Mental Health Best and safest Antidepressant to combine with Stims

adhdanon

Greenlighter
Joined
Jun 14, 2016
Messages
39
I know there are some newer ones like Brintillex and Viibryd, but I once had success for a bit with Lexapro 10 mg and Adderall, except Vyvanse didn't mix as well with Lexapro for some odd reason.

What has been your best antidepressant for depression/anxiety that safely combines with stims?
 
Abilify is the best thing you can combine with adderall and vyvanse. Bupropion -I wouldn't use too much because it blocks certain nicotinic acetylchole receptors which is undesirable and would have a negative impact... - is a good one, since it's a stimulant itself. It would potentiate other stimulants, but if it's amphetamines, the dosage would have to carefully be adjusted so it doesn't block the amphetamine from entering the cell via DAT and NET. If you can get methylphenidate, a low dose of that would also work.

There's also modafinil, a DRI and D2 partial agonist (like abilify - so it would enhance the effects while also preventing reuptake). I think modafinil would combine excellently with the meds you mentioned. It's controlled so it might be difficult to get, but you can buy adrafinil online which is the prodrug for modafinil, turning into it in your body - in essence it pretty much is modafinil.

Zoloft. I know it goes extremely well with methylphenidate. It had dopaminergic effects on its own so it's a good combo... Abilify is the best thing you can combine with adderall and vyvanse. I know it sounds strange - but since it's a dopamine type 2/3 partial agonist - it doesn't block the effect of amphetamines. It's been reported to greatly enhance them. The column on the left:

(https://books.google.com/books?id=z...&resnum=2&ved=0CC0Q6AEwAQ#v=onepage&q&f=false)

I was wondering if anybody has experienced combining Effexor with stimulants? Effexor is stimulant itself at certain doses, preventing the reuptake of serotonin, norepinephrine, and dopamine - at high doses and to a certain degree. I just know its damn stimulating on its own.
 
Thanks for sharing, do you think Zoloft would be better than Lexapro? I just took first dose of Lexapro instead of Klonopin 0.5mg and I already feel million times better and my libido/confidence are back. However, I am def. a bit irritable/lethargic, maybe I'd do better on an SNRI or I'll try Zoloft.

Also, I've heard great things about Guafacine and Gabapentin being combined with Adderall with no lethargic sides at all. I definitely want to know how i'm moving forward after tomorrow when I see my doctor.

Abilify is the best thing you can combine with adderall and vyvanse. Bupropion -I wouldn't use too much because it blocks

certain nicotinic acetylchole receptors which is undesirable and would have a negative impact... - is a good one, since it's a stimulant itself. It would potentiate other stimulants, but if it's amphetamines, the dosage would have to carefully be adjusted so it doesn't block the amphetamine from entering the cell via DAT and NET. If you can get methylphenidate, a low dose of that would also work.

There's also modafinil, a DRI and D2 partial agonist (like abilify - so it would enhance the effects while also preventing reuptake). I think modafinil would combine excellently with the meds you mentioned. It's controlled so it might be difficult to get, but you can buy adrafinil online which is the prodrug for modafinil, turning into it in your body - in essence it pretty much is modafinil.

Zoloft. I know it goes extremely well with methylphenidate. It had dopaminergic effects on its own so it's a good combo... Abilify is the best thing you can combine with adderall and vyvanse. I know it sounds strange - but since it's a dopamine type 2/3 partial agonist - it doesn't block the effect of amphetamines. It's been reported to greatly enhance them. The column on the left:

(https://books.google.com/books?id=z...&resnum=2&ved=0CC0Q6AEwAQ#v=onepage&q&f=false)

I was wondering if anybody has experienced combining Effexor with stimulants? Effexor is stimulant itself at certain doses, preventing the reuptake of serotonin, norepinephrine, and dopamine - at high doses and to a certain degree. I just know its damn stimulating on its own.
 
Yeah, guanfacine is used alongside the psychostimulants. It would cut down on adrenergic activity. I never liked gabapenting with dextroampheamine as much as the amphetamine itself. It produces this nice, crisp, alert, calm and pleasurable comfortable state of mind. But I like the stimulation better. So they do go well together. Not sure about the guanfacine, as alpha 2 agonists usually are known to inhibit dopamine release. But it would mitigate any excessive sympathomimetic activity and have an anxiolytic effect. Personally I would get tizanidine instead. It works the same way as clonidine and guanfacine, but it has odd effects which set it apart. It can be mildly psychoactive, hallucinogenic wise (mostly psychological) and it has its own unique "narcotic" feel if ingested in the right manner ie insufflation. I'm not recommending you do this though because it's not safe and healthy for your nose and it can be a little weird...

The SNRIs like effexor comletely blow the ssri's out of the water. I can't say if zoloft would be better as I don't know how you would respond to it. I would pick zoloft over lexapro, though. Have you considered Wellbutrin (bupropion). It's a stimulant NDRI itself, like methylphenidate is, but considerably weaker. It's still an excellent antidepressant. The SSRIs tend to just dope the brain up and cause numbness and apathy in a lot of people. Emotional blunting. Just so you're aware.

