She has taken up marijuana and tobacco nothing too serious, but I’m still worried about the substance abuse side of it.
And yes she is very anxious/depressed and she was recently referred to the hospital by her therapist to be placed on watch, but was not admitted because of the virus
And she is actively taking antidepressants but says they do not help..
Hi Bpdsoulmate:
Per the quoted information below from Pharmacy Times (full article at the link below), cigarette smoking can have a negative impact on antidepressants. From what I understand in the article, it's not the nicotine, but other components of cigarettes that affect some medications. So, if nicotine helps her depression, perhaps using nicotine patches or gum might be an option.
The cigarettes could be invalidating the antidepressants, whereby she would need to take a higher dose to get whatever benefit she received prior to cigarette smoking (or with less cigarette smoking). Perhaps it's something to discuss with her doctor.
Psychiatric medications such as antipsychotics, antidepressants, hypnotics, and anxiolytics are widely affected by cigarette smoking. For these classes, the drug concentration in the blood can be decreased with smoking, and reduction in efficacy may lead to inappropriate higher dosage adjustments.
Tobacco smoke induces many of the CYP450 enzymes in the liver, which play an important role in medication absorption, distribution, metabolism, and elimination. Drug interactions are caused by components of tobacco smoke itself, rather than nicotine. This means nicotine replacement therapy (NRT) can be used without concern of drug interactions and medication changes."
https://www.pharmacytimes.com/contributor/shivam-patel-pharmd-candidate/2016/05/how-smoking-affects-medications [/quote]
What else is going on with her - any issues with Covid-19 and staying home?
Is she making any effort to stay active (exercise, hobbies, etc.)?
