What I did when I accidentally mixed meds

I recently did something very irresponsible. I have only told one person (my partner, Jim) about this because, as a patient advocate and so-called mostly-self-taught expert, mistakes like this should not be made by the likes of me.

Let me start by saying everything is totally fine and that I was never truly in harm’s way.
(That line is for you, Mom.)

A few weeks ago, Jim was downtown (a ten-minute walk from our house) with friends. I’d decided to stay in because I wasn’t feeling too great. Earlier in the evening, I’d had a migraine and took my Imitrex. The meds had kicked in, thankfully, but my omnipresent back pain was still distracting me, so I took a prescription painkiller.

Jim and I texted back and forth. He wanted to make sure I was feeling better and double-check to see if I needed him to come home. I told him I was A-OK and to enjoy himself.

After I sent that text, I thought about the phrase I’d used. That I was A-OK. Something about that brought up a thought to my mind suddenly: was it okay to take that painkiller even though the Imitrex is still in my system?

I can practically hear your groans as I tell you I took to the internet to research the drugs and their interactions. (Thankfully, I am a former medical and scientific document editor so actually know of reputable places to look for accurate health information—hint, hint: don’t trust everything you read on WebMD and the like.)

On one prominent and well-trusted health website, I typed in the names of the two medications in my system and immediately saw a big red X that signifies a dangerous drug interaction. The risk was of serotonin syndrome, something that’s come up two times on Migraine.com (first by Teri Robert, next by Diana Lee) since my experience. (If Diana Lee’s article had been online a couple months earlier, I may have avoided some of my panic, even though her article mainly deals with triptans and antidepressants, not triptans and a particular type of painkiller).

My heart started pounding. I felt a little bit faint and, when I tried to stand up to go to the kitchen to drink a glass of water, I got really dizzy. Everything I’m describing here matches the signs of serotonin syndrome, which, though rare, can be very dangerous and even fatal.

What I tried to keep in mind is that I am already someone who gets lightheaded when confronted with stress. I faint easily as it is, and even imagining horrific and scary things can make my heart pound and my brain feel fuzzy. In fact, in writing this story down I find my face getting flushed and my heart rate increasing.

All the same, I was nervous enough to wonder if I need to go to the ER. Was I about to be one of those tragic cases of someone who has to rush to the hospital due to misuse of prescription drugs?

I kept as cool as I could and called the Poison Control Hotline. The doctor I spoke with assured me everything was fine. I practically heard his well-meaning eyes roll when I told him that “research” online was what drove me to this panic. Talking to him made me significantly calmer, but I had more questions. “Are you sure I shouldn’t go to the ER?” I asked him. “You are totally fine,” he assured me. “In fact, if you go to the ER, I am the expert they are going to call for advice, and I will tell them that no treatment is needed and that you’re safe.”

I thanked him, hung up, and found that all my “symptoms” were gone. I was calm. My heart rate was normal. I stood up and didn’t felt dizzy.

I woke up and felt fine the next day. End of story.

In the end, it’s obvious things turned out okay. But I’m still embarrassed at thinking of myself as a very responsible healthcare advocate who foolishly took medications that were contraindicated. I am thankful for such resources as the Poison Control Hotline and urge you to call them if you ever find yourself in a similar bind: 1-800-222-1222. As my colleague Diana Lee wrote in her article, “With this kind of condition, it’s definitely better to err on the side of caution by seeking medical treatment. Please don’t even worry about falling into the trap of feeling silly if you happen to be wrong.”

Thanks for listening. And I promise to be much, much safer from here on out.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (8)
  • Cece Yuhas
    5 years ago

    I have chronic pain issues as well as migraines, Bi-lateral Carpel Tunnel Syndrome, Bursitis in both hips and Shoulders, Fibromyalgia, and Depression. In addition to asthma and allergies. I take 9 different medication pills upon waking and more throughout the day, eight medication pills in the evening, and 5 medication pills at bedtime. I take Fiornal for Migraines (the only medication that works for me, I’ve tried everything!!!) sometimes 2 tablets and Zofran, so I won’t throw-up, on top of 2 Zanaflex (muscle relaxers), then have fallen asleep woken up and forgotten I’ve taken my Zanaflex and taken more, or sometimes I have a temporary prescription for precocet and forget and take that. On one occasion I went to the emergency room and received fluids for dehydration and had them check my tox screen level which turned out alright, they encouraged my to drink charcoal, (but I waited for the tox screen results). Now I am much more aware because I get confused during migraines anyway I write down what and when I take.

  • marti
    5 years ago

    I routinely take Tramadol and Flexeril with my Imitrex, or Percocet (when I have it) instead of the Tramadol. I know I shouldn’t, but anything to stop the pain. I’ll take the pills at work and my co-workers are amazed I can stay awake, but like many others, I’ve built up a tolerance. My insurance company won’t pay for the expensive Frova that stops the head pain, and the Imitrex works about half the time.