When I took Effexor and Zoloft, I could never cry. No matter what happened; I'd never be sad for more than a couple a seconds either.

The reaction you're having to the lexapro will be short lived, if this is your first dose. What happens is that the increase in serotonin floods the receptors and activates them, causing EPSP (excitatory postsynaptic potentials), especially at the 5-HT2a receptor site. This effect will subside as the receptors get used to the excess serotonin and adjust their density to compensate. SSRIs are also notorious for causing sexual dysfunction, especially anorgasmia. So be prepared for that.

Just curious, what have you heard about the guanfacine combination?
 
Yeah, guanfacine is used alongside the psychostimulants. It would cut down on adrenergic activity. I never liked gabapenting with dextroampheamine as much as the amphetamine itself. It produces this nice, crisp, alert, calm and pleasurable comfortable state of mind. But I like the stimulation better. So they do go well together. Not sure about the guanfacine, as alpha 2 agonists usually are known to inhibit dopamine release. But it would mitigate any excessive sympathomimetic activity and have an anxiolytic effect. Personally I would get tizanidine instead. It works the same way as clonidine and guanfacine, but it has odd effects which set it apart. It can be mildly psychoactive, hallucinogenic wise (mostly psychological) and it has its own unique "narcotic" feel if ingested in the right manner ie insufflation. I'm not recommending you do this though because it's not safe and healthy for your nose and it can be a little weird...

The SNRIs like effexor comletely blow the ssri's out of the water. I can't say if zoloft would be better as I don't know how you would respond to it. I would pick zoloft over lexapro, though. Have you considered Wellbutrin (bupropion). It's a stimulant NDRI itself, like methylphenidate is, but considerably weaker. It's still an excellent antidepressant. The SSRIs tend to just dope the brain up and cause numbness and apathy in a lot of people. Emotional blunting. Just so you're aware.

When I took Effexor and Zoloft, I could never cry. No matter what happened; I'd never be sad for more than a couple a seconds either.

The reaction you're having to the lexapro will be short lived, if this is your first dose. What happens is that the increase in serotonin floods the receptors and activates them, causing EPSP (excitatory postsynaptic potentials), especially at the 5-HT2a receptor site. This effect will subside as the receptors get used to the excess serotonin and adjust their density to compensate. SSRIs are also notorious for causing sexual dysfunction, especially anorgasmia. So be prepared for that.

Just curious, what have you heard about the guanfacine combination?

Abilify is the best thing you can combine with adderall and vyvanse. Bupropion -I wouldn't use too much because it blocks certain nicotinic acetylchole receptors which is undesirable and would have a negative impact... - is a good one, since it's a stimulant itself. It would potentiate other stimulants, but if it's amphetamines, the dosage would have to carefully be adjusted so it doesn't block the amphetamine from entering the cell via DAT and NET. If you can get methylphenidate, a low dose of that would also work.

There's also modafinil, a DRI and D2 partial agonist (like abilify - so it would enhance the effects while also preventing reuptake). I think modafinil would combine excellently with the meds you mentioned. It's controlled so it might be difficult to get, but you can buy adrafinil online which is the prodrug for modafinil, turning into it in your body - in essence it pretty much is modafinil.

Zoloft. I know it goes extremely well with methylphenidate. It had dopaminergic effects on its own so it's a good combo... Abilify is the best thing you can combine with adderall and vyvanse. I know it sounds strange - but since it's a dopamine type 2/3 partial agonist - it doesn't block the effect of amphetamines. It's been reported to greatly enhance them. The column on the left:

(https://books.google.com/books?id=z...&resnum=2&ved=0CC0Q6AEwAQ#v=onepage&q&f=false)

I was wondering if anybody has experienced combining Effexor with stimulants? Effexor is stimulant itself at certain doses, preventing the reuptake of serotonin, norepinephrine, and dopamine - at high doses and to a certain degree. I just know its damn stimulating on its own.

Given that bupropion is an NDRI, any therapeutic dose would prevent reuptake...

People don't get prescribed methylphenidate and amphetamine at the same time because they cancel out the effects of the other. Bupropion has additional mood-stabilizing and anti-manic properties that methylphenidate doesn't have.

Modafinil is a D2 partial agonist? Source?

Zoloft tends to poop out largely because of tolerance to the dopaminergic aspect, which isn't very strong to begin with.

Abilify is all but an antagonist, especially at 10mg and over. Partial agonists don't come in one flavor. It has high affinity, but low efficacy.

Effexor isn't dopaminergic until doses at least in excess of 300mg. Even then, it's not very strong.

Any increase of one catecholamine will increase the other two, since they're so structurally related.

SSRIs work well for a lot of people...

Not all serotonin receptor subtypes are excitatory. Also, GPCRs much more often cause signal transduction via the second messenger system than cause an influx of sodium cations.

Serotonin receptors don't die off. They recede in the presence of excess activation.
 
