending you our Guide to Getting a Good Night’s Sleep with a discussion of do’s and don’ts for restful sleep as well as medications and nondrug options to overcome sleeplessness. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (64 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. I-70, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharm-acy.com.

2011 King Features Syndicate, Inc.