Misc Dangers of mixing SSRI's, Diazepam and Modafinil?

[Oxy8_8]

I just started taking modafinil for fatigue/constant day-time sleepiness and also to lose weight.
According to the NHS (to those of you outside the UK, that's the National Health Service - all the nurses, doctors, hospitals etc that treat us -for free) website it says that Modafinil and diazepam may interact with each other (I assume because one is a sedative and the other a stimulant). If that is the only reason then I don't consider it a problem. I take my modafinil every morning and often get moderate anxiety during the early-mid afternoon. When this happens I take either 20mg diazepam (Valium) or 1mg alprazolam (Xanax).

It also advises you shouldn't take Modafinil with SSRIs. This concerns me a little more as I am on 100mg of Sertraline (Zoloft) a day and have been for over 4 years. What interaction could they have? I had Major (mixed depression-anxiety) Depressive Disorder w/ Psychotic Features and the Sertraline is a miracle drug to me that saved my life and astronomically increased my quality of life.

While the Sertraline has helped tremendously with my depression I still suffer from severe anxiety and panic attacks. Hence why I have benzos. I keep a steady supply of Xanax bars, 20mg diazepam tabs and sometimes etizolam or clonazepam (klonopin) for a change. Not a benzo and I'm currently off it, but I occasionally get a stash of Zopiclone for insomnia if it's going cheap.

I plan to start taking ephedrine when I get it next week, so I will be spending my days taking Modafinil, Ephedrine and caffeine for energy, metabolism boost, mood elevation and weight loss. I will also keep large supplies of the aforementioned benzodiazapines due to the anxiety that I am bound to suffer (considering I do anyway).

I know mixing uppers and downers is generally considered a big no-no and has led to numerous celebrity deaths, but I'm an addict.

I'm anorexic and plan to take Modafinil and ephedrine first thing in the morning and again at noon (as recommended) and take valium or xanax as needed and to sleep at night if I still feel wired.

Oh and to add to the list I have tripple-threat chronic pain: acute pancreatitis, two collapsed discs in my spine, and rheumatoid arthritis (pancreatitis is infamous for being more painful than childbirth but the rheumatoid is possibly worse due to being totally crippling at times) so I take 40mg methadone daily too, for pain, as well as up to 200mg oxycodone and 300mg zomorph.

Oh and I recently discovered the TV series "House M.D" so I often spend my days - after my pharmacy/doctor/methadone clinic/pain clinic visits - inhaling computer duster and insufflating OC20s or popping vicodan or oxy while watching "House".

Sorry, I didn't mean to give you my life story.

I'm just a little overwhelmed. The inhalants are a recent thing that I could stop if I wanted, it's just kinda loopy and passes the time quicker and I have been on opiates and benzos for years. As well as the SSRI.

I'm just totally not used to any uppers of any kind whatsoever so looking to see if anyone (although I seriously doubt it) is or has been in the same or a similar position.

Sorry if you guys feel a lot of that information was unnecessary, just I've often used caffeine to give me energy and suppress my appetite and what I was really worried about and wanted first hand help on was adding Modafinil and/or ephedrine to my daily intake, or about beginning on them at all. I also plan to try a little amphetamine (speed). See what is the most effective of the three.

I doubt I will get any replies to this fucked up essay but thank you very much to anyone who actually took the time to read it and I greatly appreciate the patience and kindness of those - if there are any "those" - who reply.

 

[Raze]

Bad idea! Your tolerance to modafinil will rise quickly, as well as with the diazepam. Benzo withdrawals are horrendous, you do NOT want to take them on a regular basis, as good as they are for anxiety. I recommend pregabalin for that- you can get a prescription from your doctor.. Took me a while as they love to chuck mind numbing ssris and snris at you.
Are you seeing anyone for your eating disorder and abuse problems? I know it's hard, it took me 5 years to seek help, but you should.
I used to take modafinil to override the benzo sleepiness so I could work, but that stuff isn't good to take everyday! The effects wear off quickly. I'm anorexic too.. I understand, but please you're getting yourself into even more shit by taking these substances.
Taking this will completely exhaust your body, it did with mine. It left me shaking uncontrollably, insane insomnia and really didnt help with the depression. Now I've got more health issues and problems with my heart. It won't help you, it will destroy you. Please stop and get help! X

 

[Oxy8_8]

Bad idea! Your tolerance to modafinil will rise quickly, as well as with the diazepam. Benzo withdrawals are horrendous, you do NOT want to take them on a regular basis, as good as they are for anxiety. I recommend pregabalin for that- you can get a prescription from your doctor.. Took me a while as they love to chuck mind numbing ssris and snris at you.
Are you seeing anyone for your eating disorder and abuse problems? I know it's hard, it took me 5 years to seek help, but you should.
I used to take modafinil to override the benzo sleepiness so I could work, but that stuff isn't good to take everyday! The effects wear off quickly. I'm anorexic too.. I understand, but please you're getting yourself into even more shit by taking these substances.
Taking this will completely exhaust your body, it did with mine. It left me shaking uncontrollably, insane insomnia and really didnt help with the depression. Now I've got more health issues and problems with my heart. It won't help you, it will destroy you. Please stop and get help! X

Would replacing Modafinil with Ephedrine help?

