SRS my wife is taking lexapro, what pain medications are ok?

Discussion in 'On Topic' started by spankaveli, Apr 20, 2007.

  1. spankaveli

    spankaveli OT Supporter

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    i know the pamphlet says she can't take ibuprofen or something like that.

    what CAN she take? for headaches and normal things.
     
  2. Scootin

    Scootin OT Supporter

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    Tylenol is fine. Escitalopram + Ibuprofen increases the risk of a GI bleed. I think this is the case with escitalopram + most nsaids.
     
  3. Vixxen

    Vixxen New Member

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    i took ibuprofen while i was on it. :dunno:
     
  4. Sephiroth

    Sephiroth New Member

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    Scoot, I'm just curious, what drug reference did you use for that? I'm on it myself, and take Ibproufen frequently for pain. Also a 1st semester nursing student, am looking in Springhouse Nurses Drug Guide for interactions with escitalopram, and don't see the link between the two. :dunno:
     
  5. Scootin

    Scootin OT Supporter

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    I've got a psychpharmacology reference book that runs through basic medicine interactions here. The lists are huge, and pretty much indicate ANY kind of risk associated with mixing a drug. It doesn't say its entirely out of the question, more of just a "use caution" kind of situation. Mostly just to cover the pharmaceutical company's butt, most likely.

    That said, patients with a history of any GI issues, especially bleeding, ulcers, cancers, etc, should definitely avoid using NSAIDs. Regular NSAID use alone apparently carries a 1-3% chance of developing GI bleeding (I didn't know it was that high, honestly). I'm not sure at this point why they say not to mix lexapro and ibuprofen, because I've never heard of lexapro being indicated in any bleeding issues. I'll have to look into this a bit further.

    edit: Should have seen this before.

    It's kind of an odd effect, but I'll do my best to explain it. Serotonin, as it exists in the body, is a powerful vasoconstrictor. Vasoconstrictors reduce bleeding, and inhibition of peripheral 5-HT would function as a sort of vasodilator (not to actually dilate blood vessels but to keep them from constricting). Vasodilators are commonly used to increase blood flow in certain medical procedures where bleeding is desirable. Obviously you wouldn't want to mix two drugs that enhance bleeding.

    However, and this is something I hadn't known before, SSRIs apparently inhibit nitric oxide as it occurs as a neurotransmitter, which is a vasodilator. The vasoconstriction due to decreased NO and the vasodilation due to decreased 5-HT seem to "cancel" each other out and present only a small risk of increased bleeding. I'm assuming that's why it's not listed as a drug you CAN'T take, but one with which you should be cautious of interactions.

    This is all just my hypothesis so please don't take it for fact.
     

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