PSA (antidepressants)

[rushthatspeaks]

So I've had this nasty sinus thing, and my housemate Thrud offered me some of her sinus medication. She has horrible chronic sinus and so keeps around a lot of fairly esoteric meds, in strengths she describes as 'omnipotent', 'godlike', and 'plaid'. I selected omnipotent, and went to look up the ingredients to see whether there would be any interactions with my antidepressants. And of course when you do this sort of thing you look up everything you've been taking, and I've been taking over-the-counter painkillers like whoa.

The sinus meds were fine. But I discovered-- and I hadn't had an inkling-- that naproxen sodium (most common brand name Aleve) is absolutely counterindicated for use in conjunction with sertraline (most common brand name Zoloft). Apparently in a not insignificant number of people the combination causes or aggravates bleeding ulcers in any number of places in the digestive system, and makes the ulcers hard to get under control.

Given that this is one of only three interactions of Zoloft with *anything* of which I am aware and the other two are with grapefruit juice and with Nutrasweet, and given that naproxen sodium is one of the most common over-the-counter painkillers, you'd think they'd have said something in the frickin' manual that came with the sertraline. But no.

This makes me very sad, as I use Aleve for everything-- it is, ironically enough, the only common painkiller that doesn't make me throw up. Also it works very well and doesn't have any side effects.

Except apparently huge uncontrollable bleeding ulcers, dammit.

Anyhow, persons out there who use Sertraline? Aleve = NO.

This has been a public service announcement.

I am so not switching pain meds until I'm over the sinus thing. Another few days can't do that much damage when I've already been using Aleve in conjunction with sertraline for about four years now. Right?

Comments

[kalmn.livejournal.com]

if you had a bleeding ulcer, you'd probably know. in the fainting, unable to get the anemia under control, blood in your stools kinda way.

another few days should be fine, and i'd guess that the ulcers are easier to get under control if you go off the aleve/zoloft combo, which *right* after they hospitalized you they'd make you do.

blah.

(my dad had an esophageal bleeding ulcer. no fun, that was.)

[boxofdelights]

Thank you. I had no idea.

[nightengalesknd.livejournal.com]

Wow, I had no idea and I prescribe/reccommend aleve to people all the time, and have patients on zoloft all the time.

I just looked it up in my handy dandy doctor med checker thing and they have it listed as a "caution' not a "contraindication" Which is sort of like the different between a tornado watch and a tornedo warning. I'd agree with you that four more days probably isn't going to make a difference, unless you develop symptoms, in which case the idea would be to cease the Aleve, not the zoloft, at once.

[seishonagon.livejournal.com]

Aleve can cause bleeding ulcers to anyone who overuses it. I have taken medications which had a "caution" warning on them about Aleve before, and I asked my father-in-law, who is an anesthesiologist and therefore knows a lot about painkillers, and he said that being on those medications makes it more likely you'll develop ulcers, and it means it's a lot easier to overuse the medication, but that it's not as bad as the label makes it sound. The label is a case of CYA (Cover Your Ass).

[nightengalesknd.livejournal.com]

Yes, that I know. Other NSAIDs like Advil can cause ulcers as well. That was the whole brilliant idea behind Vioxx and Celebrex, that they didn't cause ulcers. (They just caused heart attacks. . . sorta)

It's the special greater risk with sertraline I didn't know about. Although I guess it makes sense. There's a lot of seratonin in platelets.