[splitimage]

Hi everyone,

I have a bit of a dilema. I have a friend who confides everything to me, so she's told me what dosages her pdoc has increased her meds to and some of the side effects she's having.

He's got her on 20 mg of clonazapam (Klonopin) daily, and 1000 mg of Seroquel daily, plus Cipralex and some other stuff. I think this is irresponsible prescribing. Anyway it's affecting her memory - she's started to forget conversations that we've had, and she's commented on how much clumsier she is.

I don't think she should be driving. I know that when I was on 5 mg of clonazapam it affected my ability to drive (I'm now tapering off it) and I wouldn't go near a car after taking my Seroquel & I'm only taking 25 mg up to twice a day.

Up here in Ontario, Dr's have an obligation to report patients who shouldn't be driving to the Ministry of Transportation, but it really varies from Dr. to Dr. how strictly they follow that guideline, and both her Dr's are pretty lax.

I'm tempted to call the police and report her myself except I know that would screw up our friendship, and I know she'd be devastated to lose her licence. But I really think she shouldn't be driving.

So what do you guys think? Would you report a friend?

splitimage

[Pandoren]

That's difficult, especially since she could kill herself or someone else driving. Have you had an in depth conversation with her about this? Discussed alternative methods of transport? Maybe if she knew beforehand that you were so concerned about her own safety and the safety of others that you were considering this if she doesn't stop driving, she wouldn't see it as a complete backstab if you followed through?

[Perna]

Yes, I would discuss it with her. I don't know her complete story though, how often she drives, for what purpose, etc. How you are affected by meds is not necessarily how she is affected and memory problems don't necessarily have anything to do with driving ability. I would leave it to her doctor and the police unless you are there with her and have driven with her and seen that she is affected. There are warnings on the meds to be careful (not to not drive at all but to be wary of how the meds affect you) and one can't know if she waits before driving (or takes her meds after driving when she'll be somewhere a longer period of time) or only drives small distances some of the time and other people drive her other times, etc.

If I were worried, I would not ride with a driver who I was worried about but I wouldn't try to decide her competency for other people/her doctor, only my own.

[tinyrabbit]

I would talk to her, but I'd leave informing the police as a last-ditch option - I don't know how it works there but, in the UK, it's much harder to get your license back if it's taken away from you rather than you voluntarily surrendering it.

You are a good, caring friend. Perhaps you can invite her to lunch or coffee or simply go over to her home and in private discuss your concerns. She may not be happy about it and she may (or may not) fight it but at least you know you have expressed your love, concern and care.

You can even leave her a card with your feelings at the conclusion of your conversation so she remembers the discussion and that you care.

After that, it is up to her to do what she feels is best for her and her well being. Along with the others that are around her that are affected.

If her doctors are lax about Rx I should think they wouldnt take very kindly to a stranger calling sharing concerns. It might actually open a whole can of worms and be harmful for your friend in terms of future care.

As a last resort, if you were to witness her, clearly impaired and still insisting on driving, or actually driving, despite your pleas and offers to help, to spare others lives, you may have to call law enforcement. But I feel strongly only as a last resort. Would you calk the cops if you were driving around someone that was impaired anyway?

Regardless, you are coming from a good place. It may also help to ask yourself what would happen if the roles were reversed?

[amandalouise]

Originally Posted by splitimage

Hi everyone,

I have a bit of a dilema. I have a friend who confides everything to me, so she's told me what dosages her pdoc has increased her meds to and some of the side effects she's having.

He's got her on 20 mg of clonazapam (Klonopin) daily, and 1000 mg of Seroquel daily, plus Cipralex and some other stuff. I think this is irresponsible prescribing. Anyway it's affecting her memory - she's started to forget conversations that we've had, and she's commented on how much clumsier she is.

I don't think she should be driving. I know that when I was on 5 mg of clonazapam it affected my ability to drive (I'm now tapering off it) and I wouldn't go near a car after taking my Seroquel & I'm only taking 25 mg up to twice a day.

Up here in Ontario, Dr's have an obligation to report patients who shouldn't be driving to the Ministry of Transportation, but it really varies from Dr. to Dr. how strictly they follow that guideline, and both her Dr's are pretty lax.

I'm tempted to call the police and report her myself except I know that would screw up our friendship, and I know she'd be devastated to lose her licence. But I really think she shouldn't be driving.

So what do you guys think? Would you report a friend?

splitimage

no I would not report a friend just because....I ...dont think a person shoulldnt be driving doesnt mean that person really is not able to drive safely. and just because medications affect me one way doesnt mean a person on that same medication whether its higher dosage then me or lower dosage than me is going to be affected the same way..

example look at how many people here at psych central are on the same meds and varied dosages...the way the same meds affects a person is different.

I have a friend who is on the same meds I am on. I get dizzy she doesnt. she gets ringing in her ears I dont, I get cotton mouth she gets too much saliva in her mouth....shes clumbsy, Im not, she forgets where she puts things but she drives very well...never speeds, never misses a light, never turns the wrong way, follows all the driving rules.

just because someone has a problem with forgetfulness, and clumbsiness and is on a higher dosage of meds then I am doesnt say they cant drive a vehicle....there are many people with cerebral palsy, Parkinson's, MS, DID, depression, heart disease, epilepsy, and other medical and mental health issues that cause a person to be clumbsy and forgetful that are still very capable of driving according to the american Department of Motor Vehicles here in america.

the line in the sand is that here in america it isnt me that decides who can and who cant drive based on things like forgetfulness, and being clumbsy. If this was my friend I would politely suggest she contact her doctor and then let her and her doctor make the decision of whether she should drive or not. here in america we dont stop someone from driving just because a person is forgetful and clumbsy. if we did that there probably would not be any one out there driving a vehicle because everyone has times when they have been forgetful and clumbsy because of their medications, health issues, aging, mental issues, and other completely normal issues.