  • minddoctor
    5 years ago

    Janet, I am so glad that you wrote about this and appreciate your bravery at disclosing your experience. I think there are two things that happen to chronic migraine sufferers – one is that we might hit a point where death seems at the moment preferable to the pain – the second is that in the midst of acute pain, vomiting, lack of sleep and food, our thinking gets confused and we can be prone to accidental medication errors.

    I consider myself to be a highly compliant patient – I do everything the docs say I should do, and I am very careful to take all my meds as prescribed. But about a month ago I woke up with level 10 migraine and took a Vicodin (I only use this med to avoid the ER, as a last result). Somehow I passed out, only to wake a few hours later still in acute pain and completely had forgotten I had already taken a pretty heavy hitting drug. At that time my neck was in acute spasm, so I went to take what docs have suggested in those circumstances, Flexoril and what I thought was Advil, but in the dark room mistook my Advil for Xanax. Suddenly I started feeling a bit better and put together what I had actually taken – Vicodin, Flexoril, and Xanax – three CNS depressants. Similar to what I think you experienced, I started to panic. I wasn’t sure how much of what got absorbed and how much I threw up. I called my husband to return to work from home so that he could research if I needed the ER and watch over me. It was a scary and rather mortifying experience to say the least.

    What I learned from all of this is that when the pain is that bad, I can not be in charge of my medications. I’ve had to practice reaching out for help with these matters. Like you, I slept the day away and woke up just fine thankfully, but it made me wonder how many others make these mistakes. My bet is that it’s quite common, unless you’re that rare individual who has one medication for migraines that works great.

  • Janet
    5 years ago

    Wow!!! I always ask the pharmacist “is it okay if I take this when I take frova to abort a migraine? I trust them before my doc since I’m still waiting for my first appointment with a headache specialist. But over the past 38 years I’ve mixed many meds because like one posted comment, I also looked for that drill to put through my skull, so anything was better at that point than the pain. Unfortunately my husband has had to call 911 more times than I’d care to admit because I couldn’t stand the pain. My husband, now retired law enforcement, hides the guns….that I wouldn’t touch on a bet…..when my meds are Al far more dangerous if combined. So yes we need to educate ourselves…BUT…and for me this is HUGE…the pain the pain the pain…you are about to lose your mind….you don’t think about is this ok to take….so I admit…I’ve endangered myself plenty..on purpose…no…but if I’m to live like this I do what I have to with caution…but I’ve made mistakes and am sure I will in the future …during those desperate headaches where short of slamming your head against the wall or floor..or the dreaded ER visit where you’re given morphine or Demerol which, when you wake up will be in worse shape than when you passed out.

    Suffering far too long……prayers for all of us.

    Blessings
    Janet Jones

  • shine4him
    5 years ago

    Yup. Guilty as charged. I was on Pristiq and was told I couldn’t take Imitrex. After a 5-day monster, I frankly didn’t care, so I took 1/2 a pill to get through the day. It worked. And then I convinced my dr. to take me off the Pristiq, b/c it wasn’t helping. Bleh.

  • 5 years ago

    Thanks to my insurance company, I’m in danger of serotonin syndrome every time I take my rescue migraine medicine. My insurance company doesn’t want to pay for the name brand Maxalt Melts my neurologist prescribed, but the generic Rizatriptan interacts with the anti-anxiety medicine I’m on and the generic Xanax I have for anxiety attacks. I guess the insurance company feels that a life-threatening attack of serotonin syndrome is a better investment than my health and safety. Anyway, it has led to me not using my rescue meds as often for fear of the interaction between the two. I tend to suffer a lot more than I should because pain is better than death.

  • Abhi
    5 years ago

    LOL. I was used to take 40-50 Alprazolam 0.5 pills daily with wine just to have 6-7 hr sleep. Wine because wine also induce sleep. Doctors say it is sure death. Huh? My brain-body was so adapted that I was immune to even very strong poison. For others, even 5 pills can send them to meet Dr God up there.

  • Fwestivus
    5 years ago

    It’s FAR too easy, when in the clutches of a migraine, to be a danger to yourself with medications.

    I had a couple of… uncomfortable… moments with tramadol, topiramate, codeine, rizatriptan, naproxen in goodness knows what mix – if I’d had a hand drill handy, I’d have gone at my skull with it…

    Anyway, after that – I no longer keep overdose levels of medications in the house or any that’ll mix badly. It’s just not worth the risk – if there’s any way to have a friend/family look after your meds so you don’t do stupid things when in pain, I’d say you should do it.

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