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Accidental Overdose Killed Heath Ledger

Medical Examiner's Report Finds Actor Took Fatal Combination of 6 Medications
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More About the Cocktail

It's not known how Ledger came into possession of the medications.

"A competent doctor would not prescribe three benzodiazepine drugs [in Ledger's case, the Valium, Xanax and Restoril], because all benzodiazepines have the same effect," she says -- the central nervous system depressant effect.

But, Gomez emphasized, it's likely that a doctor did not prescribe them all at once.

A doctor may have prescribed one of the benzodiazepine drugs and then switched Ledger to another when the first didn't work as well as anticipated, Gomez says. But the actor may still have had supplies of the first drug. Or the prescriptions may have been obtained from different physicians.

Protocol Before Prescribing

Before prescribing drugs like those given to Ledger, Gomez says, a doctor should take a careful history, inquiring about any past drug abuse.

If a young man came to her with symptoms of anxiety and insomnia, she says, she would also try to determine how severe the anxiety and insomnia was and to get to the root of the problems. "Anxiety and insomnia are symptoms." It's crucial, she says, for a doctor to explore the reasons behind the symptoms.

She would also take into consideration other medications a patient is on before prescribing more. For instance, she says, "If someone was on painkillers already, I would monitor him more closely if I put him on Valium."

Caveats for Consumers

"People feel these medications are harmless," she says. "They are very good medications for the indications." But if they are mixed inappropriately, or not monitored, they can clearly be hazardous. "It's not even abuse, it is misuse."

The best advice? "Do not take medication that is not prescribed," Gomez says. "Do not make changes in your medication regime until you check with your doctor."

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