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Stimulants Drug Interactions

S

SHANMAC

Greenlighter
Joined
Dec 8, 2010
Messages
6
I read that if you're taking a NRI or SNRI, you will not receive the full benefit of an amphetamine such as Adderall or Dexadrine.

I was taking Cymbalta (60mg), which is a SNRI, and my doc prescribed Adderall (XR). I did not really feel any effects of the Adderall no matter how many I took. One day I tried 60mg Adderall at once and did not feel any more effect than when I took 10mg. I read on this forum and on other sites that this is a bad combination.

My doc has kept my on cymbalta but now has taken me off Adderall due to the cost and put me on Ritalin (20mg) twice per day. I read on this forum and on other sites that there should be no effect between the two, but again, I am not feeling the focus/energy that I thought I should.

I should note that I just started taking these medications a few months ago.

Can anyone shed any light on this? I'm at a loss as to what's going on! Thank you for any input you might have.
 
Contraindications, interactions, and precautions for Amphetamines (not a complete list!)
# SSRIs (selective serotonin reuptake inhibitors, e.g., Fluoxetine, Citalopram, Paroxetine, etc.) — While rare, the possibility for serotonin syndrome exists with this combination. Use only when it is directed.
# NRIs (norepinephrine reuptake inhibitors, e.g., Atomoxetine, Strattera, etc.) — NRI medications and amphetamine both enhance noradrengic activity. Possible augmentation/potentiation of effects. Use only when directed.
# SNRIs (selective serotonin-norepinephrine reuptake inhibitors) — See SSRIs and NRIs.
Click to expand...

Based on that information your problem makes no sense to me. Im guessing either too low of a dose or natural tolerance.
 
Yeah, I was about to say the same thing...I was always under the impression that taking SNRIs with amphetamines resulted in increased effects of both (usually the amphetamine). However, your case must be different (or I'm thinking of something else completely...in which case, ignore this post). I would discuss it with your doctor, it is possible he started you on a low dose of adderall to avoid or minimize any negative interactions with your Cymbalta. But then again, I know a lot of people, and there are a lot of people on this board, who are co-prescribed SNRIs/NRIs with amphetamines and don't have any problems.

I personally avoid combining amphetamines/amphetamine like stimulants with anything besides benzos and opiates, but that's just me :)

and then....


Although this is interesting, I did a drugs.com interactions checker (your friend if you haven't used it before) for cymbalta and mixed amphetamine salts...the result of which was "Major Interactions" and then a check of cymbalta and methylphenidate and the result was "No Interactions Found"...

I too am interested in the difference between SNRIs and NRIs interacting with amphetamine vs. methylphenidate...I always thought their method of action was nearly identical.

See for yourself:

http://www.drugs.com/interactions-ch...190-0,949-2273

and

http://www.drugs.com/interactions-ch...-2273,1606-979
 
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Not a problem, that interactions checker is the first place I go when I'm thinking about trying a drug combination. The whole drugs.com website is very useful, actually
 
^^ Indeed, very useful. Whenever i google something drug related a large portion of the time a result comes up for Drugs.com and its the only search result i need.
 
SHANMAC said:
I read that if you're taking a NRI or SNRI, you will not receive the full benefit of an amphetamine such as Adderall or Dexadrine.

I was taking Cymbalta (60mg), which is a SNRI, and my doc prescribed Adderall (XR). I did not really feel any effects of the Adderall no matter how many I took. One day I tried 60mg Adderall at once and did not feel any more effect than when I took 10mg. I read on this forum and on other sites that this is a bad combination.
Click to expand...

I have heard of this as well.....the fact that NRI's and SNRI's can block effects given by amphetamines such as Adderall like you were prescibed.....so it makes sense that when you were precribed both of those drugs at the same time that you could possibly not feel the Adderall at all no matter what dose you were taking.


SHANMAC said:
My doc has kept my on cymbalta but now has taken me off Adderall due to the cost and put me on Ritalin (20mg) twice per day. I read on this forum and on other sites that there should be no effect between the two, but again, I am not feeling the focus/energy that I thought I should.

I should note that I just started taking these medications a few months ago.

Can anyone shed any light on this? I'm at a loss as to what's going on! Thank you for any input you might have.
Click to expand...

Ritalin is NOT an amphetamine so the Cymbalta you are taking should have no effect on it like it did with the Adderall you were prescribed previously. I dont know if you realized this but I posted this just in case you didnt.

I apologize if you were aware of this and I wasted your time and BL's posting space.
 
Thank you for all the input. I increased the dosage of the Ritalin just a bit and found that it works well. This forum is fantastic!
 
i take prozac,an ssri and it seems to potentiate my adderall quite a bbit
the only promblem is the tolerance goes through the roof very fast
 
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i take prozac,an ssri and it seems to potentiate my adderall quite a bbit
the only promblem is the tolerance goes through the roof very fast
 
dildonian jr. said:
i take prozac,an ssri and it seems to potentiate my adderall quite a bbit
the only promblem is the tolerance goes through the roof very fast
Click to expand...

Be careful with how much you dose especially as your tolerance goes up, SSRI's + Adderall have a potential to cause serotonin syndrome.
 
what exactly is seratonin syndrome? I've read up on it, but still cannot grasp what actuallly happens. Also, does the ssri cause the increase in tolerance?
 
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serotonin syndrome is a consequence of excess serotonergic activity in the central nervous system and peripheral serotonin receptors. which in laments terms means your serotonin neurotransmitters produce extra and receptors are flooded with serotonin. which can effect your thought process, heart rate, respiration rate, and give you involuntary control of body movements, among other things. it can range from barely perceptible to fatal.
 
* Cognitive effects: headache, agitation, hypomania, mental confusion, hallucinations, coma
* Autonomic effects: shivering, sweating, hyperthermia, hypertension, tachycardia, nausea, diarrhea.
* Somatic effects: myoclonus (muscle twitching), hyperreflexia (manifested by clonus), tremor.
Click to expand...

Symptoms of serotonin syndrome, if you ever suspect you have it i would go to the hospital asap as some of those are pretty severe.
 
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