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Vyvanse (lisdexamfetamine dimesylate)

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  #1  
Old 01-12-09, 09:58 AM
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Vyvanse + Lexapro. What's the point??

I've experience anxiety and depression for a very long time along with ADD. Vyvanse was a miracle drug for me but after about 3 hours after I would take it, my anxiety would be in full swing. Vyvanse helped me get things done and stay ontop of things. It was amazing how much Vyvanse was helping, but the anxiety was pushing me over the edge.

My Dr, added 5 mgs (a very small dose) of Lexapro at night and it's helping me wonderfully. Now, it's counteracting my Vyvanse. I'm feeling too calmed and relaxed (along with being tired) and now I feel like my Vyvanse is a joke. I'm on 70mgs of Vyvanse and there's no way she'll bump it up until a higher dose is FDA approved.
I'm just feeling so frustrated and down because I feel like nothing is going to ever do the job. I wish I could have just had the best of both worlds: the motivation of the Vyvanse to get things done and the help from Lexapro to just relieve the anxiety.

This is just so frustrating. Why do I even try to fix myself??
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Old 02-25-09, 12:08 PM
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Re: Vyvanse + Lexapro. What's the point??

Yea i am going back to vyvanse 50mg, and taking klonopin for anxiety, its seems as anxiety is my main issue it turns out. So i am going to consult my doctor about it. He put me on 10mg lexapro have not taken it yet because he has to diagnose to insurance or something i dont understand that part.

But i feel the same way
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Old 02-25-09, 02:39 PM
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Re: Vyvanse + Lexapro. What's the point??

I take 50mg of Vyvanse, which I think will probably be bumped up to 70, and 20mg Lexapro 1x daily, and 2mg Klonopin 3x's a day for anxiety. When I first started Vyvanse I was amped up and very alert. Now I'm starting to feel tired again. I don't have as many anxiety attacks as I used to, but sometimes when the Vyvanse wears off I feel irritable and cranky. I would like to get off of the Lexapro or at least decrease the dosage and see what happens. I don't think I'm relaxed at all except when I take the Klonopin, which sometimes makes me sleepy. I might need to cut that down also. I'm also still very unmotivated to do things. Maybe I should say, my mind is motivated to do things, but my body isn't. Does that make sense?
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Old 02-25-09, 02:57 PM
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Re: Vyvanse + Lexapro. What's the point??

It just may take some time for your body to get use to the change to the Lexapro. It may be a small 5mg dose but your body has never had that chemical in that system before. I would give it at least 2 to 4 weeks and see how you do. If you are still feeling the same after 2 to 4 weeks than speak to the doctor about alternatives, but I'm glad you are feeling anxious free on Lexapro. I know Lexapro to be a great anti-anxiety agent as I use to take it. I can no longer take it as I had a manic episode from it. In regards to Vyvanse, I've never taken it, so I cannot comment on that medication...
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Old 02-25-09, 03:17 PM
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Re: Vyvanse + Lexapro. What's the point??

Are you looking for clarity and improved attention from Vyvanse or are you looking for the energy from speed? There is a difference. Just because you don't feel the speediness doesn't mean it's not helping attention. And... it can take a couple months for you body to adjust to Lexapro. If you still have attention problems and issues with the med, talk to you doc then.
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Old 02-25-09, 05:38 PM
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Re: Vyvanse + Lexapro. What's the point??

am on vyvanse and lexapro 20mg, lexapro takes care of GAD type anxiety for me, it does take a LOOONG time for Lexapro to settle in your body, took me like 3 months I think

oh by they way sometimes I taken up to 120mg of Vyvanse....since its about less than half d-amp...or i sometimes take 60mg Vyvanse in AM and 20-30 Adderall IR in afternoon, depends on the day

check with your doc, am not implying take more of anything, everyone is different
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Old 02-25-09, 06:25 PM
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Re: Vyvanse + Lexapro. What's the point??

I take Lexapro 20 mg a day with Adderall IR 60 mg a day. I didn't notice the Lexapro decreasing the effects of the Adderall. In fact, from drugdigest.org:


LISDEXAMFETAMINE (in Vyvanse) may interact with ESCITALOPRAM (in Lexapro Tablets)
Although the cause of this potential interaction is not clearly understood, escitalopram may increase the effects of lisdexamfetamine. This could cause an increase in side effects including irritability and depression, restlessness, and anxiety. Other more serious side effects include an increase in blood pressure, a rapid heart beat, and an abnormal heart rhythm. If these two medications are used together, your doctor may want to monitor you closely for side effects and adjust the dose of either drug if needed.Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.
This interaction is poorly documented and is considered moderate in severity.


