A pharmacist has warned of a lesser-known and dangerous side effect of a commonly prescribed asthma medication after it was found to cause suicidal thoughts.
The drug, called Singulair, is taken by 12 million people, 1.6 million of them children, and has been linked to dozens of suicides and attempts.
But Minnesota pharmacist Javi Ngo Hamilton told DailyMail.com that she is nervous about other widely prescribed drugs because of their harsh side effects.
One of these drugs is Adderall and other stimulants for ADHD, which more than 16 million Americans take.
This powerful irritant can cause a significant increase in blood pressure, which can lead to heart attacks, strokes, aneurysms, and even insomnia, which has devastating ramifications for the body.
Meanwhile, Ngo is concerned about the prescription smoking cessation drug Chantix, which has had bold warnings on its packaging since 2009 about suicidal behavior and other psychiatric side effects.
Also, if a patient is prescribed a strong painkiller for pain with no apparent cause, she should tell the doctor about it before dispensing it and make sure the patient is not just asking for the drug. Make sure.
Below, DailyMail.com highlights four medications that Ngo-Hamilton advises to take with caution.
HaVy Ngo-Hamilton holds a Doctor of Pharmacy degree and works at the University of Minnesota Medical Center.
Antibiotics – The Rise of the Killer Superbug
For Gohamilton, the issue of overprescribing antibiotics is paramount, and all orders from doctors should be scrutinized.
She says, “Whenever a new antibiotic is prescribed or ordered in the hospital, I always check to see if it is appropriate for the patient.”
“We always need blood tests to confirm that. We need to know, based on a physical exam and blood tests, that you really have a bacterial infection before we can start antibiotics. ”
Doctors may prescribe antibiotics as a preemptive strike against possible infection, for example after a severe bite or wound.
However, this habit is thought to be contributing to the rise in drug-evading bacterial infections known as superbugs.
Neisseria gonorrhoeae has developed resistance to multiple antibiotics, including penicillin, tetracyclines, and fluoroquinolones.
Doctors sometimes prescribe antibiotics as a preventative measure against infections, such as after severe bites or wounds, Gohamilton said, but this practice is contributing to the rise in antibiotic-resistant superbugs. said.
MRSA is resistant to methicillin and other penicillin-like antibiotics.
Campylobacter jejuni, which causes food poisoning, has also developed resistance to fluoroquinolones and other antibiotics commonly used to treat bacterial gastroenteritis.
recent study More than 39 million people will die from antibiotic-resistant infections between now and 2050.
More than 1 million people died each year from drug-resistant infections from 1990 to 2021, and 92 million lives could be saved between 2025 and 2050 if antibiotics were available to treat infections. There is a possibility of being saved.
But Gohamilton said when people go to a hospital or clinic, they expect to take home medicine for any illness, even a viral infection that can’t be cured with antibiotics.
She said: “The reality is that people don’t feel the effects of antibiotic resistance right away; they only feel it later when they get sick and there are no more effective antibiotics.”
Chantix – Depression and Suicide
Chantix for smoking cessation may have serious side effects, including suicidal thoughts, behavioral changes, sleep disturbances, and disturbing dreams, so the patient’s medical and psychiatric history should be carefully reviewed.
Ngo-Hamilton uses a similar comprehensive review of patient information when doctors prescribe Chantix, a drug prescribed to help people quit smoking.
The FDA found that the drug causes behavioral changes, including hostility, agitation, depressed mood, suicidal thoughts, and attempts.
Before putting a warning on the drug’s label in 2009, the FDA received 112 reports of suicide and 205 suicidal thoughts in people taking Chantix or similar drugs.
“We need to look at their psychiatric history to make sure they’re not at risk for suicidal ideation or increased suicidal ideation,” Gohamilton said.
“That would be very surprising to everyone, especially patients, but it certainly shouldn’t be ignored because the negative effects are so serious.”
This drug can also cause unpleasant non-psychiatric side effects. One in three people in trials of the drug experienced nausea, and one in 20 vomited multiple times.
Ngo issued warning after widely prescribed asthma medication was found to cause suicidal thoughts
Chantix works by activating nicotine receptors in the brain, similar to smoking cigarettes, but only partially.
