Interactions of cold medicines with antidepressants and biphasic drugs

If you wake up with an itchy throat or a runny nose, you can check your medicine cabinet first or go to the pharmacy to buy your first choice for colds and flu.

Many products for treating cold symptoms can be purchased over-the-counter (which means you can get them without a doctor’s prescription). Although these products are safe and effective, they can also interact with other types of drugs.

Prescription drugs for mental illnesses such as depression, anxiety, or bipolar disorder are the most common types of drugs that can interact with common cold medicines.If you take antidepressants, here is what you need to know about using over-the-counter cold and flu medicines.

What is a drug interaction?

When doctors and pharmacists talk about drug interactions, they are referring to the way one drug affects another drug.Understanding how different medicines interact is not only important for your safety, but also for ensuring that your medicines work as expected.

Even if the interaction is not dangerous, it can still cause problems (for example, when one drug makes another drug less effective). On the other hand, certain drugs are sometimes used in combination on purpose because they work well together or have a positive effect on each other.

Drug interactions can Pharmacokinetics or Pharmacodynamics.

Pharmacokinetic interaction means that when two drugs are taken together, the interaction can change the mode of action of one (or both). For example, taking certain drugs at the same time may affect the way the body absorbs, uses, or eliminates one (or two) drugs. When different drugs are taken together, they may increase or decrease the amount of drugs in your body.

When drugs directly affect each other, pharmacodynamic interactions occur. For example, taking more than one sedative medicine will make the effect stronger (enhanced). Pharmacodynamic interactions also occur when drugs are taken with substances such as alcohol.

If you are taking medications for depression, anxiety, or other mental health conditions, they can interact with many other types of medications—even those that are available over-the-counter, such as cold, cough, and flu medications.

Certain ingredients in cold medicines can alter the effects of antidepressants, including reducing their effectiveness. They can also exacerbate side effects or cause new side effects.

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Cold medicines and antidepressants

There are several types of drugs that can be used to treat mental illness, including antidepressants, antipsychotics, sedatives, and anticonvulsants.

Many drugs may interact adversely (or even dangerously) with common active ingredients in over-the-counter cold medicines.

Cold and flu medicines available over the counter usually contain ingredients such as pseudoephedrine (a decongestant), diphenhydramine (an antihistamine), dextromethorphan (a cough suppressant), or guaifenesin (an expectorant).

These substances can interact with prescription drugs used to treat depression and other mental health conditions and can become serious.

The following are just some examples of common medications that can interact with over-the-counter cold medicines. This is not an exhaustive list.

If you are taking any prescription drugs, be sure to consult your doctor or pharmacist before taking any over-the-counter drugs or supplements.

Antipsychotics, tranquilizers and tranquilizers

Some over-the-counter cold medicines contain ingredients that can make you feel sleepy. If you have a bad cough that keeps you awake at night, this may help. However, certain antipsychotics and sedatives also have a sedative effect. If you take these medicines with cough medicine, some decongestants, or antihistamines, you can increase the sedative effect.

Antidepressants and DXM

The list of major drug interactions between antidepressants and dextromethorphan (DXM) is extensive.

If you are taking a selective serotonin reuptake inhibitor (SSRI), such as Prozac (fluoxetine), Zoloft (sertraline) or Lexapro (escitalopram), please do not combine any drugs with Use Methorphan together. This combination can cause serious interactions called serotonin syndrome.

Like other antidepressants, monoamine oxidase inhibitors (MAOIs) can interact with other drugs, remedies, or supplements you may be taking—they can even interact with food.

If you are taking MAOI, you should not take cold, flu, or cough medicines that contain decongestants (such as phenylephrine and pseudoephedrine) or dextromethorphan.If you are taking MAOI, nasal decongestion sprays are also not safe.

Antidepressants and non-steroidal anti-inflammatory drugs

Cold and flu preparations sometimes include non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or acetaminophen, as analgesics or fever reducers. Non-steroidal anti-inflammatory drugs increase the risk of gastrointestinal (GI) bleeding.

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If your antidepressant is a selective serotonin reuptake inhibitor (SSRI), you should avoid non-steroidal anti-inflammatory drugs. Studies have shown that taking SSRIs and NSAIDs at the same time will further increase the risk of gastrointestinal bleeding.

A 2015 study found that people taking both SSRIs and NSAIDs (naproxen and aspirin, and ibuprofen) also seemed to have an increased risk of cerebral hemorrhage (intracranial hemorrhage) within one month of taking the combination.

What to do when you are sick

If you find that you have a bad cold or seasonal flu, there are a few things you need to keep in mind as you try to get better.

Continue taking medication

Unless your doctor tells you to stop taking it, you should never stop taking medications prescribed for you-including antidepressants or other medications used to treat mental illness.

Many drugs used to treat depression and other mental illnesses can cause withdrawal symptoms if they are stopped suddenly. Stopping the medication without consulting a doctor may also cause symptoms related to your mental health to relapse or worsen.

The symptoms of stopping the medication can be severe and even life-threatening. For example, if a person taking a selective serotonin reuptake inhibitor (SSRI) to treat depression needs or wants to stop taking the medication, they usually need to gradually reduce the dose to reduce the risk of SSRI withdrawal syndrome.

Another reason to continue taking medication even if you are feeling sick is to help ensure that you don’t make yourself feel worse. If you are taking antidepressants to treat depression, stopping taking them may cause your depression symptoms to recur. You don’t want this to happen at the best time, let alone when you are already feeling uncomfortable.

Take care of your body and mind

When you are sick, you need to take care of your body and mind. When you are trying to recover from a physical illness or infection that reduces your reserves, your mental health may also become somewhat sensitive.

If you are not sure whether it is safe to use cold or flu medicines, please feel free to call your doctor or even your local pharmacist. They can review any prescription drugs you are taking and recommend safe (effective) treatments for your cold symptoms.

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When you are sick, you can also do some non-drug things to help yourself recover. Although they may seem obvious, it’s easy to forget to take care of yourself when you are healthy-not to mention when you are not feeling well.

Eat well and drink well

When you feel uncomfortable, you may not have much appetite or even feel upset in your stomach. Consistently eating nutritious, simple, easy-to-digest foods will help maintain physical strength without aggravating symptoms (there is a reason your grandma’s chicken soup has such a good reputation!).

You also need to drink plenty of water. Water is usually the most effective way to supplement, but there are some exceptions:

  • If you have symptoms such as vomiting or diarrhea (which can make you more prone to dehydration), you may want to try a low-sugar sports drink to replenish electrolytes.
  • When you have a sore throat, hot tea with honey can soothe and moisturize.
  • You don’t want to drink it, but gargle with salt water may also help relieve a sore throat.

Sick leave

Although you may feel pressure from the thought of missing work or going back to bed to rest, one of the best things you can do when you are sick is to get enough rest.

Relaxing (even taking a nap) can help relieve symptoms (especially if your cough makes you sleepless all night) and give your body the rest it needs to recover.

Resting on the sofa or bed can also help prevent you from feeling (or becoming) sicker. When your immune system tries to fight the disease, you may feel extra tired and you are more susceptible to other infections.

Staying at home when you are sick is not just about your health. Avoiding close contact with people when you are feeling unwell can also help prevent the spread of bacteria, viruses, or any infectious pathogens that make you sick to others.

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