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Old 02-25-09, 11:28 PM
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Re: Vyvanse + Lexapro. What's the point??

scarletta, that's pretty cool. Never heard that lex may actually boost vyvanse, good to know though.
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Old 02-26-09, 08:31 AM
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Re: Vyvanse + Lexapro. What's the point??

Actually, I've read the opposite that Celexa/Esc (SSRI's in general) down regulates the effectiveness of Dex/Lex/AMP by reducing the number of available dopamine receptors to compensate for the body's adjustement of necessary available Seratonin ones. Therefore, a lot of seratonin less, but available dopamine for the Dex/Lex/AMP/Adderall to affect. If you research on the Inet you'll find articles that point this out.
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Old 02-26-09, 08:29 PM
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Re: Vyvanse + Lexapro. What's the point??

i've read the opposite, that celexa/lexapro in particular dont bind to the "whatever code" receptor that other SSRIs do and hence doesnt affect amphetamine effectiviness

you can search in here there are a few older posts on it....

I say is trial and error...unfortunately....
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Old 03-03-09, 05:41 PM
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Re: Vyvanse + Lexapro. What's the point??

There is literally a plethora of research on the web stating that Prozac, for example (one of the most potent CYP2d6 inhibitors) potentiates d-amphetamine. Quinine is another strong one. A weaker one is cimetidine (Tagamet). These work by inhibiting the ability of the CYp2D6 enzyme to break down the dopamine that is "leftover" in the brain.

Amphetamine works in three ways, by blocking the reuptake of dopamine and norepinephrine, by reversing the DAT transport and sucking out dopamine from their stores, and by inhibiting enzymes which serve to break down leftover dopamine in the synapse. MAO inhibitors do the same thing, for example, Selegiline, or Deprenyl, should not be used with amphetamine (or ritalin for that matter) because it stops the breakdown of those drugs. Your receptors already will be flooded with dopamine, it could be dangerous to inhibit the breakdown, and thus, the getting rid of, that dopamine. Too much.

The CYP2D6 enzyme, they theorize, is the one responsible for breaking down or getting rid of amphetamine in the brain synapse. Interference from a CYP2D6 inhibitor such as Prozac will prevent that breakdown from taking place as quickly, thus potentiating the amphetamine. It's not necessarily that you can't take them together, it's that your doctor should be aware of the risks of the combination.

Check this out: "Based on well-documented research of rat metabolism of amphetamines on CYP 2D1, and on this clinical presentation, one is lead to the conclusion that amphetamine salts are metabolized to some extent by CYP 2D6. This report demonstrates what appears to be a significant drugdrug interaction due to enzymatic inhibition of metabolic clearance by paroxetine, which caused a relative accumulation of amphetamines and resulted in trichotillomania. A resolution of symptoms was seen when an antidepressant that does not significantly inhibit CYP 2D6 was combined with a lower dose of mixed amphetamine salts."

from http://www.primarypsychiatry.com/asp...?articleid=327

And from wikipedia, it lists contradindications:

"CYP2D6 (liver enzyme) inhibitors, e.g., most SSRIs such as fluoxetine, citalopram, paroxetine, etc. Some anti-psychotics such as thioridazine, haloperidol, and, levomepromazine. The stimulant cocaine. Methadone, a opioid analgesic and anti-addictive. There are additional drugs that inhibit CYP2D6, it is important to find out if any medication or drug that is being taken is a CYP2D6 inhibitor. Taking a CYP2D6 inhibiting drug along with Adderall (amphetamines in general) will lead to a elevated level of Adderall in the system and the drug will also remain longer in the body, this can lead to undesired or possibly serious side effects. "
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Old 03-03-09, 07:41 PM
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Re: Vyvanse + Lexapro. What's the point??

If you are getting anxious when the drug starts wearing off in the afternoon, the dose is probably too low. My doctor won't go over 70mg either, but he didn't have a problem with prescribing a small Adderall IR booster dose for the afternoon, which basically eliminated this problem for me. It's a pretty common solution.
Good luck.
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