Amphetamines aren't occupying and passing through all the transporters in the brain, so at low dosages an NDRI would complement the effects. Bupropion is used alongside psychostimulants quite often, actually, if you read around on other forums. An NDRI combined with an amphetamine at reasonable dosages isn't counter intuitive. The brain still has free monoamine transporters available.

modafinil - https://www.ncbi.nlm.nih.gov/pubmed/19391150

What are you talking about regarding the abilify? I didn't say they did...? I merely said that it enhances the effects of amphetamines. Are you disputing this?

Regarding the Effexor: I specifically said at high dosages, didnt't I?

I'm aware they're not all excitatory; I was merely stating an effect the excitatory ones cause. Seriously, just because I mentioned serotonergic - perhaps I should have used better terms to describe them - where are you getting the idea that I said or believe them all to be excitatory...?

"Adjust their density to compensate" How do you get "dying off" from this? downregulation is the cell adjusting it's receptor density...

Yeah, and the same could be said for the same amount of people they don't help or tend to blunt the emotions for. Which is quite common - regardless if they are working or not.

Are you talking about the 5-ht2a receptor. I didn't mention it being a ligand gated ion channel or GPCR... Either way, it's still excitatory. My wording may have been poor. My bad
 
Last edited:
Amphetamines aren't occupying and passing through all the transporters in the brain, so at low dosages an NDRI would complement the effects. Bupropion is used alongside psychostimulants quite often, actually, if you read around on other forums. An NDRI combined with an amphetamine at reasonable dosages isn't counter intuitive. The brain still has free monoamine transporters available.

modafinil - https://www.ncbi.nlm.nih.gov/pubmed/19391150

What are you talking about regarding the abilify? I didn't say they did...? I merely said that it enhances the effects of amphetamines. Are you disputing this?

Regarding the Effexor: I specifically said at high dosages, didnt't I?

I'm aware they're not all excitatory; I was merely stating an effect the excitatory ones cause. Seriously, just because I mentioned serotonergic excitation - perhaps I should have used better terms to describe them - where are you getting the idea that I said or believe them all to be excitatory...?

"Adjust their density to compensate" How do you get "dying off" from this? downregulation is the cell adjusting it's receptor density...

Yeah, and the same could be said for the same amount of people they don't help or tend to blunt the emotions for. Which is quite common - regardless if they are working or not.

Are you talking about the 5-ht2a receptor. I didn't mention it being a ligand gated ion channel or GPCR... Either way, it's still excitatory. My wording may have been poor. My bad
 
I've never had any problems mixing either Dexedrine or Prolintane with Prozac or Lexapro and with Dex in particular I have probably combined it with prozac over a hundred times and with Lexapro probably like 30 so based on that I feel safe doing so.
 
Amphetamines aren't occupying and passing through all the transporters in the brain, so at low dosages an NDRI would complement the effects. Bupropion is used alongside psychostimulants quite often, actually, if you read around on other forums. An NDRI combined with an amphetamine at reasonable dosages isn't counter intuitive. The brain still has free monoamine transporters available.

Bupropion isn't methylphenidate. Bupropion is used as an antidepressant, and has a reputation of having a very low chance at triggering mania, relative to SSRIs and the like. As far as I'm aware, the reason for this is unknown. Methylphenidate is a more classical stimulant. It has very little use in depression after month or two. People don't get prescribed methylphenidate and amphetamine at the same time.


Plausible.

What are you talking about regarding the abilify? I didn't say they did...? I merely said that it enhances the effects of amphetamines. Are you disputing this?

It depends on the dose, and the individual. Partial agonists will lean toward one side or the other. It's little more than lip service to call Abilify a partial agonist at 10mg or over, and a bit ridiculous to equate it with modafini and say that it's the "the best thing" to take with a stimulant. If someone feels that their stimulant isn't doing its job, best to discuss with the doctor.

Regarding the Effexor: I specifically said at high dosages, didnt't I?

...yeah you did.

I'm aware they're not all excitatory; I was merely stating an effect the excitatory ones cause. Seriously, just because I mentioned serotonergic - perhaps I should have used better terms to describe them - where are you getting the idea that I said or believe them all to be excitatory...?

What happens is that the increase in serotonin floods the receptors and activates them, causing EPSP (excitatory postsynaptic potentials), especially at the 5-HT2a receptor site.

Sounds pretty categorical to me.

"Adjust their density to compensate" How do you get "dying off" from this? downregulation is the cell adjusting it's receptor density...

Because the receptor density isn't adjusted. The active receptor density is. Semantics.

Yeah, and the same could be said for the same amount of people they don't help or tend to blunt the emotions for. Which is quite common - regardless if they are working or not.

I'd imagine they have a pretty good track record.

Are you talking about the 5-ht2a receptor. I didn't mention it being a ligand gated ion channel or GPCR... Either way, it's still excitatory. My wording may have been poor. My bad

Amino acids and monoamines function very differently. Activation of monoamine receptors, especially serotonergic ones, and especially serotonergic subtypes in the hippocampus, where SSRIs mostlyt produce their therapeutic effect, tends to involve signal transduction/transcription. At least in the acute phase.
 
Top