If you are on Seroquel up to 300 mg at night klonopin 0.5 bid ativan 0.5 prn and Cymbalta 90 mg qd should you be concerned with interactions or addictions?
Seroquel (quetiapine), Cymbalta (duloxetine), Klonopin
(clonazepam), and Ativan (lorazepam) are typically safe to take
together as long as the medications are ALL prescribed by the
same doctor, and you use them as prescribed. If they have been
prescribed by different doctors, you should consult with your
primary physician regarding all the medications you are taking from
all sources. She can advise you. So can a pharmacist.
The significant interaction is that the medication combination
can have additive effects causing more sleepiness and increased CNS
depression. In some cases people have a very difficult time
functioning because they are so tired. Those side effects would
occur almost immediately so if you are tolerating the medication
now that should not be an issue.
Also if you have a personal or family history of diabetes or
other major metabolic problems then there is an increased risk
(although it is rare) for developing diabetes, even more uncommon
potential problems are neuroleptic malignant syndrome or serotonin
syndrome. Using both Seroquel and Cymbalta do increase these risks
however the majority of the risk comes from Seroquel. Seroquel can
also cause tardive dyskinesia, a serious movement disorder that
typically lasts for years (and often for life). However most
people, especially those with bipolar or a psychotic disorder don't
have any of these rare reactions.
Overall the medications are not strange at all. Granted it is a
very sedating combination and that is the primary thing you need to
be aware of.
It may also be worth talking with your doctor if you find you
are tired a lot or you are having other side effects.
As for addiction you do take two controlled substances, Klonopin
and Ativan. However neither drug is significantly addictive.
Benzodiazepines, the class of drugs Klonopin and Ativan are in,
have been shown to have a moderate abuse liability in animal and
human testing. It is important to avoid increasing the dose of
either drug, especially the Klonopin since you take it every day.
As long as you do not start dose escalation (taking more without
doctor approval) addiction is rare. In fact 80-90% of
benzodiazepine addicts have a separate active addiction to
something like heroin, alcohol, or cocaine and they use the
benzodiazepines to augment other drugs or help them "come down" of
Yes, you need to be careful with Alcohol for sure. I would then
susspect addictions too. I am on Seroquel and have had a bad
reaction with Alcohol.My doctor always says to me,"One should never
drink alcohol with Seroquel. The Pharmacist,tells me it is not
advisable and is dangerous.
The pharmacist said though, if you should try Alcohol, drink
very little at first and see how you react. So I did try it. For me
it makes me tense instead of relaxed.It makes me feel like I have
taken more Seroquel. On the very first beer, I felt increase in
muscle spasms of my tongue and back. My heart raced 5 hrs later and
I felt like dying. I try'd a sip of a stronger cocktail once with
Vodka and emiediately had one of the worst headaches you could
I have also researched and found interactions with grapefruit
juice and Seroquel. Drugs that sedate you will make you way more
sedated. You should check even over the counter meds and
prescriptions with your pharmacist. Even some cold remidies may
cause a problem.
Remember everyone is different. I had a reaction with Seroquel
I think a little Ativan should be fine, but be careful when
driving and other tasks with needed mental and motor functions.