A couple years ago I took adderall for ADHD and it worked great. But, i stopped after a couple years due to weight loss. So then I was on zoloft for OCD and agoraphobia, and it was workin good for that, but concentration sucked, so i started adderall. The adderall and zoloft worked in conjunction for a day, thats all. The next day, BOTH MEDICINES STOPPED WORKING!! So, they switched me to lexapro. During the switch, the adderall worked for a couple days, but then stopped. They upped my dosage to 60 mg adderall a day, and it still didnt work. Not only did it not work, but i felt no side effects whatsoever (energy, loss of appetite, etc.) So, I was switched to dexedrine. I guess it worked for maybe a couple hours, but then suddenly stopped. So, my theory is that SSRIs and stimulants may counteract eachother is some cases. It would make sense though, since dopamine and seratonin levels have a see-saw effect (dopamine rises so seratonin lowers). People with OCD and ADHD have low dopamine AND seratonine. So, as the stimulant raises dopamine, the seratonine lowers. And as the SSRI raises the seratonine, the dopamine lowers, hence having no therapeutic use whatsoever. Now, this is only my theory and opinion and have no proven evidence, so u guys may argue both sides with cases and "evidence."

Major Drug-Drug Interaction: Zoloft (sertraline) and Adderall (amphetamine-dextroamphetamine)
* The interaction is due to amphetamine which is a component of amphetamine-dextroamphetamine

GENERALLY AVOID: Several case reports suggest that patients treated with serotonin reuptake inhibitors (SRIs) may exhibit an increased sensitivity to sympathomimetic agents. The mechanism of interaction is unclear. The reaction has been reported when fluoxetine was used concomitantly with phentermine, amphetamine, or phenylpropanolamine. Additionally, some sympathomimetic agents (e.g., amphetamines) may possess serotonergic activity and should generally not be administered with SRIs because of the additive risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors. The interaction occurred in a patient treated with dexamphetamine approximately 2 weeks after the addition of venlafaxine. The medications were discontinued and the patient was given cyproheptadine for suspected serotonin syndrome, whereupon symptoms promptly resolved. A second episode occurred when dexamphetamine was subsequently resumed and citalopram added. The patient improved following cessation of citalopram on his own, and residual symptoms were successfully treated with cyproheptadine. MANAGEMENT: In general, amphetamines should not be combined with serotonin reuptake inhibitors. Close monitoring for enhanced sympathomimetic effects is recommended if these agents must be used together. Patients should also be monitored for signs and symptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia.

Source: Copyright 2003 Multum Information Services, Inc. The information in contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

yes ive read that somewhere, thanks for ur input. also, symptoms of SSRIs include decreased concentration and apathy (no motivation), which Adderall is supposed to be treating. So those also counteract eachother. I know that some people take SSRIs and stimulants together and they work fine, but with some cases it just doesnt seem to cut it.

this is interesting, because if you research so many adults are on a SSRI and a stimulant. Since their treating different chemicals, it seems it would be OK. I think a proper doseage is key.

The drugs don't counteract each other, it's not that simple - nothing in the brain is simple! The neurotransmitter levels are linked to each other, but the way that the drugs modify these levels will change this relationship too, I should think.

Thank you thank you thank you for posting this.
So, I'm not crazy!
Er, ah, maybe I am, but I am not imagining the counteracting of Zoloft and Adderall and the miserable side effects (confusion etc. -- and this is supposed to help me at work...how?)
which side effects, btw, my doctor doesn't think are of any significance, except for giving me additional meds for tremmors and twitches and anxiety enhanced and/or created by the other meds.

See: picture (http://thesmudge.com/shapeshifter/being-me.htm) of my new and "improved" thought process

Recently, I was on a low dose of Paxil, a strong SSRI, and also Adderall. This combination worked fine, but I stopped the Paxil because I was no longer depressed (and I missed my normal emotional rock and roll).

Now, after over a month off Paxil, I need LESS amphetamine to be effective. I was taking 60mgs a day, now 40 works well, and 60 will make me alternately hyper, sluggish and spacy during the day and then impedes my sleep at night.

It seems interactions among neurtransmitters and an individual's brain chemisty are not very generalizable.

BUT, there's a company (I forget the name, but it is in Walnut Creek, California) that will take a wad of money along with a bit of blood and hand you back your DNA profile. Their profile will predict your responses to many drugs and to potential drug interactions. No more muss and fuss!

If you believe them, that is. I wonder what their disclaimer looks like.

sosninity (member.php?u=5570), great panel. I can't even look at your picture without becoming muddled. Uhh. Where was I? How did I get out on the street with my laptop, and where are my pants?








