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SSRI therapy in conjunction with Dexedrine

K

Kudos

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May 3, 2007
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There's a formal warning against taking Dexedrine while on SSRI's, but at therapeuatic doses/regimens of both is this a safe combination? If there's no danger, i.e. serotonin syndrome, what are they warning against?
 
Dexedrine has serotoninergic effects too, but I think at therapeutic doses they can both be taken together safely.
 
Yes. The amphetamine's effects on serotonin should be too small to cause serotonin syndrome. The effect of the amphetamine may be dampened by the SSRI, though.
 
Are there supplements one should take when taking Dexedrine regularly? I would think that something needs to go in for all the extra dopamine that's being pushed out....
 
Amino acids like Phenylalanine or Tyrosine and dietary tryptophan (reccomended from dairy, because it's bioavailable and comes with carbs and calcium) and optionally L-theanine. Plus Magnesium and vitamin-B complex. Theirs other ones that it would be wise to take it with, but those are the most important ones. Or better yet just take a high dose XR multivitamin/mineral along with the amino's, to save you some pill popping and money. Quercetin, SAMe, acetyl l-carnitine and gingko biloba are also good adjuncts.
 
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I have been taking dextroamphetamine with venlafaxine for years now (at least 4 years, I think) at 60mg / 150mg per day (both XR), respectively. Before that, I was on methylphenidate, sertraline and bupropion. In contrast to what some authors claim (based upon high-dose studies in rats), dextroamphetamine has little to no appreciable serotonergic effects at moderate, therapeutic-level doses in humans. Curiously, however, administration of a serotonergic agent along side a typical dopaminergic/noradrenergic amphetamine (like dl-amphetamine or 4-fluoroamphetamine) attenuates some of the rewarding/reinforcing affects of the amphetamine and may help prevent amphetamine tolerance (Rothman and Baumann, 2006; Rothman et al, 2006; Blough, 2008). The same can't really be said about d-methamphetamine, however--meth has about a 2.5-3-fold greater ability to induce the release of serotonin.
 
I take 45 mg of Dexamphetamine and 100 mg Sertraline daily. I have taken doses exceeding 125 mg daily of Dexamphetamine with an anti-depressant before and I'm not suffering from serotonin syndrome. Personally, I think d-amphetamine targets the dopamine, noradrenaline receptors only, not the serotonin receptors. Otherwise, d-amphetamine would feel more like MDMA, which it doesn't even at psychosis-inducing doses of 125 mg.

I am interesting in the supposed dulling of effects of d-amphetamine from SSRI usage. Is this a common fact, or a myth exuberated from petty encyclopaedia references from Wikipedia?
 
Not necessarily for everyone. The idea that acute (d)-amphetamine causes psychosis in every single person, as long as it is above a certain dose, is not necessarily true. Usually, amphetamine psychosis is the result of repeated high doses without sleep.
 
Combining with venlafaxine is interesting. I would have thought that would be overkill.

My plan has been to mix 10-20mg of citalopram with 5-10mg of dexedrine xr (evidently I'm extremely sensitive, because 60, let alone 120, would be psychotic no doubt). I've done this the last few days and at first it is extremely effective. No "high" whatsoever, just full symptom relief (depression/ADD). A couple days later though I'm descending into headaches, major irritability and a vaguely angry bad mood. Can I adjust something or supplement with something to try and maintain the initial effects of the combo?
 
Its actually a very effective treatment for depression,and amphetamine is even given with a MAOI.You can read it up on a very fine paper from Gabriele Stotz, "Psychostimulants in the therapy of treatment-resistant depression".A pdf can be downloaded here:

http://www.epsy.de/ritalin.htm
 
^^^ 125 mg is a psychosis inducing dose?
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Well, once you've been up for 2 days on plain old d-amphetamine and been staying up on school nights so you're just hanging around in your bedroom for hours awake and amped up. I don't think I've ever had amphetamine psychosis except for 1 time, where I was dissociated from my mind, body and soul completely for a long time. It was very scary, similar to benzodiazepine withdrawal.

