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?

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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 off stimulants.

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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 imagine.
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 and Celexa.
I think a little Ativan should be fine, but be careful when driving and other tasks with needed mental and motor functions.