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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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What is the treatment for compulsive shopping Ive really

Customer Question

What is the treatment for compulsive shopping I've really got this disorder and I'm so out of control.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe I can help you.

Elliott, LPCC, NCC :

I would like to ask you some questions to start off with.

Elliott, LPCC, NCC :

How long has this been going on?

Elliott, LPCC, NCC :

Do you ever have any other compulsive or reckless behavior (such as driving, gambling, or sex)?

Customer:

about 15 years

Elliott, LPCC, NCC :

Do you sometimes feel totally on top of the world, like you are flying along without a care?

Elliott, LPCC, NCC :

Do you have racing thoughts?

Customer:

at times

Customer:

yes!!!!!!!!!!!!!!!!

Elliott, LPCC, NCC :

can you be more specific about the reckless behavior?

Customer:

I go into a store and I totally lose it. I have no control. I just buy and buy thinking how cute this would be on or something. Everything I wear has to match. I've probably got 250 pairs of shoes. Five closets of clothes in my home are full plus a13 closets in the basement. So many antiques that I had to buy 8 curio cabinets. Etc....

Elliott, LPCC, NCC :

What about driving?

Customer:

I like to drive. I'm a good driver.

Elliott, LPCC, NCC :

Do you drive recklessly?

Elliott, LPCC, NCC :

Speed?

Customer:

No. But I get impatient when other drivers don't drive right.

Elliott, LPCC, NCC :

Do you react?

Customer:

just usually verbally.

Elliott, LPCC, NCC :

Road rage or not quite?

Elliott, LPCC, NCC :

Tailgate? Cut people off?

Customer:

Not quite. I always try to be safe.

Elliott, LPCC, NCC :

Good.

Elliott, LPCC, NCC :

Do you sometimes talk very rapidly when you are feeling very up?

Customer:

Yes

Elliott, LPCC, NCC :

And you have flights of ideas or racing thoughts?

Customer:

All the time. my mind goes faster than my mouth. I will start multiple sentences and can't finish.

Elliott, LPCC, NCC :

Are you easily distracted at times?

Customer:

Yes My mind goes in different directions

Elliott, LPCC, NCC :

Do you sometimes have a reduced need for sleep?

Customer:

I need the sleep but sometimes I sleep 2 or 3 hours and then get up and stay so busy--like something is driving me

Elliott, LPCC, NCC :

Do you, on the other hand, sometimes feel down and depressed - no longer in this high mood?

Elliott, LPCC, NCC :

You mood changes.

Customer:

Yes. I completely crash. I get so lonely and feel so down.

Elliott, LPCC, NCC :

How often do you change moods?

Customer:

Sometimes I can go for a while and feel good but I know that at any minute I might hit the floor Then I have to crawl back up

Elliott, LPCC, NCC :

Are you taking any medication or do you have any physical ailment?

Customer:

I take Lipitor. I"m on three antidepressents and abilify Also Adderall and Valium if needed. I crochet all the time because I can't even sit still. I have a lot of anxiety. I go to bed and realilize my fists are clenched and my teeth too.

Elliott, LPCC, NCC :

What three antidepressants? And who is giving these medications to you?

Customer:

Surmontil, Cymbalta and Lexapro

Customer:

My doctor

Customer:

mental health doctor

Elliott, LPCC, NCC :

Does that mean a psychiatrist?

Customer:

Yes

Elliott, LPCC, NCC :

Do you have a diagnosis?

Customer:

Bi-polar, adult adhd and ocd

Customer:

My meds have helped me I'm not as bad as I used to be

Elliott, LPCC, NCC :

I knew you had bipolar. You may not have adult adhd. Your compulsive shopping is from the mania of the bipolar disorder.

Elliott, LPCC, NCC :

It seems that the Adderall may be making you worse.

Elliott, LPCC, NCC :

You are also taking too many antidepressants which may be making your mania worse.

Customer:

Really. I would have thought that ws

Customer:

I sure hope this is private. What would you suggest?

Elliott, LPCC, NCC :

Let me prepare an interaction website reference for you to show you the risks of the medication combinations you are taking. Others can see this site but not see who you are or where you live. I do not know either, and do not even know your name and could not contact you. Give me a minute or two please.

