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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 6001
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Hi, I am a 59 year old male and started my first medication

Resolved Question:

Hi, I am a 59 year old male and started my first medication for depression in my entire life on August 27th, 2013. The doctor prescribed 10 mg celexa but I was having some episodes of my skin burning so I cut back to 5 mg and have gradually increased to 20 mg at the suggestion of my general practice doctor. I started 15 mg about three weeks ago and have just now increased to 20 mg. The same doctor prescribed prilosec at 20 mg about 15 years ago and I have taken it every day since. I have been reading that is a bad combination because both drugs work on the same liver enzyme. My pharmacist just laughed and said there is absolutely no problem. My gp realizes the potential problem but doesn't seem real concerned about it. The Mayo clinic web page says that it isn't recommended to prescribe both but if it is necessary than both are prescribed together. I also have a concern about qt elongation if I have too much celexa in my system. Is it safe to take the two drugs together? What are your thoughts on qt elongation in my situation. I don't have heart abnormalities.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Dr. Z :

Hello

Dr. Z :

I believe I can help you with your concern

Dr. Z :

Please give me a couple minutes to read over your question carefully, so that I may better assist you

Dr. Z :

You are correct from your own research that there is a possible interaction effect when combining the Celexa and Prilosec. These can include increasing the blood levels of the Celexa and causing an irregular heart rhythm, but since you have not noticed any heart issues at this time and you do not have a history of heart problems, then that interaction effect is low for you

Dr. Z :

Also concerning the "too much Celexa" in your system would also be a low risk concerning that you are taking 20mg. I would be more concerned at the QT prolongation if you were taking a higher dose of the Celexa at 40mg when combined with the Prilosec

Dr. Z :

And also you Prilosec dosage is only moderate at 20mg as it can be higher for some certain cases, so if this was at a higher dose as well than your increase of these interaction effects would be higher.

Customer:

In your practice have you seen many people on both of these drugs?

Dr. Z :

So your research was correct about the interaction effects, but the benefits of these medications outweigh the risks.

Dr. Z :

I have seen many patients with ulcers being prescribed similar antidepressants (this isuse is not limited to just Celexa) and the Prilosec with no issues. If you are concerned though you can ask for regular blood tests to test the level of the Celexa in your system

Customer:

Thanks for your help.

Dr. Z :

In addition, if you want, you could switch to Zoloft or Effexor as these are good antidepressant medications without this interaction effect with the Prilosec

Dr. Z :

There are many antidepressants to choose from without this interaction effect and it can give you some peace of mind as well

Dr. Z :

Here are links showing that there are no interaction effects with the Effexor and Zoloft

Dr. Z :

Is there anything else I can do to assist you today?

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 6001
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Dr. Z
Dr. Z
Psychologist
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Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.