Hi! Is anybody here on amphetamines + ssri or snri for depression? I have depression and adhd. Ritalin doesn't work for me. I wanted to try adderall but I don't know if this would be safe. I'm currently trying out Cymbalta 60mg. I found a lot of warnings online which say that amphetamines + serotonergic antidepressants are not safe. This sucks. http://www.drugs.com/drug-interactions/amphetamine-with-cymbalta-2543-0-949-2273.html
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OD Moderators: Keif’ Richards | negrogesic
Stimulants Serotonin syndrome risk from amphetamines + ssri/snri
- Thread starter sacsky
- Start date
pinpoint
Bluelighter
Amphetamine does not affect serotonin in a way that would lead to SS even if used in conjunction with SSRI's. SS is seriously overblown on these forums (and others, too) - it's definitely a serious condition but it is not as common as the internet would have you believe.
Wouldn't your doctor advise you of this risk anyways?
Wouldn't your doctor advise you of this risk anyways?
But there are medical reports about people getting SS from amphetamines + ssri/snri at pubmed. This means that this stuff is real! For me this is a huge issue cause I have anxiety. With this in mind I don't think I'd even dare to try adderall now and I'm sure that my doc also will not prescribe it if he reads those warnings. Also, if there was no real risk then why do all medical interaction sites which I checked discouraged amphetamine use with ssri?
sekio
Bluelight Crew
There are also reports of people having all their skin fall off and having multiple organ failure after taking drugs like Tylenol, but that doesn't mean it's a common occurrence.
Amphetamine itself or amphetamine plus SSRI doesn't cause serotonin syndrome unless you have reckless doses of one or the other. It's also a risk if you take amphetamine analogues that release serotonin (methamphetamine, MDxx, cathinones, 4-Methylamphetamine, etc)
SNRIs and amphetamine are more of a concern because amphetamine works by releasing norepinephrine, so there's a corresponding risk of hypertension ("norepinephrine syndrome") if dosages get fucked up or if amphetamine inhibits metabolism of your SNRI. (Being in a SNRI will also make Ritalin next to useless because it too is a norepinephrine transport blocker - e.g. a NRI - so the SNRI will probably override its effects, assuming the SNRI has a higher affinity.)
Amphetamine is contraindicated with SSRI therapy because it can be easily abused by someone looking for a mood lift, not to mention it can worsen depressive symptoms ("the crash") after the drug wears off. Regular use of amphetamine, especially the extended release stuff, can also reduce sleep quality because not all the drug is excreted by the time you go to bed. But there's no reason you can't take reasonable doses of amphetamine with a SSRI under your doctor's supervision.
Hi, is the norepinephrine syndrome as dangerous as the serotonin syndrome?
The problem is that I recently started with cymbalta and I hope that this one will work.
I started with 30mg and directly on the first day I imagined that I felt different.
I don't think it's placebo cause I am very sceptical of antidepressants now since so many failed.
The next few days I also felt more "up to it". But now on day 7 I felt pretty crappy again.
If cymbalta also shouldn't work then there wouldn't be much left except maoi and I'm scared of maoi.
I also tried anafranil but I couldn't tolerate the anticholinergic side effects.
I was on 20mg Lexapro for a few months and it didn't do anything.
I believe now that a pure SSRI isn't the right thing for me. Going back to a SSRI only in order to be able to take an amphetamine with it might not be worth it.
So this means that since I'm on a SNRI ritalin has no effect at all? That would suck. I thought that ritalin would still have an effect on dopamine.
The problem is that I recently started with cymbalta and I hope that this one will work.
I started with 30mg and directly on the first day I imagined that I felt different.
I don't think it's placebo cause I am very sceptical of antidepressants now since so many failed.
The next few days I also felt more "up to it". But now on day 7 I felt pretty crappy again.
If cymbalta also shouldn't work then there wouldn't be much left except maoi and I'm scared of maoi.
I also tried anafranil but I couldn't tolerate the anticholinergic side effects.
I was on 20mg Lexapro for a few months and it didn't do anything.
I believe now that a pure SSRI isn't the right thing for me. Going back to a SSRI only in order to be able to take an amphetamine with it might not be worth it.
So this means that since I'm on a SNRI ritalin has no effect at all? That would suck. I thought that ritalin would still have an effect on dopamine.
Lucy Bookit
Bluelighter
I take an SNRI (effexor) and have recently been put on adderall. My doctor is extremely thorough and never mentioned a concern about serotonin syndrome. I think that adderall should work, and I doubt it will cause serotonin syndrome. I think that you may be overblowing the possibility of it.
How much Effexor and Adderall do you take? And does the adderall work for you?
Since my doc isn't really experienced with amphetamines I highly doubt that he would even be willing to prescribe it and I don't know if I'd even dare to take
it with my anxiety.