[hamster-bamster]

Originally Posted by splitimage

1000 mg of Seroquel daily, plus Cipralex and some other stuff.

I think this is irresponsible prescribing. Anyway it's affecting her memory - she's started to forget conversations that we've had, and she's commented on how much clumsier she is.

I don't think she should be driving. I know that when I was on 5 mg of clonazapam it affected my ability to drive (I'm now tapering off it) and I wouldn't go near a car after taking my Seroquel & I'm only taking 25 mg up to twice a day.

If you think that it is irresponsible prescribing, your recourse should be to go after the prescriber's license to practice medicine and not your friend's driver's license.

The consequences of losing a license are catastrophic in places where public transit is subpar.

I lost the license in 2009 because my then husband first decided that he would be driving me himself after my suicide attempt, then changed his mind due to our internal dynamics, and then told my GP that he would not be driving me (nobody asked him to drive me or to talk to my GP).

All the while, I was driving just fine on 900 mg of Seroquel (almost as much as your friend takes), without any issues (I have never had any issues with driving, on meds or off meds).

The GP, a young woman, was trigger-happy and reported me to the DMV. I later shamed her for that and she quickly filled out an MD evaluation form and sent it to the DMV, saying that I was OK.

Well, they believed her for the purposes of revoking my license but not for the purposes of giving me my license back - for that, they needed the form filled out by a p-doc. Eventually I recovered the license and I have a perfect driving record with no points.

A couple of take-aways for you:

- one can drive fine on 1000 mg Seroquel, because her reaction to taking 1000 mg Seroquel and my reaction to taking 900 mg Seroquel are independent of your reaction to taking 50 mg Seroquel, as noted above by amandalouise and Perna.

- you would not be able to undo the damage if you report and the agency listens to you.

Nor is her recall of the conversations between the two of you related to her driving skills, as noted above by Perna.

And her self-reported clumsiness has very little to do with her driving ability, because she is driving a car and not riding a unicycle, and you do not need to be an acrobat to drive a car. Clumsiness has to be really severe to stop one from driving a car, especially an automatic transmission.

Now, you are in Ontario, right? You are not in Copenhagen and not in Amsterdam, so you should realize that public transit would be lacking for your friend if you report her. And you do realize it - you said that " I know she'd be devastated to lose her license".

So you are making wild errors in judgment by believing that her reaction to her medications matches your reaction to same medications, by believing that one needs to be super nimble to drive a car, etc., and with those wild errors in judgment you want to do something that would devastate your friend? Are you in your sound mind?

You are of course entitled to believing what you believe, but the proper course of action for you in that case is to find out who her prescriber is and to write him or her a letter.

I do agree with you that 1000 mg of Seroquel is a very high dose, and "20 mg of clonazapam (Klonopin) daily" is a HUGE dose, but still it does not justify you in taking a step that could very well lead to devastating consequences.

Unless, of course, you can first agree to drive your friend anywhere she needs to be driven 24/7 on a 30-min notice for her lifetime. Are you willing and able to do that? And if you are able and willing to do that, have you thought of what would happen if she were to survive you upon your death?

More on undoing the damage. You would not be able to reverse the impact of your report. If you change your mind, if you come to the realization that her reaction to 1000 mg of Seroquel is independent of your reaction to 50 mg of Seroquel AFTER you have reported her, you would not be able to undo the damage. If you find yourself in this dilemma in which you are tempted to do damage that you would not have power to undo, you really should take more peaceful steps first. You say that she has two doctors who are both lax and that she confides in you. If she confides in you, obtaining the names of her doctors should not be difficult for you. Once you have their names, you will be able to write to them or to write to the licensing boards complaining about them, saying that they are irresponsible. I do not know if the licensing boards in Ontario consider complaints from non-patient third parties, but it would be worth looking into. After all, it would make sense of them to consider such complaints, since your caring about the prescribing standards of the licensees is in the public interest...

[nicoleb2]

If you see her driving impaired, certainly report her. It isn't just her life she's taking into her hands, it's everyone else's too. Whether that affects her having a license or not, if you see her impaired, she should be reported.

Based on memory loss and med doses though, that alone isn't a determining factor.

[-jimi-]

Had a friend on tons of meds. So I asked that she took a reaction speed test online and she did. I had noticed her reaction speed overall was kind of slow, but th test really set that straight. She had such extended reaction speed the test thought she had forgotten to click the mouse...

She kept driving, she said she drove slowly so it was safe. Then she crashed her car but of course it wasn't her fault even if the cops said it was. After a while her husband forbade her to drive because they couldn't afford more fender benders. No one seemed to care about human lives. Sigh.

[Maven]

I believe you should talk with her, discuss how you're feeling. Ask if she would be willing to talk to her doctor to make sure she's safe to be driving. If it came down to it, I'd say yes, you should report her if you know she's not driving safely. Just like with a drunk driver.

[hamster-bamster]

OP,

the responses may be summarized as following:

1) there are more or less objective tests that have more relevance to whether your friend can drive than your reaction to Seroquel is. Speed of reactions tests, your watching her drive, and others have been mentioned.

2) you at least owe your friend a conversation before you act