Medication not working as well after an accident?

[ScottyMet]

Has anyone been involved in a car accident, only to find that your medication didn't work quite as well as it did before?

The details: A couple of weeks ago, I was involved in a car accident. It was nothing to do with my ADD, btw. I was obeying the traffic rules, paying attention to everything going on around me, I even saw the vehicle that ran the light and hit us, I just didn't have time to react before they hit us.

My wife was in the passenger seat, which is the side they hit us on. She was pretty banged up, and still is now. I wasn't as badly hurt, but still am in some pain, mostly due to the seatbelt bruising my ribs, some deep tissue bruises on my right calf, and my left knee being a bit messed up. We both suffered a concussion too. We're both generally okay now, just stressed out by the insurance company taking its time ruling fault (the other drive claims he had the green light, so the police couldn't assign fault). Our poor '04 Mini Cooper, Murray, was totaled. We replaced him with an '08 VW Rabbit on Wednesday.

Back to the medication part, though... I really need to pay more attention to my focus levels, but it seems like I'm forgetting things like I did before being diagnosed, and getting things done seems to be difficult again. I read something about how post-concussion syndrome can mimic ADD symptoms.

As it is, I have pain, pain medication (mostly tylenol, but also vicodin overnight), stress, and possibly a bit of post-concussion syndrome, although my concussion wasn't bad, and I figure I'd be over it by now.

[trishcan]

I found my medication didn't work well after a back injury, and I attributed it to having taken pain medication for a little over a week. It took about a week after stopping the painkillers to get back on track. after that, the same medication worked just as well at the same dosage. i don't know if there's any merit to what I'm telling you, since it was just my personal experience, but I wasn't able to think of anything else in my life that would have caused a decrease in the medication's effectiveness.

But definitely, if you think you may have more going on neurologically because of the accident, I wouldn't want to deter you from seeking medical advice by telling you it's all okay. I can't make that call, but I hope you're feeling much better soon.

[ADHDTigger]

It is not uncommon for your ADHD meds to not work as effectively in the face of other new (temporary) medications. I have had a similar experience to what Trish describes while on Vicodin. I finally had to quit the Vicodin because I needed the Adderall to work.

If you haven't seen your doc since the accident, I strongly recommend that you do so. Both you and your wife need to follow up with your regular MD. The ER really only wraps you in bailing wire and duct tape. They don't know you and don't know your history. You really need to follow up with your regular M.D.

The fact that you have ADHD and had a concussion makes that even more important. While I grant that a scrambled egg is gonna be scrambled whether you beat it for one minute or two, you want to make sure that your cognitive function returns to your normal.

[Covenant]

Hmhm agree with this. Accident that involves your brain might make you more 'clutched' than normal. And if the symptoms are the result of your brain being hurled around, then the ADD med's usually won't work, because the underlying symptoms might not be caused by something that is solved with ADD meds. Logically

Also you mentioned getting pain meds. Problem is that a lot of medications influence the workings of other medications. This can be because they act on the same tissues and thus can enhance or inhibit each others function (although that doesn't have to happen) and it can also be because the medication influences the way your liver processes drugs. The liver basically functions as a huge cleaning machine. It processes all sorts of (foreign) substances including medication with the P450 cytochrome enzyme family. These modify the drug a bit so that it can be modified further and eventually the drugs, some modified, some not, can be excreted in the intestine through bile acid secretion, or eliminated through the kidneys in the urine. Problem is that a lot of drugs influence the expression of the P450 enzyme family so that they either provoke more or less of these enzymes to be made in the liver cells. And since al lot of drugs are processed by these enzymes, drugs can alter the rate and amount of themselves and other types drugs that are being metabolized by the liver.

[ScottyMet]

Thanks for the replies, and for the info Covenant.

We have tried to follow up with our regular doctor, however they will require us to pay out of pocket for the visit, since our regular insurance won't cover anything having to do with the car accident. It has to go through our car insurance first, and the car insurance can never 100% guarantee that the bill will be paid (since it's a static amount of coverage with them, and some has already been used up by the hospital, but we're not quite sure yet how much), so, without a lot of cash in the bank, we're sort of stuck. Sure, we'd be given the insurance forms by the doctor to fill out and send the claim to our car insurance, but we just can't afford to throw a couple of hundred dollars at the doctor for each of us right now. With having to replace our car, we're only barely going to cover rent, food and utlities this month.