Since my doc isn't really experienced with amphetamines I highly doubt that he would even be willing to prescribe it and I don't know if I'd even dare to take
it with my anxiety.
Modafinil is different than amphetamines I think there's no risk.
Does moda also improve mood? I needed something which I can use as an add on to my antidepressant to get an extra "boost".
Ritalin doesn't improve my mood. If I cannot take amphetamines then there's nothing left.
Does moda also improve mood? I needed something which I can use as an add on to my antidepressant to get an extra "boost".
Ritalin doesn't improve my mood. If I cannot take amphetamines then there's nothing left.
pinpoint
Bluelighter
Modafinil is more of a wakefulness-promoting drug rather than a CNS stimulant. I believe it is thought to work through hypocretin (orexin) rather than dopamine/NE. I never noticed any mood effects from my short trial with Modafinil. Some people just don't respond at all to it - I was one of them.
Depending on how much sedation I am trying to overcome I take between 200mg-400mg to have me function effectively for a entire business day at work. I would highly recommend as I did when starting out with a low dose, even cutting a 100mg tablet in half and dosing up slowly. As you can have quite a manic effect starting out if you are like me.
The whole "Serotonin Syndrome" basis can be completely overblown,
I've been on 20-60mg of Vyvanse for about 3 years, daily + I was on 10-40mg of Prozac (with that consistently as well), and now I'm on 10mg of Luvox for OCD.
From what I can tell: Serotonin Syndrome is very uncommon unless you binge on stimulants, abuse SSRI's (not sure why you would because they have no recreational value), or you are on an extraordinary large dose of the SSRI.
But if you want to just be extra safe try taking the antidepressant before you go to bed, and then your prescribed amphetamine in the morning.
@ sirfoxey
Does moda only make you more awake or does it also make you smarter or lift your mood? I don't need something to be more awake I need something which you can take as a booster when you're depressed.
@ literacy
I'm not sure how long cymbalta is in the system. I'd have to look it up.
I also wonder could I not simply ask my doc to prescribe me an emergency drug which I take in case I get serotonin syndrome symptoms?
Wouldn't it make sense to have something like this at home? But I doubt that doctors would want to prescribe something like this.
Does moda only make you more awake or does it also make you smarter or lift your mood? I don't need something to be more awake I need something which you can take as a booster when you're depressed.
@ literacy
I'm not sure how long cymbalta is in the system. I'd have to look it up.
I also wonder could I not simply ask my doc to prescribe me an emergency drug which I take in case I get serotonin syndrome symptoms?
Wouldn't it make sense to have something like this at home? But I doubt that doctors would want to prescribe something like this.
There is no mood lift in it from my understanding from a technical/medical drug point of view. There is a lift for me in such as I am not a couch potato sedated out of my brain from the cocktail of drugs I am on. I am able to get up and function in life, and in doing so there is a mood lift for me as I am able to get on with life and thus feel much better.
No my insurance doesn't cover it so I have to pay the full price. I have spoken with my pharmacist and worked out a deal to get it cheaper though. He gives me a significant discount on it, for me agreeing to have all my other medication scripts filled at his store. Given I am on quite a few medications for my depression it is a win/win as I don't pay anymore for the other medications than i would having them filled elsewhere.
That's good.
Do your antidepressants work for you? May I ask what you're taking?
I haven't yet found anything which works. I'm really discouraged. I feel like these drugs are totally useless.
I have been on pretty much all new drugs out there. Lexapro,Wellbutrin,Valdoxan,Tianeptine,Remeron,Ritalin,Memantine. Currently I'm on cymbalta. The first day
when I started I felt better. I thought maybe this is it. But now after 7 days I feel pretty much the same again. I increased to 60mg today, didn't really feel any difference.
Nothing works for me neither against anxiety nor depression nor ocd!
I mean if an antidepressant works then shouldn't you really be able to tell that it works? If it's so weak that you cannot really tell if there is a slight
improvement then what's it good for?
I needed something to keep me stable and keeps me from diving into depression on bad days. If these drugs can only reduce depression a bit then they're
not good at all.
Do your antidepressants work for you? May I ask what you're taking?
I haven't yet found anything which works. I'm really discouraged. I feel like these drugs are totally useless.
I have been on pretty much all new drugs out there. Lexapro,Wellbutrin,Valdoxan,Tianeptine,Remeron,Ritalin,Memantine. Currently I'm on cymbalta. The first day
when I started I felt better. I thought maybe this is it. But now after 7 days I feel pretty much the same again. I increased to 60mg today, didn't really feel any difference.
Nothing works for me neither against anxiety nor depression nor ocd!
I mean if an antidepressant works then shouldn't you really be able to tell that it works? If it's so weak that you cannot really tell if there is a slight
improvement then what's it good for?
I needed something to keep me stable and keeps me from diving into depression on bad days. If these drugs can only reduce depression a bit then they're
not good at all.