Dex & SSRIs/SNRIs

[getonline33]

Hello. Does anyone have any experience in taking Dex along with multi selective reuptake inhibitor antidepressants? I took Adderal in the summer (30mg, 3x/day) when I was taking Welbutrin. I was able to focus great. At work, I could start writing a report and stay intently focused on it for hours. At home, I would mow the lawn, then not stop until it was perfect.

However, I took a break from the meds for about 3 months. Now, I'm taking 60 mgs of Cymbalta (similar to Effexor - hits serotonin & neopenephrine), and 60mgs of dex (30/20/10) per day (after reading other posts, I should add that these are barr 10mg generics). However, I feel very few mental effects of the dex. The physical effects are certainly there (increased heartbeat/dry mouth).

I'm surprised because from what I've read on these boards, 60mgs per day is no insignificant amount. Could the differences on how each (adderal/dex) work on my body be that great? Or is it more likely that the Cymbalta's effects are somehow blocking the full therapeutic effect of the dex? Should I give moving back to Adderall a try as a more valid test to compare against my original - and successful - 'control' situation?

Any thoughts are welcome.

Also, I've seen another mention of someone using Trazodone to help in sleeping when dex induced insomnia hits. Is this typical? Traz is a mood stablizer, boosting serotonin (the side effect happens to be extreme drowsiness). Why not prescribe a GABA active drug like a benzo or Ambien? The Traz left me groggy in the morning and with a headache. No more of that (interesting side effect fact - 1 in 6000 men will experience priapism; an erection that doesn't go away and may require surgery...first thing I did when I woke up after taking it was to look under the sheets...I was ok.)

Eric
Seattle

[Gregster]

Wellbutrin is stimulant like, so perhaps it in combination with the Adderall worked better than the Dexedrine and Cymbalta because of the additive stimulant effect? I haven't tried cymbalta but I take an SNRI called Remeron and find it works great with the Dex I take. It induces sleep quite well too, so it helps me with my insomnia.

[KnittingJunkie]

Insomnia? What's that? Good God, I need sleep. Maybe it's time to take some Xanax.

[Temoigneur]

Cymbalta is known to be among the medications that inhibits the breakdown or metabolism of Dexedrine as it affects the 2D6 enzymes family which Dexedrine is mediated by. It's likely that what you're experiencing is the Dexatrine failing to be broken down because it's been blocked by the higher dose of Cymbalta. I'm not sure how it works with central peripheral nervous system, bit it's possible that the drug could fail to be broken down in a way that it could reach your brain, and still affect your peripheral nervous system causing increased heart rate and other symptoms you've mentioned. A fantastic book, in my opinion that talks all about getting measured, targeted and effective ADD treatment with medications, is ADHD the rules by Dr. Charles parker. In the book he talks about drug interactions, and affirms that depression often exists with adult ADHD, and may require drug treatment. He goes on to give a list of safe and unsafe antidepressants as far as their likelihood to interact with stimulants. Safe antidepressants include Effexor, Luvox, Celexa, and a couple others, while Cymbalta and Wellbutrin show moderate potential for interaction. Prozac and Paxil show high potential for interaction with stimulus and should never be used concomitantly. Hope that helps