I think amphet psychosis is different for everyone and manifests itself differently. Tweakers can manage 5 days awake and not have amphetamine psychosis, whereas I'm particularly sensitive to amphetamine psychosis-related state of mind.

Not necessarily for everyone. The idea that acute (d)-amphetamine causes psychosis in every single person, as long as it is above a certain dose, is not necessarily true. Usually, amphetamine psychosis is the result of repeated high doses without sleep.
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People handle drugs differently. Someone could do 75 mg of amphetamine and suffer from 48 hours of no sleep and amphetamine psychosis.

Amphetamine psychosis is a combination of a dopamine overload from excessive stimulant use/sleep deprivation. One potentiates the other and vice versa.

Peace.
 
I think this very combo would set me up as I would want, at least in the short term.

I'm on citalopram now but suffer side effects of lethargy/apathy/general can't be arsed syndrome and loss of libido.

In theory I think the combo should be safe. Just add the dex at a v.low dose to start off with to be sure. Incidently, there's next to no chance of having dex added to my cit. I live in the UK. U Americans are so lucky. I'm sure if I lived there, I could make it happen.

SS
 
Kudos said:
Combining with venlafaxine is interesting. I would have thought that would be overkill.

My plan has been to mix 10-20mg of citalopram with 5-10mg of dexedrine xr (evidently I'm extremely sensitive, because 60, let alone 120, would be psychotic no doubt). I've done this the last few days and at first it is extremely effective. No "high" whatsoever, just full symptom relief (depression/ADD). A couple days later though I'm descending into headaches, major irritability and a vaguely angry bad mood. Can I adjust something or supplement with something to try and maintain the initial effects of the combo?
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Are you able to sleep well with this regieme? If not, your side effects are the classics I get if I'm not sleeping, for whatever reason.

Also, be aware that while the Dex may be effective immediately, your SSRI will take 2-6 weeks before you start feeling significant andidepressant benefits.

SS
 
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The IC50 of amphetamine for occupancy of MAO-A is >12 uM, so unless one is taking grams a day, the MAO inhibitor properties of d-amphetamine never come into play. And if you are taking grams of amphetamine a day, you've got some big fucking problems, far bigger than just the possibility of pissing off your monoamine oxidase enzyme.

I'm on citalopram now but suffer side effects of lethargy/apathy/general can't be arsed syndrome and loss of libido.
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Man, I wish I had a loss of libido with my SERT inhibitor...libido is just an annoying and depressing distraction when you're alone, just reminds you of all things that you'll never have. Without it, I wouldn't give a shit about it (obviously)--and the ability to truly not give a shit is freedom.
 
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Riemann Zeta said:
Man, I wish I had a loss of libido with my SERT inhibitor...libido is just an annoying and depressing distraction when you're alone, just reminds you of all things that you'll never have. Without it, I wouldn't give a shit about it (obviously)--and the ability to truly not give a shit is freedom.
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Well said...it's so true!
 
serotonin-system said:
Are you able to sleep well with this regieme? If not, your side effects are the classics I get if I'm not sleeping, for whatever reason.

Also, be aware that while the Dex may be effective immediately, your SSRI will take 2-6 weeks before you start feeling significant andidepressant benefits.

SS
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I get insomnia from the citalopram most of the time. Lately, I've been taking 10mg of citalopram every day plus 2.5mg of IR dexedrine twice daily. It works brilliantly, the dexedrine is remarkably transparent. If I wasn't putting the pill in my mouth I would just assume I was in an unusually positive mood.

I stopped taking the citalopram for 3 days though, which seems to have fucked things up :(. Hopefully it'll revert after a couple weeks of consistency again.

Riemann Zeta said:
Man, I wish I had a loss of libido with my SERT inhibitor...libido is just an annoying and depressing distraction when you're alone, just reminds you of all things that you'll never have. Without it, I wouldn't give a shit about it (obviously)--and the ability to truly not give a shit is freedom.
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I'm not so sure it works that way. On the citalopram alone I get what I would consider "lowered libido". It doesn't vaporize an interest in sex, it just makes it less visceral, less pleasureful, and hampered by ED. You're still driven to fuck, but the act itself is unsensational, if not aggravating.
 
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