Lovenox, Concerta ER, Celexa and Trazadone

[Betsy]

My client has a Dx of anxiety, ADHD and clotting factor disorder.
She is on lovenax 40iu/day of
Concerta ER36 mg/day
Celexa 60 mg/day
the psychiatrist wants her on trazadone, dose not yet determined. The naturopath is concerned about adding this medication, the psychiatrist (and her husband) would like her to be able to focus.

Is there any concern about the combination of these medications, and is there any concern specifically about trazadone? thank you.

[admin]

Betsy:

The transfer of methylphenidate (Concerta) into milk is really quite low and I doubt it will pose a problem. Just observe for excitement and insomnia. Lovenox levels in milk have not been published, but they are generally quite low. I've had one case only that reported bloody stools, but this is so common I don't know if it had anything to do with this drug. Generally its OK to use. Watch for bruising or blood in stool. Trazodone has been studied and levels in milk in are 2.8% of the maternal dose. Not very much. Infants seem to do just fine.

I wouldn't be too concerned about this combination.

Tom Hale Ph.D.