Beta Blocker + Tricyclic AD + SSRI AD for the same person?

[binsel]

Hello,

My mother has been taking Zoloft (Sertraline hydrochloride) for anxiety, panic attacks and depression for ~10 years. It has been helpful usually but not all the time. She does not feel weel when she goes outside. I recently asked her to see a doctor if they can prescribe a sedative like Ativan for air travel etc. She is very scared to travel alone especially.

Somehow she has seen a Neurologist, instead of a Psychiatrist. The doctor gave her 3 medications and I dont understand why?

1) Propranolol (beta-blocker)
2) Clomipramine (tricyclic anti-dep)
3) Paroxetine (SSRI anti-dep)

Any idea?

Thanks,

Burhan

 

[Retired]

Re: BetaBloker + Tricyclic AD + SSRI AD for the same person?

Every doctor has his/her own preferred selection of medications to treat specific conditions, because they have gained clinical experience with those particular meds.

Your mother's medical history along with the issues she told the doctor were of concern would have determined the way this doctor thought those issues would best be treated.

If you feel your mother might not be able to accurately describe her medical issues, you might ask her if you could accompany her when she sees her doctors. That way you can feel certain her care is being adequately managed and you can ask the doctor questions, take notes about her medications to ensure she takes them correctly.

That being said, your options are to call the doctor for clarification, with your mother's permission or arrange for a follow up visit and accompany your mother. Before doing that, though, I would suggest you have a conversation with your mother's pharmacist regarding the combination of these three medications, not for their therapeutic value, but rather to evaluate their drug interaction potential.

Technically, there are potential drug / drug interaction concerns that may or may not be an issue in your mother's case, but I would first discuss it with the pharmacist and ask if the pharmacist thinks it merits a follow up with the doctor.

Do you feel your mother is accurately reporting her medical issues to the doctor, and how would she feel about your accompanying her to the doctor?

BTW, accompanying one's mother is a common practice for children of elderly parents, but their privacy and dignity must be respected in and out of the doctor's office. In the doctor's office, you would excuse yourself and wait outside during any physical examination, of course, and outside the office, not discuss anything you hear, unless your mother permits you to do so.

 

[binsel]

Re: BetaBloker + Tricyclic AD + SSRI AD for the same person?

Thanks, Steve.
I think my mother is accurately reporting her medical issues to the doctor.

 

[Daniel E.]

2) Clomipramine (tricyclic anti-dep)
3) Paroxetine (SSRI anti-dep)

From what I remember from many years ago, I didn't have any problems being on two serotonin meds at the same time. But I have noticed that there seems to be less of a trend for such cocktails.

 

[binsel]

I talked to my pharmasist today. He said there is a medium level interaction between #2 and #3, basically, Paxil is increasing the risk of side effects of Clomipramine.