For me, the SSRI muted some affects of AMPH. And the AMPH improved some of the negative sexual sideaffects of the SSRI.

i take adderall, 40-50mg a day, depending on the days needs and 60mg of cymbalta. i was on wellbutrin prior to the adderall and it was a killer combo for me. but found out i was allergic and had to find a new drug for the panic disorder. so far, i have only been on cymbalta for a little over month and half and have noted some improvement from the wellbutrin fallout, but i am not to the point of clarity as i was with the WB. the only main thing i noticed side effect wise is that i have no appetite what so ever. im lucky if i take in 1000 calories a day. but i do not think that the cymbalta counteracts the adderall because i am not hyper during the day like i am when i rebound at night. everybody's brain chemestry is different in some sense and i guess i dont fall in to the counteraction thing. who knows, maybe since cymbalta is a SSNRI its a bit different.
-heather

SSRI's don't counteract stimulants, but I did find them to be "demotivating" and I can see how you might need more stimulant when you were taking something like Paxil - which I found to be the "worst" in this regard, of the 2 or 3 I have tried over the years. I've said it before that I really like "Remeron" (mirtazipine) - it is not demotivating at all, but it will make you very sleepy when you take it, which of course is great for me and another reason I do take it. It's an NaSSI and is good for depression and anxiety. With most things psychotropic, you either love it or hate it!

...there's a company ... in Walnut Creek, California) that will take a wad of money along with a bit of blood and hand you back your DNA profile. Their profile will predict your responses to many drugs and to potential drug interactions. ...No doubt if so much money wasn't being spent down-sizing populations of the US and Iraq, custom-made drugs would be the norm. Since my body's chemistry seems to be outside the norm so that drugs never effect me as they effect most others, I have long imagined the day when designer medications would be dispensed routinely. I can even now imagine how it might result in wiping out the "common cold."

Okay, where was I? (Stan, glad you understood the image.)

I'm still getting my psychiatric medications adjusted -- was just switched to Requip from Mirapex to counteract the jitters, wiggles, and spasms from Zoloft and the amphetimines. (I'm taking a fairly high dose of Zoloft because of a strong OCD component -- it's genetic from both sides.) Thank goodness the painful muscle cramps have subsided.

I was also just switched from 10mg Adderall XR (time release) in the morning and 5mg regular Adderall in the afternoon, to 10mg regular in the morning and 5mg Ritalin in the afternoon. At least I'm not staying up being busy until 4:30am anymore, which was especially grueling when I had to go to work just 4 hours later.

It's not all bad. I am starting to be able to focus -- more than when I created the image. (http://thesmudge.com/shapeshifter/being-me.htm)
Speaking (or typing) of which: in the bottom, green, horizontal oval, I attribute my lighter images to the season of spring. But I think it's really more due to a relief, at least in part, of a lifetime of depression. I have lived by Lake Michigan for nearly 4 years now, but it's only in the last few months that I have discovered and enjoyed the beauty and soothing waves of the lake.

mrsvoorhees26, I had the same problem with loss of appetite and caloric intake when I first started the ADD meds. But now I'm also taking low doses of Risperdal for anxiety, and it's also an appetite stimulant. Most people gain 20 pounds in the first month while adjusting. So, between the 2 drugs, I'm balanced in terms of appetite.

Because they work with different chemicals, they will not counteract each other.

I took 50mg/day (think that was the dose) of Zoloft along with 20mg 2x/day IR Adderall. Both seemed to work very well together. I just hate anti-d's in general(had taken before prescribed adderall)
just my $.02

From Post #2


Major Drug-Drug Interaction:

Zoloft (sertraline) and Adderall (amphetamine-dextroamphetamine)

* The interaction is due to amphetamine which is a component of amphetamine-dextroamphetamine.

MANAGEMENT: In general, amphetamines should not be combined with serotonin reuptake inhibitors. Close monitoring for enhanced sympathomimetic effects is recommended if these agents must be used together. Patients should also be monitored for signs and symptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia.
...
Has anyone seen any more information about not taking SSRIs with amphetamines??

Or is this drug-drug interaction (Warning) for when taking Zoloft with Adderall only?

Thx! :)

dopamine and serotonin levels have a see-saw effect (dopamine rises so serotonin lowers) Anyone know where I can read more about this medication related neurotransmitter see-saw effect??

I've also seen this mentioned elsewhere on our ADD forums.

Again Thx! :)

My research indicated that in many cases, when untreated adhd and depression coexisted, it was suggested the adhd be treated first. Why? Because the utter and intense frustration of dealing with untreated adhd often results in depression (and other problems too). My doctor concurred, and in my case, somewhat successfully treating my adhd with Adderall alone indirectly resulted in curbing my depression for exactly that reason.
That's the good news. Unfortunately, I said somewhat successfully, because the impulsive behavior component of my adhd still remains a major problem. I can't increase my current dosage (adderall xr 20mg/day) without having unacceptable side effects. I recently read ssri's have been recommended for use in conjunction with stimulants specifically for treating unacceptable impulsive behavior. And, since (believe me) mine is unacceptable, I found this interesting.
So, has anyone out there been treated with ssri's (or some other meds) in conjunction with a stimulant specifically for impulse control?

re: post 13

IME, side effects go up, benefits go down.

The way to check out metabolism interactions is to look at a CYP 450 chart.



http://medicine.iupui.edu/flockhart/table.htm

and


http://www.theberries.ns.ca/archives/cyp450.html