I've been on dexedrine spansules (15mg 2x day or 30mg 1x day) for Inattentive ADD and recently started on Effexor 75mg, which seems to work for my Atypical Depression, but made my Dexedrine a lot less effective, especially regarding MOTIVATION (task initiation, executive functioning, getting out of bed at least??? Nah...). IT KILLED IT!!


Should I try a Dex/Ritalin combo? Dex/Provigil? What are the benefits? Any other ADD combos that would work with Effexor?

Any suggestions/experiences are welcome!!! Thank you!!:)

Hello If...

Just so you know--getting of the effexor can be like getting of a long term opiate addiction. I'm sorry for bringing it up, but you really need to research to find out if this is something you want to use. It may be the only option, and it definitely works, but it definitely comes with some baggage.

I'm currently taking dex (30 mg) per day. Before that I was taking 15 mg adderall xr 2x per day, but I don't have insurance; it was doomed not to last.

The best motivation I had was on Bupropion (Wellbutrin), but it made me edgy and irritable. Sometimes I wonder if my motivation mostly comes when I'm fed up (irritated) by my normal existence? Bupropion did this for me. I eventually stopped it (after a little over a month), because of the irritability. This is just me. I've heard of others who say that Wellbutrin and dexedrine or adderall are the best possible combination.

Adderall gave me motivation, but not necessarily to do things I already didn't want to deal with. Unfortunately a lot of my life is forcing myself to do tasks (due to responsibilities) that I have no initial desire to do. Sometimes the adderall made me more avoidant of uncomfortable tasks.

Dexedrine has the least amount of side effects of any stim or antidepressant I have ever tried, but it doesn't seem to help with reading comprehension, motivation, or studying. It really helps with mood and anxiety ( I feel much calmer), but since it makes me more comfortable, it doesn't really help me change.

I'm sorry if this is a downer response. I'm really trying to work through this myself. To change I need to feel some sort of dissatisfaction with my current condition. If I take something that makes me feel more satisfied or comfortable, it seems that I will be much less motivated to change.

I'm not suggesting that you should stop any meds---again I'm just trying to figure this whole thing out myself, and unfortunately it looks like I'm entering into existentialism again.

ah well.....sorry

Lunar....

Hi Lunar,

It's good to know that I'm not alone on this one, there are other concerned existentialists in the world other than myself. :)

You brought up a very interesting point regarding motivation: if you are comfortable with the status quo, why change it, right? In my case, I have just recently found out that my problem might not be a lack of motivation (as in "I don't get out of bed") but instead agoraphobia (which makes me stay home in my "safety zone" to avoid external anxieties and could result in my not wanting to get out and do anything).

The reason I'm trying Effexor inspite of its withdrawl nightmares, is because I'm running out of options before trying a tricyclic or a MAOI. So far, after 3 weeks on 75mg, I'm not "depressed" but I'm as "blah" as a dead fish (which so far, is all I seem to get from any AD, if they work at all). Adding Wellbutrin to it or switching to Cymbalta might be my last try. What has worked for you?

If...

Hello If,

Unfortunately, I can't tell you what's worked; I'm still in the discovery stage myself.

Here are some ideas. These are definitely only suggestions that you may want to talk to your doctor about.

Since your feeling so "blah", i would guess that the effexor is having more of a seratonin uptake inhibition response (ie. Your seratonin levels might be high). Usually when seratonin levels are high, dopamine levels are lower (which in addition to norepinephrine gives you the get up and go feeling).

You might want to try a specific SSRI (like paxil - still has bad withdrawals -but not as bad as effexor or cymbalta) with dexedrine, which you seemed to say may have given you more motivation. I've found that Dex is alot easier on my system than adderall (heart palpitations etc.).

Effexor, besides the withdrawal horrors, is a multi-reuptake inhibitor, and can affect dopamine and norepinephrine in addition to its primary effect on seratonin. If you combined this with a Stim that increases Dopamine and norepinephrine you may have problems with anxiety due to over elevated levels of the Dop... and Nor.... This is just a theory.

I have a friend whose been taking cymbalta for awhile. It definitely helps with his depression, but it also has extreme withdrawal symptoms. He told me that he ran out at one point and was not able to get his prescription in time. He said throughout the day he would get what felt like electrical shots going through his spine and up into his head that would cause his head and neck to violently jerk. If you google withdrawal symptoms for cymbalta, I think you'll find this isn't that uncommon. The withdrawals can be very similar to effexor.

If your doctor is willing, I might try the dex with ritalin. There are people on this forum who say that the combination is much better for them than either one alone. I haven't seen any negative reviews on the combo. You would know soon if it would work, instead of having to wait a month or more. You could then try another AD if that didn't work. This is just what I would do. I'm always opting for the RX with the least long term side effects.

You also might want to ask about clonodine, if anxiety is any issue. I'm not sure about the SE's.

Whatever you discuss with your doctor, make sure that you google for side effects and interactions before agreeing to a script. I've found that sometimes the doctors either don't know about the current experiences with the drugs, or they don't tell you about the SE's or dismiss them as not typical, because they have decided it's in your best interest to take a particular drug. There's way too much info on these drugs for the doctors to be able to be current on everything.

I am no doctor. You may very likely find misinformation in the above post. I'm just someone trying to figure out how to straighten out their own chemical imbalances. A little knowledge can be a dangerous thing. Check with your doctor and do some research, which you are probably already doing.

Good Luck!

Let me know how it goes, and what works for you. I'm sincerely interested.

I'm actually going to be trying the Daytrana patch in the next month to avoid rebound effects between doses. I've never tried ritalin. I'm looking forward to another couple weeks of adjusting. Ah, well; at least it's not boring:).


Lunar.....