Prozac (fluoxetine) is primarily an antidepressant, but is also prescribed off-label for a variety of conditions, including panic attacks and acne. Ativan (lorazepam) is a mood stabilizer usually prescribed for people with anxiety disorders.Accutane (modified viatamin A) is a brand name drug to tread severe acne. Sometimes people take all three drugs. What potential side effects could they experience?
People with anxiety disorders may also have depression, so Prozac may be prescribed first and then Ativan added if panic attacks continue, but other depression symptoms lessen. Both Prozac and Ativan may cause drowsiness. The real complications begin when Accutane is added to the mix. Accutane is known to produce symptoms of major depression in some people, possibly negating the effects of Prozac and Ativan, according to “Accutne and Psychiatric Adverse Effects” (Eric Wooltorton, Canadian Medical Association Journal, Jan 7, 2003).
Warning For Women
Prozac is in a family of antidepressant drugs known as SSRIs. These drugs are suspected of causing birth defects in the lungs of fetuses. Accutane definitely can cause severe birth defects with just one dose. According to Accutane’s makers, Hoffman-LaRoche, sexually active women taking Accutane need to get a pregnancy test once a month. Pregnant women or nursing women need to avoid Prozac, Ativan and Accutane.
Hoffman-LaRoche has been sued many times by Accutan patients claiming the drug causes irritable bowel syndrome (IBS). Although it is unknown if Accutan can cause IBS, Eli-Lilly (the makers of Prozac) warn Prozac patients that Prozac may cause loss of appetite, nausea, diarrhea or bleeding of the digestive organs. The makers of Ativan warn that their medication may also cause loss of appetite, nausea and diarrhea. Taking all three drugs may significantly increase a person’s chance of developing IBS.
Not everyone who takes Prozac or Ativan gets digestive side effects. Also, according to the aforementioned “Canadian Medical Association Journal” article, only 25 percent of all Accutane patients developed symptoms of major depression. It is also unknown how many of those patients were already on Prozac and/or Ativan. Still, Accutane should only be used as a last resort for severe acne that will not respond to other treatments, especially in women.
The makers of all three drugs recommend that any sudden unusual symptom that develops in a patient should be reported to a doctor immediately in order to prevent IBS or for anyone to act on suicidal thoughts. It’s also recommended by the makers of both Ativan and Prozac that a patient on these medications should not drink alcoholic beverages, which can increase a person’s drowsiness, digestive upsets and symptoms of depression.
Eli Lilly. “Prozac Medication Guide.” http://pi.lilly.com/us/Prozac-Medguide.pdf
“Hoffman-LaRoche Ordered to Pay Accutane User $2.6 Million” May 30, 2007 http://articles.latimes.com/20 07/may/30/business/fi-accutane 30
“Accutne and Psychiatric Adverse Effects” (Eric Wooltorton, Canadian Medical Association Journal, Jan 7, 2003) http://www.cmaj.ca/cgi/content /full/168/1/66