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Dr. Goldberg how long does medication stay in your system?
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bipolargal posted:
Sometimes I forget to take my meds. Occasionally I have said to myself "I know I forgot my morning med yesterday, but I can't remember if I took today's med" so I don't take it because I don't want to take too much medication, because I know that is not good to do.

I know there are severe things that can happen if a person discontinues meds suddenly. How long will the meds stay in my system if I forget to take one or both of them? Does one type of med stay in the system longer than another type?

The Lamictal I am on has you taper up the dosage when you first start taking it, so I am afraid of what might happen if I forget to take it for a few days. Would I have to taper myself back up, or just take my normal dose?
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Joseph F Goldberg, MD responded:
Dear bipolargal,
The duration a medicine stays in your system varies depending on the medicine. Lamictal, for example, stays in your system for about 5 days after the last pill you take -- which is why if you miss more than a few days, the manufacturer recommends starting the dosage taper-up again from the very beginning, because it is unknown if the risk for skin rash may re-emerge with a rapid taper-up once the drug has left your system.
Having a pill box with a week's worth of medicines laid out every Sunday night is helpful for some people to remember what to take when. Medicines that are dosed only once daily tend to have a lesser risk for forgetting doses as compared to medicines that are dosed twice a day. If your doctor has you taking any medicines more than once a day, ask him or her if any could be consolidated to be taken all together just once a day -- Lamictal, lithium, Depakote, Seroquel or Seroquel XR, Zyprexa, Risperdal, Invega and Abilify can all be given as once-a-day medicines, and there is seldom any need to give any of these more than once daily. So can Wellbutrin XL, Prozac, Lexapro, Zoloft, Paxil, Effexor XR, Pristiq, and Remeron. Geodon is usually 2 or 3 times a day because its duration is fairly short. Cymbalta is usually twice a day. Neurontin cannot be absorbed if more than 900 mg at a time is given, so if someone takes more than 900 mg per day, they need to take it more than once a day in order for it to get into your system. Saphris (a newer medicine that dissolves under the tongue) is dosed twice a day. Usually if someone misses a medicine and no more than half a day has gone by, we advise taking the missed dose, but if more than half a day has passed, we usually say to skip it and try not to forget a next dose...but this can vary depending on the drug. Lastly, some medicines are rather unforgiving if you miss a dose because they cause withdrawal symptoms if even one or two doses are missed -- Effexor and Pristiq and Cymbalta are good examples.
- Dr. G.
 
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ffltat replied to Joseph F Goldberg, MD's response:
Dear Dr G

How long does Lithium last in your system?

ffltat
 
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Joseph F Goldberg, MD replied to ffltat's response:
Lithium has a half-life of 24 hours. It takes 5 days for a medicine to leave your system, so, 5 x 24 hours = 5 days.
- Dr. G.
 
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Joseph F Goldberg, MD replied to Joseph F Goldberg, MD's response:
Further clarify: a half-lfe is the amount of time it takes for half of a medicine to leave your system. It takes 5 half-lives for any medicine to be eliminated from the body, so the amount of time it takes for any particular medicine to leave varies depends on the half-life. (Same is true for how long until a medicine builds up to a steady state. This is why feeling "better" in any sustained way after just one dose is pharmacologically not possible. Lithium and Lamictal both have a half-life of about a day, hence, 5 days and either is out of your bloodstream (or, at a steady state). Abilify, by contrast, has a half-life of 75 hours, so it takes about 2 weeks either to reach a steady level or to leave your system. Prozac and its metabolite together have a half life of a week, so it hangs around for well over a month (which is why there's no need to taper it off when stopping; its long half-life means it will taper itself off).
- Dr. G.
 
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2256ab replied to Joseph F Goldberg, MD's response:
How long does zyperxa stay in your system?
 
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Joseph F Goldberg, MD replied to 2256ab's response:
Zyprexa, the medicine itself, stays in your system about 5 days. But that does not mean that on day 6 all hell breaks loose, the same as missing a day here or there does not specifically translate into having more symptoms on that particular day. Medication effects produce trends over time, and if someone goes off of an effective medicine, it may be any duration of time until a relapse happens (or, possibly, even no relapse; can't predict with any certainty).

- Dr. G.
 
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2256ab replied to Joseph F Goldberg, MD's response:
Dear, Dr. Goldberg, thank you. So if I take a drug test, I would come clean in 5 days? I'm taking the medication because I am bodybuilding and it helps me sleep for 14 hours. I gain around 10 pounds in a week for the the first month. After I gain around 5 a week. Will Zyprexa lower my testostrone. Also, I grew one inch and a half in one month on zyprexa is that common? I was 17 when I grew that inch and half now I'm 18 is there a possiblity I will grow another? Thank you so much for the response.

P.S I'm a pretty shy guy so I wouldn't ask these questions to my psychiatrist these questions, sorry. God bless.
-Alexander
 
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mommaange1 responded:
Dr. G gave alot of good information here, but I want to stress the use of a pill box. I take meds 3 times a day and have the entire weeks worth already set up so I dont have to worry about the half dozen bottles I have to deal with. What I also do so I dont forget my meds is I set the alarm on my cell phone since it is with me all the time. That way I have a good reminder to take my meds. My family is also familiar with my alarms and will tell me right away if it goes off and I am not in the room. The alarms have been a life saver and I havent missed a dose since I started.
 
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Joseph F Goldberg, MD replied to 2256ab's response:
Dear Alexander,

A blood test, like a toxicology screen, would not measure or pick up Zyprexa unless someone was specifically looking for it. Usual toxicology screens measure illicit substances (eg, pot, cocaine), benzodiazepines (eg, Klonopin), opiates, stimulants, and maybe aspirin or Tyleon. Anything else of interest would have to be specifically requested by the requester.

Growth from Zyprexa is usually sideways, rather than up-and-down. ....ie, weight gain, and usually it's not lean muscle mass.

Zyprexa should not affect height, or testosterone levels

- Dr. G.
 
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bipolar18cm replied to Joseph F Goldberg, MD's response:
I am on Lamictal and citlopram, sometimes i run out of one or the other first. how long does the citlopram stay in the system?
 
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Joseph F Goldberg, MD replied to bipolar18cm's response:
Citalopram and Lamictal each have a "half life" of about a day and, rule of thumb, medicines reach a steady state (or are eliminated from your system) in five half-lives....so, in the case of citalopram or Lamictal, each is about 5 days.

- Dr. G.
 
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Mellow22 replied to Joseph F Goldberg, MD's response:
How Long Does Risperidone Last In Your System After Taking It For 25 days?
 
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Joseph F Goldberg, MD replied to Mellow22's response:
Dear Mellow22, risperidone lasts about 5 days in the bloodstream after it is stopped, regardless of how long someone has been taking it. Dr. G.
 
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Mellow22 replied to Joseph F Goldberg, MD's response:
Oh okay thank you very much. I have one more question Dr.G. Since i have stopped i still have the small hint of the side effects...how long will such effects last?


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Joseph F. Goldberg, MD, is a Clinical Professor of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY. He also maintains a private prac...More

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