AboutNigel Simmons Expertise I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised.
Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner.
I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question.
Consider.. would you want me to discuss your care with a friend or relative without your knowledge?
Experience Registered as a UK pharmacist in 1982 and have worked in a number of hospital and health management posts around the UK. Formerly Chief Pharmacist for a 440 bed general hospital in Cambridgeshire.
Past/Present clients Previously Sysop on CompuServe UK Professionals forum.
Expert: Nigel Simmons Date: 4/19/2008 Subject: Maxalt & Lexapro - please help me
Question Almost Killed me!! Last week I was experiencing severe migraines. I went to the Doctor, and he prescribed both, 10 mg. Maxalt and 10mg. Lexapro for depression. I started taking the medication as prescribed, and became VERY ILL. Worse, I went to a drug screening and was found positive for Amphetamines. I HAVE NOT HAD ANY DRUG OTHER THAN MAXALT AND LEXAPRO IN MY SYSTEM. It is my understanding that the doctor should never have started me on both of these medications together at the same time because it causes Serotonin Syndrome. Again, IT MADE ME VERY SICK! If I am to understand it correctly, Maxalt is a selective 5-Hydroxytryptamine, and one of its components is N-Dimethyl-5. I read somewhere (and can not relocate the link) that Dimethyl metabolizes into Methamphetamine and Amphetamines. Is this correct? And where can I locate the information? Because of this false-positive test, they are threatening to send me away, and possibly take my children from me. Please, I beg you, please help me. Please. Thank you.
Answer Christa
From the number of questions I receive, this seems to be an all too common occurrance and it is impossible for me to give any response with 100% confidence.
Firstly, if you have any positive result you should always get a confirmatory blood test immediately if you suspect the result is incorrect. I also recommend splitting the urine sample and retaining part for independent testing.
There is some evidence of false positives as a result of other (permitted) medications, but this is not well documented and can vary between products and manufacturers. They would be the best source of information for their product, or alternatively the Medical Information departments of the drug companies who sell the Maxalt and Lexapro. They may not be prepared to share information with you directly, but your doctor or local pharmacist may be prepared to contact them on your behalf. Likewise the testing service as it is in their interest to ensure their results are accurate.
Finally, I always caution to ensure that all tests are performed in your presence and that you can hold or see the sample upto the point of testing. Substitution or inadvertant switching are always possibilities.
