CSIDreamer
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Yes, I was wondering the same thing. Olanzapine and citalopram (SSRI) is not a combination I've ever seen before or would ever recommend. For one thing, that combo can trigger more manic episodes. Furthermore, it would increase the risk of a potentially fatal heart arrhythmia. If I saw that combo at work I would not approve it and would contact the doctor to get more info.
If she was diagnosed with one of either
then olanzapine with fluoxetine, another SSRI, may have been indicated. This combo HAS been approved and does not increase the risk of fatal heart arrhythmia. So why in the world would she be prescribed citalopram when a much better and safer alternative is available? I just don't see a competent doctor prescribing that. Knowing her mental health and prescription drug history would definitely help put the pieces of the puzzle together. Had she tried and failed literally every combo possible and this was a last resort? Or was she borrowing someone else's medications because she had misdiagnosed herself and thought these drugs might help?
- Acute depressive episodes in bipolar I disorder
- Treatment resistant depression (major depressive disorder in patients who fail 2 separate trials of different antidepressants
For whatever reason, she had those two Rx drugs in her system, and the combination could certainly drive a person to mania and paranoia. That paired with methamphetamine is a very dangerous combo! She very well may have had hallucinations, delusions and paranoia that caused her to inflict harm upon herself.
I was just reading elsewhere about a drug interaction that resulted in serotonin syndrome. I know nothing about it really. Any chance of that here? JMO.