How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Thomas, MD Your Own Question

Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 57646
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
24257177
Type Your Medical Question Here...
Dr. Thomas, MD is online now
A new question is answered every 9 seconds

Dr.Thomas, Regarding my question a few minutes ago I must add

Resolved Question:

Dr.Thomas, Regarding my question a few minutes ago I must add that I also take 20Mg Fluoxetine daily. Will that have any effect on the 75Mg Trazodone and 0.5Mg Alprazolam I asked about in my previous question?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Phil, MD replied 1 year ago.
Hello. I'm Dr. Phil, licensed and practicing Internal Medicine Physician. Excellent service is my goal.

Thanks for this excellent question.

Yes, the trazodone and the fluoxetine can both increase serotonin levels

This increases risk of a toxic syndrome called serotonin syndrome that can be fatal.

I would be very careful with this mix

You can use it but your doctor should monitor closely

I hope this helps if you have more questions just reply. :)
Customer: replied 1 year ago.

Thanks Dr. Phil. I'll discuss Trazodone further with my Doctor. In the meantime, I'll take the daily 20Mg dose of Fluoxetine and the Alprazolam (Xanax) when I feel the need which should also help with sleep. I was on Citalopram for years and am only in my third week of taking 20Mg Fluoxetine. My Doctor very recently told me to increase the Fluoxetine to 40Mg daily which I'm about to do (although I'm a little hesitant but I understand the doctor as I feel the 20Mg isn't really helping that much.


 


Your comments on my above reply would be appreciated.

Expert:  Dr. Thomas, MD replied 1 year ago.
Hello
You started a new post for this follow up.

You do not have seritonin syndrome at present.


You can increase the drug as your doctor instructed....with caution and reporting to your doctor.

There is still the problem with all of the potential interactions that have been mentioned...so also discuss these with your doctor.

Please don’t forget a positive rating.
I am Dr. Thomas, double board certified doctor, and I will help you with this and any follow up questions.


Customer: replied 1 year ago.

I will do that with my doctor and won't take Trazodone while taking Fluoxetine (in any dose) until then. Thanks to "JustAnswer", I now better understand the connection of serotonin to Trazodone & Fluoxetine.


 


My only question now is: I assume it's safe to take Fluoxetine while also taking Alprazolam.......Is that correct?

Expert:  Dr. Thomas, MD replied 1 year ago.
As I said before it is a moderate interaction and can increase sedation, but yes with caution it is safe.
as prescribed by your doctor.

Remember, I am almost always on, if you request me with my name in the title, I will get to your question in a short period of time in almost all cases.

Please let me know if you have further questions.
Please don’t forget a positive rating. This is the only way we are paid by ja.
Customer: replied 1 year ago.

Yes, I understood your answer regarding taking both Trazodone and Alprazolam on the same day, moderate interaction & increased sedation. I had forgot to mention in that question that I also take Fluoxetine which led to the Seritonin matter.


 


I assume serotonin is not an issue with Alprazolam but could be an issue while taking both Fluoxetine & Trazodone thus my last question is:


 


If Trazodone is not used tonight and I've already taken Fluoxetine this morning, I assume it's ok to take Alprazolam tonight.


 


 

Expert:  Dr. Thomas, MD replied 1 year ago.

As prescribed.

 

Effectively this combination increased the blood levels of the alprazolam...so keep that in mind.

 

 

Please let me know if you have further questions. Please don’t forget a positive rating.

Customer: replied 1 year ago.

I'll discuss this with my doctor tomorrow. Right now, I really don't know what to take tonight Trazodone to assist sleeping or Alprazolam to help reduce anxiety...

Expert:  Dr. Thomas, MD replied 1 year ago.
I think you can take the doses your doctor prescribed.
Your doctor knows you, and should know what you can tolerate.

If you have not had this prescribed by your doctor or have not talked to your doctor about taking both at once, then you should hold off.

If you have at least several hours in between the drugs, I doubt it will be a problem.

Please let me know if you have further questions.
Please don’t forget a positive rating.
Customer: replied 1 year ago.

Thanks Dr. Thomas. I am, indeed, under a Doctor's care and these medications have been prescribed to me. I should have and I do have confidence in all my doctors but I've never quite felt so anxious & restless before so I'm just asking a lot of questions here and there. I do have hernia surgery coming up real soon and I've had a infected/blocked ear recently both of which have caused anxiety. Again, thanks for you advise and patience. A positive rating is on the way.

Expert:  Dr. Thomas, MD replied 1 year ago.
Thank you!!
Find me anytime
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 57646
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
Dr. Thomas, MD and 5 other Medical Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    46349
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/DrThomasMd/2012-7-25_134438_Imagess1.64x64.jpg Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    46349
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
  • http://ww2.justanswer.com/uploads/MY/mysticdoc/2012-6-8_15615_mysticdoc3.64x64.jpg Dr. D.J.'s Avatar

    Dr. D.J.

    Board Certified Physician

    Satisfied Customers:

    14679
    MD
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2562
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/DrDLove/2009-08-12_141522_DrDLove.jpg Dr. D. Love's Avatar

    Dr. D. Love

    Doctor

    Satisfied Customers:

    11961
    Family Physician for 10 years; Hospital Medical Director for 10 years.
  • http://ww2.justanswer.com/uploads/CO/commissure/2011-4-15_192514_REISD20080926JR1090.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    10667
    Experienced Physician trained in New York City. I'm ready to help.
 
 
 

Related Medical Questions

Chat Now With A Doctor
Dr. Thomas, MD
Dr. Thomas, MD
Internal med/integrative med/family med
47652 Satisfied Customers
Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc