Australia - Is this even legal? Prescribing antidepressants plus ritalin

[sknkv2]

I know this must be extremely unethical but is it illegal?

Okay, so someone I know was a very heavy amphetamine abuser. She got put onto an experimental program where she is prescribed ritalin for her addiction. She took her meds and they worked well, she described it as just as good as speed. So we saw this as a good thing, she was off the street stuff and was saving money and at least being functional because she has kids living with her and she wasn't going out to score any more. But she started needing higher doses. She's currently on 60 mg ritalin a day (i think the highest allowed dose) but she told the doctor she wanted more. the doctor couldn't prescribe more, or said he didn't wnat to, and instead said something to the effect of "ill prescribe you an antidepressant and just take one a day and it should make the effects more noticeable". Now swim doesn't know which antidepressant was prescribed, but he's pretty sure they're contraindicated. I don't even see how this is legal? just put it out there maybe as a discussion of unethical med pushing doctors and was curious about the legality of it, but i was pretty shocked when i found out, thought it was very dangerous.

[thebige]

Swim belives this is not medically unethecial........
And since we don't know what medication was prescribed,and don't know how the doctor is planning to care for this patient over a possible prolonged course of treatment,it is probebly more unethical to pass judgement on doctor and patient.....
imho..

[sknkv2]

Originally Posted by thebige

it is probebly more unethical to pass judgement on doctor and patient.....
imho..

First of all, you are passing judgement on me by saying I am judging her. In future, use the fact that you might not know somebody as a general rule to not decide what and what they do not judge. I do not judge her. At no point did I even hint that I judge her. She is a good person. It just seems risky that a doctor would give her an antidepressant to potentiate the effects of the ritalin, do you not agree? I am just genuinely worried for her health. I think a good doctor would actually address why she was addicted and help her work through the addiction instead of just giving her more drugs. It does seem unethical to me on behalf of the doctor, IMHO. Antidepressants are for people that are depressed as far as I know. Prescribing them to boost the effects of ritalin isn't actually a proper use.

[missparkles]

Originally Posted by sknkv2

First of all, you are passing judgement on me by saying I am judging her. In future, use the fact that you might not know somebody as a general rule to not decide what and what they do not judge. I do not judge her. At no point did I even hint that I judge her. She is a good person. It just seems risky that a doctor would give her an antidepressant to potentiate the effects of the ritalin, do you not agree? I am just genuinely worried for her health. I think a good doctor would actually address why she was addicted and help her work through the addiction instead of just giving her more drugs. It does seem unethical to me on behalf of the doctor, IMHO. Antidepressants are for people that are depressed as far as I know. Prescribing them to boost the effects of ritalin isn't actually a proper use.

Using the term "just put it out there maybe as a discussion of unethical med pushing doctors" does come across as judgmental.
And swim believes swi the bige was actually saying that even discussing this case (the patient and doctor) could be deemed unethical. No one knows the circumstances and can only give general advice.
Swim thinks it comes across as swi OP being pissed that the doctor wouldn't prescribe the increase in meds swi OP wanted, is all. But back on topic.
From what swim has heard it's quite common for some doctors to prescribe these two drugs together. There's a school of thought that says one complements the other and heightens the anti depressant effect. But that's what swim has read, not backed by any science.
Perhaps this discussion should be taken back to the prescriber, they're the expert.
Hope this helps a little.

[anonuser30500]

I doubt it is illegal because prescribing Ritalin with anti depressants has been noted as a practice which goes on in the West.

As for the morality of it - maybe its better to put anyone abusing speed onto the legal version of the dog that bit you. Especially a mother who could lose children through using illegal drugs.

Maybe the docs given her the lesser of two evils in some ways.

Good luck as ever.

[lulz]

It's neither unethical nor is it illegal.

Ethical issue: the doctor thinks that your brain chemistry is unbalanced, and is trying to correct it. Antidepressants are often used in treating drug addiction apparently. The doctor can not justify prescribing higher doses of Ritalin for medical reasons, so they are trying another option to try to help you. Why do you think this is unethical? Also, can you say why did you start needing higher doses of Ritalin?

Legal issue: if the doctor is prescribing an uncontrolled substance (antidepressants are generally uncontrolled) for a valid medical reason (treatment of addiction), there's nothing illegal going on.

60mg/day of Ritalin is the maximum recommended dose used in most Western countries. Higher than 60mg/day is called "off label" usage, and although it's legal, the doctor has to have a justifiable medical reason for doing it. When prescribing a controlled drug (Ritalin is a controlled substance) on an "off label" basis, most doctors are going to be nervous about covering their ass, and need a good justification for doing it. You can't just say you want a higher dose, that's not a valid medical reason on its own. Especially since you used to abuse stimulants, so there's a risk you would start the cycle of abuse with Ritalin.

The doctor's probably trying to help you, and cover their own ass with the medical profession. You're very lucky to be on this experimental Ritalin program (experimental programs like that are uncommon), try to make the best of it and remember they're trying to help you.

P.S. What was the antidepressant? Was it Wellbutrin?

[sknkv2]

It's actually not me. I am also prescribed ritalin but this is honestly someone else and I was just concerned for them that's all. I guess it must just happen more than I realised, thanks for enlightening me.

[Rainbowzz]

Prescribing antidepressants with ritalin is VERY common here in canada.They do it both to potentiate the affect and keep the dosages as low as possible, and to take away nasty side effects that can happen, such as irritability and anxiety. Also, antidepressants are used for way way more than just depression.. also anxiety, mood lability, hostility, negative thoughts, sleeping problems, PTSD, addiction, and lots lots more.

Whether this is ethical or not..I cant say.I was not there and i dont know the patient or the doctor personally.. but swim can tell you for sure that it definetly does happen and she thinks it is WAY better this way than using ice.(methamphetamine)

[Junkhead23]

Sounds perfectly ethical to me and is a combo that is used a lot in medical circles. I think the doctor knows what he is doing. Of it were dangerous and she died he would be in major trouble.