Elliott, LPCC, NCC :

You are at very high risk with the combinations of medications you are taking.

Elliott, LPCC, NCC :

Here is the list. The RED warning signs mean HIGH RISK. You have 5 high risk combinations and these interactions are probably making things worse for you.

Elliott, LPCC, NCC :

 


Drug Interactions Results

Drug interactions for the following 7 drug(s):





























Unsaved Drug List
trimipramine
Abilify (aripiprazole)
Adderall (amphetamine / dextroamphetamine)
Cymbalta (duloxetine)
Lexapro (escitalopram)
Lipitor (atorvastatin)
Valium (diazepam)


Interactions between your selected drugs



dextroamphetamine ↔ escitalopram


Applies to: Adderall (amphetamine/dextroamphetamine), Lexapro (escitalopram)



Talk to your doctor before using escitalopram together with dextroamphetamine. Escitalopram can increase the effects of dextroamphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision

Full Size Image
, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



escitalopram ↔ duloxetine


Applies to: Lexapro (escitalopram), Cymbalta (duloxetine)



Consumer information for this interaction is not currently available.


MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period is recommended following use of fluoxetine before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.



trimipramine ↔ duloxetine


Applies to: XXXXX XXXXX (duloxetine)



Talk to your doctor before using trimipramine together with DULoxetine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision

Full Size Image
, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



amphetamine ↔ escitalopram


Applies to: Adderall (amphetamine/dextroamphetamine), Lexapro (escitalopram)



Talk to your doctor before using escitalopram together with amphetamine. Escitalopram can increase the effects of amphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins

Full Size Image
and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



amphetamine ↔ duloxetine


Applies to: Adderall (amphetamine/dextroamphetamine), Cymbalta (duloxetine)



Talk to your doctor before using DULoxetine together with amphetamine. DULoxetine can increase the effects of amphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



trimipramine ↔ escitalopram


Applies to: XXXXX XXXXX (escitalopram)



Talk to your doctor before using escitalopram together with trimipramine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



dextroamphetamine ↔ duloxetine


Applies to: Adderall (amphetamine/dextroamphetamine), Cymbalta (duloxetine)



Talk to your doctor before using DULoxetine together with dextroamphetamine. DULoxetine can increase the effects of dextroamphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



escitalopram ↔ aripiprazole


Applies to: Lexapro (escitalopram), Abilify (aripiprazole)



Consumer information for this interaction is not currently available.


MONITOR: Coadministration with inhibitors of CYP450 3A4 and/or 2D6 may increase the plasma concentrations of aripiprazole, which is primarily metabolized by these isoenzymes. According to the product labeling, administration of aripiprazole (15 mg single dose) following pretreatment with the potent CYP450 3A4 inhibitor ketoconazole (200 mg/day for 14 days) increased the systemic exposure (AUC) to aripiprazole and its active metabolite, dehydro-aripiprazole, by 63% and 77%, respectively, compared to administration of aripiprazole alone. Likewise, administration of aripiprazole (10 mg single dose) with the potent CYP450 2D6 inhibitor quinidine (166 mg/day for 13 days) increased aripiprazole AUC by 112%, although dehydro-aripiprazole AUC was reduced by 35%.

MANAGEMENT: Pharmacologic response to aripiprazole should be monitored more closely whenever a CYP450 3A4 and/or 2D6 inhibitor is added to or withdrawn from therapy, and the aripiprazole dosage adjusted as necessary. The manufacturer recommends that aripiprazole dosage be reduced to one-half the normal dosage during concomitant administration with ketoconazole or quinidine, and additional dosage adjustments be made based on clinical evaluation. No dosage recommendations are available for concomitant administration with less potent CYP450 2D6 or 3A4 inhibitors.



trimipramine ↔ aripiprazole


Applies to: XXXXX XXXXX (aripiprazole)



Using trimipramine together with ARIPiprazole may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beats, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



diazepam ↔ trimipramine


Applies to: Valium (diazepam), trimipramine



Using diazepam together with trimipramine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



dextroamphetamine ↔ trimipramine


Applies to: Adderall (amphetamine/dextroamphetamine), trimipramine



Before taking dextroamphetamine, tell your doctor if you also use trimipramine. You may need dose adjustments or special tests in order to safely take both medications together. This combination could cause an increase in blood pressure, fever, headache, or fast or irregular heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.


