Can xanax, librax and nortriptylene cause suicidal ideations?

[nuamor]

I'd like to start off by saying that its good to know that I am not the only one experiencing bad reactions with medications. For the past two years or so I've been taking xnx for my panic disorder. My psychiatrist has me on xnx 1mg, xnx xr (time release) 2mg and nortriptilene. About two months ago, i was diagnosed as having ibs as well. The gastro doc prescribed to my librax and he told me to take it 3 times a day, 45 mins before each meal. I have to say that the librax has worked wonders for me and has diminished my stomach spasms, but what i have noticed is that at night and sometimes during the day, i'm on an emotional rollercoaster, i start having these weird thoughts (suicidal ideations to be exact), something that i have never experienced in my life,never, but ever since ive been taking the librax with the xnx i've been having these real bad experiences, its to the point where im afraid of doing something drastic or stupid. I've consulted both of my doctors about this and they each tell me that xnx and librax together r not suppose to have a bad interaction. They both have told me that all the meds that i am on (described above) are ok for me to take together, yet one pharmacist and my research has shown that benzos should really not be taken together. I dont know what to do anymore, i'm so tired of them saying that there is nothing wrong. Can someone please help me and give me direction of what can be going on? Please. Thank you

[Alison L, RPh]

Suicidal ideation has been reported in patients participating in clinical trials with antidepressants. The symptoms of aggressiveness, akathisia (psychomotor restlessness), agitation, anxiety, insomnia, irritability, hostility, mania, hypomania, impulsivity, and panic attacks have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications. It may be that your depression is worsening causing you suicidal ideation. Have you talked to your doctor about changing the dose of your nortriptyline or switching to a different antidepressant altogether? The drowsiness and CNS effects caused by the combination of benzodiazepines may be a contributing factor to increased depression as well.

[nuamor]

So what do you think is causing these ideations? Before I started taking the librax, i never had these ideations with xanax alone. I always seem to get these ideations at night time and im getting tired of them. I've spoken to my psychiatrist about it and he told me to take another xanax 2mg xr during the day. is that the correct answer, to increase the dosage of xanax? Thank you for your response.

[Sandra Y, RPh]

There are no major drug interactions between Xanax, Librax and Nortriptyline.

Though you are past the age range, there is a warning for all antidepressants (Nortriptyline). There is an increased risk of suicidality in children and adolescents during the early phase of treatment. A similar risk was found for young adults (18 to 24 years). Analysis of short-term studies in adults older than 24 years did not show an increase in the risk of suicidality compared to placebo.