It provides some of the pleasurable effects of smoking by stimulating the “feel good” hormones dopamine and acetylcholine (which play a role in memory and alertness), but not as much as cigarettes. Helps reduce cravings and withdrawal symptoms while smoking. stop.
Dopamine and acetylcholine are also essential for regular sleep and dreams.
Higher levels of dopamine in the brain make a person feel more awake, making it harder to fall asleep.
Acetylcholine, on the other hand, is an important regulator of REM sleep (rapid eye movement), the stage where our most vivid dreams occur. Chantix increases brain activity during REM sleep, making your brain more stimulated, resulting in more vivid or even frightening dreams.
Opioids – Addiction
In addition to having a high potential for abuse, opioids can cause severe constipation and other gastrointestinal symptoms, shallow breathing and drowsiness, and can increase the risk of falls in older adults.
The negative effects of overprescribing or inappropriately prescribing opioids are incredibly serious, with the risk of addiction being the most significant.
Ms Ngo Hamilton said: “Pharmacists, whether in hospitals or in retail stores, should be very diligent in assessing patients to ensure that opiates or benzodiazepines are being administered appropriately, and I am committed to doing so.” I feel that way,” he said. [an anti-anxiety medication with addiction potential] That’s appropriate for that patient. ”
Opioids can hijack the brain’s reward processing system, and nothing is more important than getting the drug and thwarting withdrawal symptoms, even food and shelter.
Between 3 and 19 percent of people who take prescription painkillers become addicted, leading to 81,100 opioid-related deaths in the U.S. in 2023.
When a doctor’s prescription runs out, people who become addicted to the drug often seek it on the black market in the form of pills laced with heroin or deadly fentanyl.
In addition to being highly addictive, opioids can cause nausea, vomiting, severe constipation, dizziness and drowsiness, and increase the risk of dangerous falls.
Even a single dose of opioids can cause severe breathing problems.
Opioids bind to opioid receptors in the brain stem and control the body’s breathing rhythm.
Normally, when carbon dioxide levels rise in the blood, the body sends a signal to the brain stem telling it to breathe more to get rid of some of the carbon dioxide.
However, opioids impair the brainstem’s ability to sense elevated levels of carbon dioxide in the blood and trigger the necessary response of increasing the rate and depth of breathing.
As a result, you may feel less of an urge to breathe, and your breathing may become shallow or slow.
Medications for ADHD – Overmedication
Go Hamilton is especially cautious when administering stimulants such as Adderall and Ritalin to teenagers and young adults.
Ms. Gohamilton is equally cautious when administering stimulant drugs, such as Adderall and Ritalin for ADHD, especially to adolescents and young adults.
The stimulant is designed to treat ADHD, but it’s also popular as a party drug and study aid across college campuses.
Pharmacists work with doctors and nurses to carefully assess patients before starting treatment.
Patients need to be thoroughly evaluated to ensure they have a legitimate need for the drug, “and not just so they can stay up all night studying for exams,” Ms Ngo Hamilton said. Ta.
Stimulants such as Adderall, Ritalin, and Vyvanse can be addictive and come with a myriad of side effects, but symptoms typically include loss of appetite, insomnia, irritability, headaches, rapid heart rate, and irritability. It’s manageable.
Doctors often consider a patient’s entire medical history before sending a prescription to the pharmacy.
But pharmacists who specialize in how drugs work and interact with other medications add a much-needed extra layer of security that can potentially save patients’ lives.
Some doctors have criticized what they say is an overreach in giving these drugs to children whose long-term effects are not yet clear.
The rise of telehealth services led to a surge in prescriptions during the pandemic, with prescriptions jumping from 35.5 million in 2019 to 45 million last year.
And an NIH study found that an estimated one in four American teens abuses prescription stimulants such as Adderall.
Of all American children and adults, approximately 6 million take prescription medications for ADHD.
Although this disorder is usually detected in children, an increasing number of adults are being diagnosed.
DSM-5 has detailed criteria for diagnosis. Clinicians look for five or more symptoms of inattention or hyperactivity-impulsivity that have lasted at least six months, are significantly disrupting daily life, and cannot be explained by another mental health condition.