Switch to professional interaction data



amphetamine ↔ trimipramine


Applies to: Adderall (amphetamine/dextroamphetamine), trimipramine



Before taking amphetamine, tell your doctor if you also use trimipramine. You may need dose adjustments or special tests in order to safely take both medications together. This combination could cause an increase in blood pressure, fever, headache, or fast or irregular heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.


Switch to professional interaction data



diazepam ↔ duloxetine


Applies to: Valium (diazepam), Cymbalta (duloxetine)



Using diazepam together with DULoxetine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



diazepam ↔ aripiprazole


Applies to: Valium (diazepam), Abilify (aripiprazole)



Using diazepam together with ARIPiprazole may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



diazepam ↔ escitalopram


Applies to: Valium (diazepam), Lexapro (escitalopram)



Using diazepam together with escitalopram may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.


Switch to professional interaction data



aripiprazole ↔ duloxetine


Applies to: Abilify (aripiprazole), Cymbalta (duloxetine)



Consumer information for this interaction is not currently available.


MONITOR: Duloxetine is a moderate inhibitor of CYP450 2D6 and may increase the plasma concentrations of drugs that are substrates of the isoenzyme. According to the product labeling, when duloxetine (60 mg twice a day) was administered in conjunction with a single 50 mg dose of desipramine, a CYP450 2D6 substrate, the systemic exposure (AUC) of desipramine increased 3-fold. Conversely, many CYP450 2D6 substrates can also be competitive or noncompetitive inhibitors of the isoenzyme and may increase the plasma concentrations of duloxetine, which is partially metabolized by CYP450 2D6.

MANAGEMENT: Caution is advised if duloxetine must be used concomitantly with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range such as tricyclic antidepressants, phenothiazines, beta blockers, and class IC antiarrhythmic agents (e.g., propafenone, flecainide). A lower initial dosage, as well as clinical and laboratory monitoring, may be appropriate for some drugs.

Elliott, LPCC, NCC :


HERE IS THE WEBSITE:

Elliott, LPCC, NCC :

http://www.drugs.com/interactions-check.php?drug_list=2252-0,233-109,190-1645,949-2273,1013-565,276-128,862-441

This is a very reputable site.

Elliott, LPCC, NCC :

I strongly urge you to change doctors and see a different psychiatrist.

Elliott, LPCC, NCC :

Your current treatment puts you at high risk.

Customer:

What drugs do you think would help me and work together?

Elliott, LPCC, NCC :

An antipsychotic drug (perhaps Abilify in an appropriate dose, or another antipsychotic or mood stabilizer) and perhaps one antidepressant, and no amphetamine. This is not up to me, however, but up to a doctor who does not give you drugs that can possibly make you very ill when combined together. I am not recommending anything. That is up to a psychiatrist, but I would not use this one any longer.

Elliott, LPCC, NCC :

You have serious bipolar symptoms and they are not being properly treated, and perhaps are being made worse by an inappropriate use of medications.

Customer:

Well I thank you for taking the time to answer my questions and I will take the appropriate action needed. All I ask is this--I stay so tired and that is why the adderall has helped me. I only take 1 a day But it helps me.

Elliott, LPCC, NCC :

This you can see by the high risk warnings I have showed you. This is not my opinion but researched and proven information.

Customer:

I appreciate your time. You have helped me and will get an excellent rating.

Elliott, LPCC, NCC :

It is speed and it will counteract the fatigue of the depression. However, you see, above that it increases your mania (racing thoughts) and perhaps increases your compulsions.

Elliott, LPCC, NCC :

It has a big downside to it.

Elliott, LPCC, NCC :

You need a physician who will treat you with much more care and regard, and you can be helped and improved when treated properly.

Elliott, LPCC, NCC :

I am happy to have helped you and I shall keep you in my prayers for recovery and a more normal life.

Customer:

Thank you sir. I think the prayer will help the most. I will also pray for you. I will see another Doctor.

Elliott, LPCC, NCC :

I am so happy to hear that. May God bless and protect you. Amen.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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