drug interactions and drug-induced psychological effects

[dreamersmom]

Firstly, let me remind everyone of how many drugs, including the OTC ones, can cause psychiatric reactions. But here's my Q: My 8 year old daughter suffered a psychological adverse reaction to Reglan.  She had been taking a low dose before bed time and while it worked for her stomach (stimulate motility) it slowly increased her anxiety and depression to the point where we now learned it become nearly toxic (mania, crying, obsessive thoughts, constant urination). At no time was I told by her pediatric GI doc that Reglan may cause psychiatric side-effects (I've since learned that Reglan is well-known in medical circles for it's possible undesirable effects). Now she is cleared of this drug, but I've come to suspect that Zantac may also have effected her. Prior(and at times concurrently)to her taking Reglan, she took Zantac. Looking back, it did nothing for her stomach, and she was clearly anxious while she was on it.  At that time, I just assumed her morning stomach aches were just nerves.  Now I'm thinking that Zantac either caused her agitation it or made it worse. I read an article where one mother was told that Zantac can actually increase Reglan's toxicity (but it sited no literature).  Thankfully, my daughter has recovered completely (and remembers little of the horrific episode). Could the Zantac have increased her anxiety? What is it's effect when taken with Reglan -- does it increase the probability of Reglan toxicity? Does a drug reaction necessarily mean that certain people have underlying mental problems or just sensitivities? She is also in the midst of early puberty -- can hormones have also played a role? How can I protect my daughter from future reactions?

[Roger Gould, M.D.]

You bring up  some important information that all parents should be aware of and I am glad that you posted your message here. You should post the same message and question on this site at a different forum....the one that focuses on children's behavior. They have the expertise to answer these questions, and I don't .  I don't treat children nor prescribe either of those medications.

I can answer one question you pose.  Having a drug reaction is not a sign of an underlying psychiatric problem.  Your daughter's extremely early  puberty is some thing that you and your pediatrician might explore further to make sure it just that.