 

[Iseeviolets]

Make that leap. Try detoxing.

 

[sekio]

Stop inhaling computer duster before you kill yourself. Seriously. It's not meant to be inhaled and is really toxic - deprives your brain of oxygen but can also stop your heart from conducting electricity properly. It is by far one of the most harmful drugs, even wanton opioid abuse is probably safer...

Taking modafinil, ephedrine, and caffeine together, plus not eating properly, is a great way to collapse from exhaustion and get seriously fucked up from malnutrition and overexertion. If you're going to use one, stick to caffeine or modafinil. Ephedrine is far more side-effects prone (elevates blood pressure and heart rate) than either modafinil or caffeine.

Don't start taking benzos to offset the "side effects" of stimulant usage. Reduce your stimulant dose, or, y'know, eat properly and get some solid non medicated sleep once in a while. Especially on stimulants, low blood sugar can cause irritability and anxiety. Just don't get onto the wonderful benzo plus stimulant addiction train - it's a real fun time trying to get off again.

If you find yourself needing to medicate for anxiety on a regular basis, try determining what the cause of it is, rather than trying to mask it. The anti-anxiety effects will eventually wear off one day.

Also - you didn't say - what's your modafinil dose?

 

[Sparrowbee]

Sup! Newbie here, thought it might be preferable to revive this thread than to start a new one, as my question is basically the same but this thread doesn't entirely answer it?
Also, I've noticed a lot of people asking for themselves, whereas I prefer to ask on behalf of my pet ferret. I hope you understand, it's just that he doesn't care as much about his career so he tends to use drugs whereas I don't cause I'm an angel *heavenly chorus*

So ferret takes 100mg modafinil and 50mg (hopefully rising soon to 100mg) of sertraline at 8am. Then 0.25mg xanax around 5pm and another 0.25mg around 9pm. Safe?

Bit of backstory: undiagnosed adhd and borderline personality disorder for years leading to severe depression and anxiety. Cause he's a smart little ferret he made it as far as uni, but then it all got too much and his world fell away and he had to drop out. Now he's back, and is happy to trade up something as minor as a stomach ulcer for a forst class degree if that's all it is. He ain't too keen on dying though, or becoming an addicted and addled psychotic mess.

The sertraline is the only thing prescribed. Were he in the prescription happy US the modafinil and xanex might also be prescribed as doctors recognise his severe anxiety and such and he's getting soe counselling, but unfortunately where he is he had to fight just to get an SSRI other than citalopram. Because of all the undiagnosed issues going on in his head up until now, he developed a severe cannabis habit that basically bankrupted him, used all his student loan and made him really friendly with cash converters (ever heard of people selling their shit for weed? Heroin maybe but weed? bahahahaha silly ferret). After smoking a 20 spot daily for 5 years he said 'no more! I must have money for nice things!' and is cutting down drastically/ going without now.

Sertraline is necessary to get out of bed in the morning. Modafinil is necessary to just maintain a line of thought (if you've got adhd you'll know what I mean), one day the ferret will be able to convince a doctor that but not today, but those two together and he hasn't had a ridiculous library fine or a forgotten assignment all term!

Really what he's nervous about is the downers. Preferably he'd just start smoking at 5pm and have finished up a 50spot by bedtime and would do that every day and also lay in a hammock in the sun, but this is not life. He first popped xanax the other day, wasn't in a very good place and took 2mg (scoundrel) and another 2mg the next day, lost 4 days, slept through an alarm clock which is basically a rave in his room and which woke up everyone else but him, etc etc XD then had horrible withdrawal effects. So ferret is now well aware of being careful with xanax.

But yes, the modafinil does have the unfortunate side effect of increasing anxiety during the day. For ferret and for many others, it's a double edged blade. He'll get anxiety from being on uppers, but if he didn't take them he'd forget everything in life and have anxiety from that. But, as stated, the modafinil is a must. So, last night, ferret thought 'maybe I'll try using xanax reasonably'. He took 0.25mg at 5pm, which settled the post work 'aaah I need to do more work but I'm on edge and just want to get higghhhh' anxieties nicely. A lovely evening of being productive but at a steady pace followed with minimal cravings for cigarettes and spliffs. Then 0.25mg at bedtime, and he has just woken up for his early alarm feeling GREEAAAATT. Ahhh, he's having breakfast for a change, totes gonna bike to campus rather than get the bus even though its rainy, just to get some natural light. The xanax must still be in his system a little because where is all the morning anxiety and throwing up? He's been up for an hour and a half and only had one cigarette! This is too good, it has to be bad for him somehow, right?

