Charcoal symptoms and conditions

Hats off to Dr. Engler. Patients need this type of support. He is a unique individual willing to tell his own experiences.

Singulair increases risk of Suicide? Don't just poo-poo the possibility

This analysis is solely the work of the author. It has not been edited or endorsed by GLG
.
Analysis By:David Engler, MD
Physician, The Allergy Clinic

Implications: It is difficult to imagine why taking Singulair would increase the risk that someone would complete suicide. After all, what does a leukotriene receptor antagonist have to do with mental health? I don't know. But doctors, ask yourself, have you ever had a Singulair patient stop taking it because it caused headaches? I have had dozens of them stop taking it because of headaches. When they attempt to try it again, the headache comes back. But the package insert says that the risk of headache is no greater than it is in people who took placebo. Try explaining that to the patient who got the headache--it's very real to them.

Analysis: The story about Singulair and suicide may be based on some cause-effect relationship. I don't know what that is, but I will tell you story of a patient I saw last week. She is a 19 year old college student, with the usual stresses of college. I have been treating her for asthma and allergies since she was 10 years old, and she had been on Singulair for about 5 years.

She was treated in the town's ER for an intentional Tylenol overdose; she took 15 of them for a headache that wouldn't go away. The usual charcoal to the stomach, with Mucomyst to protect the liver from the Tylenol went fine. While under evaluation, the ER doc also noticed she had been "cutting" her wrists and arms. She said that it relieved stress.

They asked her about the Singulair and she said it gave her bad dreams. Astutely, they stopped it. All this happened a week or so before the recent news headlines.

Is that cause and effect? No way....but remember that MRK is the same company that still denies that Vioxx can increase the risk of heart attack. Oh yeah, Vioxx. That drug would have been great as a niche drug if given to treat pain in those already at risk of a GI bleed. But, no, MRK was encouraging dentists to give it out for toothaches, and most patients in my practice who were on it had no history of GI bleed. MRK wanted Vioxx to be a billion-dollar blockbuster; had it been marketed appropriately, it may still be on the market.

So how will I change my prescribing habits? For patients who have a psychiatric history, including those who take antidepressants, I'll mention the story of this patient to those on Singulair and start asking questions to try to determine if they are brittle or fragile from a psychiatric standpoint.

This may be much ado about nothing, but what if it's not? I've learned to stop drinking the drug company Kool Aid without a few grains of salt.

My 13 yr old daughter was put on Singulair along with Asmanex and Clarinex for her asthma about 6 weeks ago. Everything seemed to be going very well at first and her symptoms were starting to get controlled. I started noticing after about 3 to 4 weeks that her temper and attitude were getting much worse. Anyone with children this age knows what I mean but this was like a 180 degree turn for her. Her actions were becoming totally out of character. Before I knew it she would cry and get highly upset over the least little thing. Week 5 came around and things totally bottomed out. She came home from school and WAS NOT HERSELF. Made comments about how she hated her life and it was not worth living. Later that evening we had a big argument because I was telling her nothing was worth saying that. She went totally out of control and I had to physically restrain her to calm her down. It appeared everything was better so she went to her room. I went down to check on her and she calmly told me that she had taken advil and tylenol pm and things would be better for her forever now. We went to the ER where they made us wait for at least an hour, then finally took her back. She had to drink two cups of charcoal and was poked and prodded repeatedly. They did a catheter to get a urine sample. She was very cooperative but also was in a complete daze so who knows. The poor child couldn't even lift her head up when she started the vomiting to get rid of the drugs. It was very upsetting and sad. Her heart rate and blood pressure went very low and I really thought in the back of my mind that this was it. Finally, after several hours she started coming out of it and they sent us home. The next evening when she was starting to really come around she proceeded to tell me how she had been seeing a man walking around in her bedroom at night and she was afraid to go down there. Breaking down and crying telling me about all of the horrible nightmares she had been having recently and didn't know why. I thought what am I dealing with here? This just isn't her. Three days ago I heard about singulair in the news and looked it up on the internet. OH MY GOD THIS SOUNDED LIKE US!!!!! I immediately had her stop taking it and the next day phoned her asthma specialist who agreed she should stop now. We are going to watch her for two weeks and see if any symptoms return and then decide if she needs something else or will be fine on just the Asmanex. As a side note, she also mentioned being unable to concentrate in school (unable to do even the simplest math problems) and that her brain felt confused or like something was missing. She said this had been bothering her for several weeks. I know it was this drug. They really need to take this off the market NOW and stop flirting with disaster. The only reason I posted this was to let others know they are not alone.

About eight to ten years ago i had a violent reaction to lactaid. I had taken it numerous time before with no problems and then I woke up one morning - had a bowl of cereal and a lactaid pill - within the hour I was experiencing severe stomach pain along with vomiting and diarrhea. I thought it might have been due to the fact that i had had very little to eat the day before and only a bowl of cereal that morning with the extra strength pill.

the following weekend i was brave enough to try it again with some ice cream at night (this time i had a full stomach from dinner). BIG mistake - this time it was worse - the stomach pain was out of this world (i have a high pain threshold but this had me in the fetal position) and i couldnt leave the toilet and trash can for a few hours. My girlfriend was scared and called one of those nurse hot lines. they told her to coat my stomach with some kaopectate - which seemed to help. I checked the bottle of lactaid - and the expiration date had passed - so i threw it away and swore off of lactaid pills. fortunately they came out with the lactaid milk!

Fast forward to now - never touched the stuff again. well the other day I was out of lactaid milk and my wife (yes the same girlfriend) had picked up some samples of lactaid pills at a trade show - so I guess with the passage of time - I forgot how painful and miserable the other experiences had been - so i took the pill. Nothing happened!

Last night i decide to take another one because i had a craving for ice cream (had been awhile!). I figured it was ok since i had no reaction a week ago. Well sure enough - within the hour I was on the floor in severe stomach pain - followed by vomiting and diarrhea. This time we had kaopectate in the house - so i started taking it - well i just threw it right back up.

This episode lasted about an hour and a half this time. There was a metallic taste in my mouth about the third time i vomited, and the fifth and final time, there was puddle of yellow liquid that came out at the end.