Amphetamines and antidepressants

[taylorbb]

I have been on bupropion (a NE/DA reuptake inhibitor) and Vyvanse (prodrug that metabolizes to dextroamphetamine) for about a month now. I am a third year pharmacy student and I have scoured the medical literature and clinical trials and studies for HOURS looking for some kind of interaction/connection with these two. It doesn't make sense to me that they both release and prevent reuptake of NE and dopamine at the alpha-2 adrenergic receptors in the CNS. I swear that I think bupropion somehow can block or blunt the effects of the amphetamine. I am taking Vyvanse for clinically-diagnosed hypersomnolence, which pretty much is borderline narcolepsy without all the paralysis and crazy hallucinations. I have been increased from 30mg (equal to 20 mg Adderall XR) to 70mg (equal to 30 mg Adderall XR) in a period of 3 weeks with 2 titrations from 30 to 60 to 70mg. I STILL cannot stay awake to save my life. I notice that when I stop taking the Wellbutrin, the next day, my dose of Vyvanse feels more potent, but not in a good way. I am extremely fatigued, mainly because I am lightheaded and burning up from the cardiovascular effects of the amphetamine.

My question is if anyone else has experienced this. The day after I didn't take my Wellbutrin (I'm on 150mg XL, so it took a day or so to be eliminated from my body) my blood pressure shot up to 152/116 (normal for me is around 120s/mid-80s) and my pulse was 140 (normal of 100). I had to take a beta-blocker to bring it back in check because it stayed high for at least 3 hours.

I truly believe there is some inhibition going on with these two, and it probably holds true for any other antidepressant that affects NE or DA, like Pristiq, Effexor, Cymbalta...maybe not so much for SSRIs but who knows? Still trying to locate actual literature preferably related more to hypersomnia/narcolepsy instead of ADHD. If anyone has any info, please pass it on.

 

[rangrz]

interaction between how they work. Amp forces the release of stored DA. That requires a transport mechanism that works. (in this case, works overtime and only in one direction)
bupropion lowers re-uptake, which generally happens by interfering with the function of transport mechanism.

Perhaps thats why its stronger feeling sans wellbutrin?

two years of pharma, a few years back, so dont hate too hard if I'm off, but it seems a plausable interaction.

think MDMA+SSRI.

 

[Tronica]

Hi taylorbb, welcome to Bluelight.

Drug Studies isn't the right place for your thread - we take threads about research studies, specifically those recruiting participants and we provide a space for participants to engage with researchers.

Your desire for medical and pharmacological literature on this topic makes me think this thread could work in Advanced Drug Discussion.

ADD mods, please move somewhere more appropriate if this doesn't fit.

 

[taylorbb]

That sounds valid to me and would make sense. I stopped taking the Wellbutrin for a few days to see how the amp would do alone, and I felt horrible, like someone hit me with a car. I was exhausted all day, especially in the afternoon and late night. What the hell? So I asked my prof in class today and this is what he said:

Taylor:

You would likely see some synergy but not additive purely on a receptor mediated basis. However, the clinical spectrum of activity is less for bupropion than the stimulants. This is probably an affinity difference between brain regions.

From what I gather, both can be synergistic and cause an increased release of dopamine and NE, but the brain only has so many receptors to receive the signals. There would therefore be no additive effects. Maybe I have too few receptors, or they are downregulated? Who knows. Got an appt with my psychiatrist tomorrow and gonna get her opinion. Thinking about switching to Effexor or SSRI but I really don't want to have any of the sexual dysfunctions problems like I did with Prozac. No fun!

 

[drminaq]

I have been on Dexatrostat and Effexor 300mg and I noticed a profound difference in the D amp when I cut out the Effexor. That was in the spring and as winter approaches I have started taking cymbalta and Vyvanse it has only been a few weeks but in general I feel that Cymbalta does not interfere with the vyvanse as much as Effexor and possibly has syngerstic effects. I know that NorEpeph is important in the production of Dopamine and while Amphetamines do a poor job of releasing Serotonin why not have that blockade of serotonin receptors ?

 

[Gormur]

am i the only one who seems alarmed by this?

when i started on vyvanse in march 09' i was also put on Strattera. the combo put my blood pressure through the roof and made me manic

vyvanse does a number on blood pressure as it is

 

[Hammilton]

Strange, even on a fairly high dose of Vyvanse my blood pressure was uneffected.

 

[Gormur]

maybe weight and metabolism are a factor

i'm 120lbs / 54kg and naturally sensitive to amps, tho my tolerance rises unusually fast - after 2 days of use, i don't feel anything by the 3rd day.. maybe just a bit fatigued. same story since i started on them almost 2yrs ago..took a 3 1/2mo break this year.. which made no difference

meh. everyone's different i guess. i guess i just read wellbutrin and vyvanse as blood pressure spike, but maybe some people don't have that issue.. altho that seems strange to me

 

[NeighborhoodThreat]

Happens to me do, I also have the problem if taking a break from amphetamines and it not really changing anything about my tolerance.

I've found that magnesium helps more than taking breaks (I'm talking two or three week breaks) but that's another thread for another day.