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  • BDD Moderators: Keif’ Richards

Amphetamines and SSRI's/SNRI's?

T

TrainerGold7

Greenlighter
Joined
Mar 2, 2012
Messages
17
I've researched it to death and have so many conflicting answers. How great is the risk of serotonin syndrome from mixing amphetamines and SSRI's/SNRI's? I've read that it's quite risky but I've also read about people being perscribed both. Sometimes up to 75mgs of adderall and 300mgs of effexor. I've recently started effexor (5days ago, 75mgs) and I've taken amphetamines 2 times since then (60mgs of adderall one day and 100mgs of vyvanse another day) I was on celexa for a month and a half and took 30mgs of adderall one day also. Obviously I'm ok but that doesn't mean I will be the next time I do this.

So I'm wondering how big the risk is for serotonin syndrome? It's got me pretty worried but if there's little to no risk I'd like to keep doing this. Thanks :)
 
The risk is low for amphetamine (Adderall etc) as it is not significantly serotonergic.

It is theoretically possible however, and there may be the odd case in the medical literature, I haven't looked.. Drug interaction checkers tend to mention it, as amphetamines can affect serotonin, but compared to true serotonin releasers such as MDMA, DXM, sertotonergic psychedelics etc the risk is pretty minimal.

Don't take huge doses of amphetamines and you should be okay (we can never absolutely guarantee anything though!)
 
The thing I would be most worried about is lowered seizure threshold due to mixing the Effexor with amphetamines. Serotonin syndrome is something you want to avoid as well, and I believe it is possible to arise with this mix of meds. In the name of harm reduction, I wouldn't mix these drugs, but if you I advise you keep the doses relatively low, and monitor your vitals (BPM, body temp, blood pressure etc.) as often as possible. This could help to thwart a serious case of serotonin syndrome, but seizures are more unpredictable, I might keep a fast-acting benzo on hand in case if you want to continue this combo, but again I do not advise it.
 
^ that is a very good point actually Alex. Even a fast acting benzo wouldn't work with a seizure - by the time you knew it was happening it would be too late..

Keep your doses low for sure.
 
Seizure risk isn't something that is easy to predict. People's seizure threshold varies hugely.. Both do lower the seizure threshold, but I really wouldn't like to say what the chances are of seizing are. Not hugely high at those doses I would think, and you're right people are prescribed the two, but this isn't always an indication of safety unfortunately!

At 75mg, venlafaxine is predominantly an SSRI rather than an SNRI, which doesn't tend to lower the seizure threshold as much. Once you get to 150mg and higher the risk will increase.

Sorry I can't be more specific.. in the interests of HR I can't make promises I am afraid!

Be careful to avoid any other drugs which may also lower the seizure threshold if you are combining the two, and keep your amphetamine dose as low as you can.
 
effie said:
^ that is a very good point actually Alex. Even a fast acting benzo wouldn't work with a seizure - by the time you knew it was happening it would be too late..

Keep your doses low for sure.
Click to expand...

Seizures don't have to be tonic-clonic seizures, they come in various forms, some in which you retain some lucidity, though not much. A benzo would be helpful in that sort of case, or in a case of status eplilepticus, or to prevent another seizure from occuring after the first, which would be a possiblity. I know it wouldn't work well in all cases, but it is better than nothing. Also, someone could always administer the benzo for him.
 
^ Yeah indeed - but more often than not it would be too late, and even partial/absence seizures it would be tricky to remain lucid enough to pop a benzo and for it to act fast enough. You're right, though, it is better than nothing for sure (while awaiting medical help) and something given sublingually would hit fairly fast. Best not to put pills into the mouth of someone having a tonic-clonic seizure though in case they choke (or bite your fingers off!)
 
effie said:
^ Yeah indeed - but more often than not it would be too late, and even partial/absence seizures it would be tricky to remain lucid enough to pop a benzo and for it to act fast enough. You're right, though, it is better than nothing for sure (while awaiting medical help) and something given sublingually would hit fairly fast. Best not to put pills into the mouth of someone having a tonic-clonic seizure though in case they choke (or bite your fingers off!)
Click to expand...

True, asphyaxation and loss of digits is not something we want. ;) But, in all seriousness, to the OP, I would be concerned with this combo. Just my feelings on it.
 
Yeah, agreed - and I too am more concerned about seizure risk than serotonin syndrome..
 
I would say the risk isn't that high but if you are thinking about taking a fairly large dose of amphetamines to get high then I would suggest you don't do it alone, so that in the case that you do have a seizure there's someone there to do something about it
 
wow thanks for all the great info guys.I think I'm just going to pass on the amps for awhile. again thanks :)
 
Yea i hated the conflicting answers, it was driving me nutts everywhere you look it says no your fine to mix. Then you look somewhere else, no it will give you SS / a seizure. If you want to combine it keep the amp doses low, and when i was combining coke + ssri or Meth + ssri i would also have a low dose benzo in me. In case of seizure risk
 
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