From Anna Nicole Smith to Adam "DJ AM" Goldstein to Heath Ledger to Michael Jackson, Hollywood has seen its fair share of accidental overdoses from prescription drugs. The question is: Does the death of actress Brittany Murphy also fall into that category?
Ever since the 32-year-old was pronounced dead at Cedars-Sinai Medical Center after collapsing at her Hollywood Hills home Sunday morning, rumors have been swirling about what exactly led to her death.
As reported by TMZ.com and confirmed by FoxNews.com, notes obtained from an L.A. Coroner's Office official indicate that large amounts of prescription drugs were found in Murphy's bedroom when paramedics arrived at her home.
Dr. Julie Holland, a clinical assistant professor of psychiatry at NYU School of Medicine in New York City, who also specializes in psychopharmacology, and Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, ran down exactly what these medications are used for — and their potential dangers.
Topamax & Carbamazepine (anti-seizure medications used to treat depression and bipolar disorder; Topamax is also commonly used to treat migraines)
"There are two medicines here that are basically used as mood stabilizers in psychiatry — and that’s the Topamax and the carbamazepine, which is also known as Tegretol," said Holland. "Carbamazepine and Topamax were initially used to treat seizure disorders, specifically epilepsy. But more commonly these days, they’re used to treat depression or bipolar depression.
"One of the nice things for some people about Topamax is that it cuts appetite," she added. "So, Topamax is very popular. I have people call me all the time and ask me if I can put them on Topamax because they heard it’s good for depression but they also heard that they could lose weight taking it. You could sort of think of Topamax as a fancy diet pill for some people."
Scott Chambers, executive producer of one of Murphy's last films, "Something Wicked," told the Los Angeles Times that the actress had appeared frail.
"She looked ill, as much as 10 pounds underweight, and she's a small person to begin with," Chambers told the newspaper. "She easily could have made an excuse not to come to work, but she didn't. She said, 'I've got to get better, but I want to do this part.'"
In January, Murphy was to begin shooting the romantic comedy "Shrinking Charlotte." Writer-director Rene Eram told E! News that Murphy was "impressive" and professional, but looked very thin.
"I noticed that she had dropped a lot of weight in the last six months," he said.
Klonopin & Ativan (anti-anxiety)
Klonopin and Ativan belong to a class of medications called benzodiazepines. Klonopin can be used alone or in combination with other medications to control certain types of seizures. Like Ativan, it is also used to treat anxiety.
Siegel said these drugs should never be taken together.
"I want to highlight that you would never prescribe Klonopin and Ativan together," Siegel said. "You would use one or the other. They are too similar."
Holland also talked about the dangers of these two medications.
"If you took these two sedating anti-anxiety medicines, and another ‘downer’ like alcohol, you can absolutely die."
Vicoprofen & Hydrocodone (narcotic painkillers)
"And then you have the vicoprofen and hydrocodone, which are two opiates, and if you take too much of those, you could stop breathing," Holland said.
TMZ reported that the actress "had been complaining of shortness of breath and severe abdominal pain" for the previous seven to 10 days.
"There is also the issue of how sick she was," Holland added. "We know that she was sick with flu-like symptoms. The question is ... did she have pneumonia on top of it?"
Holland pointed to the death of Heath Ledger.
"The thing with Heath Ledger is that he had pneumonia, and then he took downers," she said. "He took pain meds, sleeping meds, anti-anxiety meds, and then he had pneumonia, and that is the combination that killed him because he was already working on a diminished lung capacity."
Propranolol (treats hypertension, used to prevent heart attacks; can also be used to treat migraines)
"Propanolol has a few different uses," Siegel said. "It’s a beta blocker, so it was used for high blood pressure and heart disease, but these days it’s also used as a performance anxiety drug and for migraines. But you wouldn’t prescribe it with Topamax."
Holland said the problem with propranolol is that it lowers the heart rate.
"So, combining the propranolol with the pain medicines or the anti-anxiety medicines is also very dangerous," she said. "The pain medicines decrease your respiratory drive and the anti-anxiety medicines can also do the same thing."
Remaining Drugs
Other drugs found in Murphy’s home include fluoxetine, which is the generic for the antidepressant/anti-anxiety drug Prozac; the antibiotic Biaxin; and methylprednisolone, which is an anti-inflammatory.
Siegel said methylprednisolone is used to treat asthma and allergies for a short period of time, and it’s unlikely Murphy was taking it chronically.
"It’s quite possible they found it in her house and she used it in the past," Siegel said.
The L.A. County Coroner’s Office said an autopsy had been conducted and officials were awaiting the results of toxicology and tissue testing before determining an official cause of death.
It could take up to six weeks before a determination is made public.
Recipe for Disaster?
Citing the same L.A. Coroner's Office official's notes, TMZ said there were numerous empty prescription medication bottles "in the decedent's husband's name, the decedent's mother's name, and unidentified third party names."
"What that means is that it’s very unlikely that there’s one doctor who is overseeing all these medications," said Holland, who’s also the author of the new book, "Weekends at Bellevue." "There were most likely multiple doctors ... some that are prescribing for the mom, some that are prescribing for the husband. It’s unlikely there was one doctor giving her all these medications."
This is called polypharmacy, which is the administration of excessive medications, and Holland said it’s one of the leading causes of drug overdoses in the country.
"This happens when there are multiple doctors and there is no one overseeing what the patient is doing," she said. "I pretty much guarantee that there were multiple pharmacies and multiple doctors, and that’s really a recipe for disaster."
In the meantime, Holland said there are several lessons to be learned from the recent deaths of celebrities who’ve overdosed on prescription medications.
"Prescription drug abuse is a huge problem in America right now. It’s the new drug epidemic to some extent," she said. "And if you take away anything — it’s the fact that we are living in a culture of dangerous polypharmacy. Too many people are taking too many medications without enough supervision."
FoxNews.com's Jessica Doyle and The Associated Press contributed to this report.
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