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Adderall (four amphetamine salts)

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Old 04-19-09, 11:49 PM
Josh177 Josh177 is offline
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Adderall and 2D6 enzyme SSRI interaction?

I read on thread somewhere here on the boards and also on a couple of other sites, speaking of an interaction between some SSRIS and Adderall (rather amphetamines in general). Something about an interaction due to the 2D6 enzyme.

Although I couldn't get any exact answers as to what this interaction CAUSES. It says that SSRI's (mostly Prozac and Paxil) effect the 2D6 enzyme along with amphetamines, therefore taking Adderall along with certain SSRI's, such as Prozac, can cause Adderall to "build up in the system".

So does that mean taking prozac will INCREASE Adderall's effectiveness, due to it not metabolizing properly, you therefore have higher levels in your system than you really should? For example, since your body isn't properly metabolozing the Adderall, it really "builds up" in your system, causing adderall to be "overly effective", therefore causing side effects similar to that of too high of a dose?

Or does it mean that taking prozac will DECREASE Adderall's effectiveness, since Adderall isn't being properly metabolized and broken down in the body, therefore you are in reality getting LESS Adderall in your system, therefore it makes it less effective.

I wasn't sure which of the two it causes. I'm going to ask my doctor next appointment, too. But one thing I noticed - the Adderall lost some effectiveness only about 4-5 days after using it. Also started to become quite tired in general. But before I even started, I was on Prozac 20MG for about 7 weeks. So I was wondering, maybe it's the prozac to blame, that is, assuming it decreases Adderall effectiveness.
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Old 04-20-09, 01:50 AM
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Re: Adderall and 2D6 enzyme SSRI interaction?

In the liver there lives an enzyme called 2D6. This enzyme, among others, is one of the enzymes that breaks down most drugs (Adderall, Prozac et al).

If your body has too much of this enzyme, you break down the drugs and flush them out of your system too quickly.

If you have very little of the enzyme, you don't break down the drugs, and instead get very ill very quick on the drug as your body doesn't break it down, and instead accumulates in your system.

If you only have half of the regular amount of 2D6 in your liver, then you'll metabolise half of the drug and feel fine for about a year or so, until you get very sick, because the drug has accumulated slowly in your system.

Now with that said, certain drugs can inhibit 2D6. A list I find are:
amiodarone, chloroquine, cimetidine, citalopram(weak), codeine, delavirdine, dextropropoxyphene, doxorubicin, fluoxetine, fluphenazine, fluvoxamine, haloperidol, lomustine, methadone, mibefradil, mirtazapine(weak), nefazodone, norfluoxetine, norfluvoxamine, paroxetine, perphenazine, primaquine, propafenone, propranolol, quinidine, ritonavir, sertraline(suspected), sildenafil(weak), thioridazine, ticlopidine, venlafaxine, vinblastine, vinorelbine, yohimbine.

from (http://www.smbrower.com/mediawiki/in...2D6_Inhibitors)

So yes, Prozac (fluoxetine) is an CYP2D6 inhibitor (along with Celexa, Viagra, Paxil, Luvox, ...)
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Old 04-20-09, 04:39 AM
jeffpuffer jeffpuffer is offline
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Re: Adderall and 2D6 enzyme SSRI interaction?

Some of the SSRI's inhibit the enzyme that metabolizes amphetamine. This means that more amphetamine will build up in your system before it is metabolized, thus causing an increased effect. Depending on your SSRI dosage and your amphetamine dosage, this can be extremely dangerous.
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Old 04-20-09, 08:45 AM
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Re: Adderall and 2D6 enzyme SSRI interaction?

so us on here that take both Adderall AND an SSRI, what should we do? Are there any other SSRIs that won't do this?
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Old 04-20-09, 01:14 PM
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Re: Adderall and 2D6 enzyme SSRI interaction?

amphetamines and SSRIs complement each other nicely in most cases....is not as bad as jeffpuffer puts it...our neuro chemistry is a lot more complicated that just interaction with an enzyme (actual name is CYP2D6), otherwise we would have figured out all diseases by now.....

it depends on YOU and YOUR chemistry and how it works for YOU.....still trial an error with advice of your doctor unfortunately.... I take Lexapro (escitalopram) with Vyvanse and is by far best combo i've tried, but still not perfect, i never expect it to be perfect
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Old 04-20-09, 01:26 PM
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Re: Adderall and 2D6 enzyme SSRI interaction?

would lexipro have less of an interaction then Paxil or Pexeva?
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Old 04-20-09, 06:09 PM
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Re: Adderall and 2D6 enzyme SSRI interaction?

I took lexapro and it didn't have a noticeable effect on the adderall. This could be because lexapro isn't metabolized by CYP2D6 even though its sister molecule citalopram is. SSRI's also decrease dopamine in the brain, overall, so a stimulant may not work as effectively when you take lexapro since lexapro won't lead to higher-than-normal blood levels of stimulants.
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