Unlike cannabis, the xanax won't bankrupt him. Unlike cannabis, the xanax actually allowed him to work quite comfortably. Unlike cannabis, the xanax made him go to bed early feeling quite happy and looking forward to getting snuggly and comfortable rather than what he does when smoking which is just smoke and smoke and smoke until he's comatose and passes out. This smoking habit was developed partly due to insomnia, and partly due to anxiety about having insomnia ("I have to make damn sure I'm totally conked cause if I try to sleep before I'm ready it'll just be worse" kinda thoughts). The xanax totally reduced the anxiety about the insomnia, it's hard to tell but this may have been the more effective part.

Unlike cannabis, xanax is an unfamiliar and less safe feeling drug and probably doesn't have magical wonderful healing properties blah blah (we all know weed is safer)

Soooo... he wants to do this every god damned day. At the weekends he generally only takes sertaline to give his body a little break from all that crap, so he'll probably stay off it at the weekends and just have a smoke. He doesn't drink bar the odd cheeky pint at a late meeting (rare) so not worried about mixing with that, if he's socialising he's getting stoned.

So SO MANY questions. They are as follows:

What are the dangers of mixing these drugs? He's aware of serotonin syndrome, and also of the need to eat well, stay hydrated and keep his stomach lined.

What are the tolerance dangers? This won't be a cheaper way of staying medicated if he ends up on 20mg xanax a day in 5 years time.

More tolerance stuff: With the modafinil it seems that regular use actually decreases the anxiety. Afternoon anxiety is worse on the Monday, by Friday modafinil use feels settled. Is detoxing maybe the wrong thing to do, should he be adjusting to modafinil instead like an SSRI? After all, many people are prescribed it every day. Is a weekend detox long enough to get rid of xanax?

Thanks so much if you can answer these questions. Ferret just wants to get a good degree with minimal stomach ulcers. He's physically healthy though, and there does come a point where mental health becomes a priority over physical health. It's no good being an olympian only to off yourself because you cant hold down a job. Please drop me a line though cause I've asked elsewhere to no avail.

Sidenote: I know this post is very old now but ferret's been where OP has been. Many people with adhd develop anorexia, it's a control thing. It seems ferret has similar self medication needs also. If you fancy dropping him a line, he's here to listen.

xx

 

[Hodor]

What are the dangers of mixing these drugs? He's aware of serotonin syndrome, and also of the need to eat well, stay hydrated and keep his stomach lined.

Therapeutic doses of Sertraline, Modafinil and Alprazolam should not produce any harmful interactions.

What are the tolerance dangers? This won't be a cheaper way of staying medicated if he ends up on 20mg xanax a day in 5 years time.

That is a very astute observation. Unless you want to experience runaway tolerance buildup, you'll probably want to keep your Xanax dose at 1 mg or less per day.

More tolerance stuff: With the modafinil it seems that regular use actually decreases the anxiety. Afternoon anxiety is worse on the Monday, by Friday modafinil use feels settled. Is detoxing maybe the wrong thing to do, should he be adjusting to modafinil instead like an SSRI? After all, many people are prescribed it every day. Is a weekend detox long enough to get rid of xanax?

Detox to get rid of Xanax? Do you mean drug holidays, i.e. days where you're not taking your drugs to slow down tolerance buildup?
That is, in general, not a bad idea with Modafinil or Xanax (unless you're taking enough Xanax to the point where going cold turkey would mean risking a seizure).... but no, a weekend is nowhere near enough to return your tolerance to baseline. Yes, Xanax has a pretty short half-life so most of it will be eliminated after 48 hours, but the "damage" to your receptors has already been done.

 

[Sparrowbee]

Thanks for such an informative reply,

Yeah, I meant drug holidays! He didn't really consider doing it as a method of returning tolerance to baseline, more as just a gut reaction to not enjoying taking so many pills, just a sort of body cleanse thing. But that's good news, he'll definitely keep it to less than 1mg. He's on 0.5 atm and that seems to be doing the trick. So roughly how long would you recommend for a total return to baseline, like a few weeks? And do you think the withdrawal effects will be awful from just 0.5 a day? I've found other threads on this but they all seem to be about abusing large amounts rather than cutting a pill up in to tiny bits which is what he does every day. He ought to do a lot more homework on it really, he's done a lot of homework on the other drugs he takes but has just sorta dived in to this xanax thing and just wanted to make sure he wasn't going to drop dead in the immediate future.

Thankyou!!

 

[ragsy]

no wow perfect answers for me cuz i plan on waking with modadfinil then coming down later with alprazolam aka zanax or mexazolam,,,thanks!!

ragsy de medellin colombia