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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by g_g_g_unit on January 20, 2011, at 5:21:08
I apologize if this has been covered, but I tried searching the archives and there didn't seem to be much general information on the combination of the two .. I am just trying to gather as much information as possible before seeing my psychiatrist again.
What I am curious about is whether stimulants (particularly amphetamine) made SSRIs tolerable (particularly for ADD patients) where they might have not been otherwise?
The reason I ask is because I tried several of the more reputedly calming SSRIs (Paxil, Luvox, Lexapro) for OCD prior to being diagnosed with ADD and found them extremely intolerable (I felt foggier, more inhibited, etc.).
From my research, it seems like Zoloft might be the best from the vantage point of cognition and vigilance, but I'm worried it might be too stimulating in combination with amphetamine.
So, I thought it might be best to return to something like Lexapro but I am curious how far stimulants go towards offsetting the negative s/es?
Posted by floatingbridge on January 20, 2011, at 13:21:27
In reply to combining stimulants with SSRIs, posted by g_g_g_unit on January 20, 2011, at 5:21:08
In my experience, yes, the stimulant overcame the brain fog. I get BF terribly.
fb
Posted by creepy on January 20, 2011, at 14:00:24
In reply to combining stimulants with SSRIs, posted by g_g_g_unit on January 20, 2011, at 5:21:08
This combo is used fairly often, especially with ADD + depression.
Unfortunately, stimulants lose their AD effects after some time. Its a little better with weekend breaks, Ive found.
Posted by g_g_g_unit on January 20, 2011, at 22:06:59
In reply to Re: combining stimulants with SSRIs » g_g_g_unit, posted by floatingbridge on January 20, 2011, at 13:21:27
> In my experience, yes, the stimulant overcame the brain fog. I get BF terribly.
>
> fbDid stimulants help overcome the numbing/zombiness?
Posted by Christ_empowered on January 21, 2011, at 10:58:43
In reply to Re: combining stimulants with SSRIs » floatingbridge, posted by g_g_g_unit on January 20, 2011, at 22:06:59
In my limited experience taking stimulants (mostly Adderall) with antidepressants (usually an SSRI, sometimes Tofranil-PM), I found the combo was pretty helpful.
The stimulants seem to help overcome the antidepressant-induced "blahs". I also noticed that the antidepressant seemed to mellow out the effects of the stimulant a bit, so there wasn't as much of harsh on/off feeling as I had when I took the stimulants w/o an antidepressant.
The combo does raise the risk of serotonin syndrome a bit, so be aware of that. I believe that psychiatrists call adding an upper to antidepressants "dopamniergic augmentation."
Good luck!
Posted by floatingbridge on January 21, 2011, at 11:17:53
In reply to Re: combining stimulants with SSRIs, posted by Christ_empowered on January 21, 2011, at 10:58:43
C_E,
I never knew that, esp the lingo.
ggg, don't know how severe your fog, but it worked for me.fb
Posted by g_g_g_unit on January 21, 2011, at 18:33:01
In reply to Re: combining stimulants with SSRIs » Christ_empowered, posted by floatingbridge on January 21, 2011, at 11:17:53
Thanks FB and Christ_Empowered..
My brain fog is pretty bad, and so is my motivation, but what I was particularly interested in is whether stimulants offset the *emotional* numbing on SSRIs, i.e. was it possible to feel more pleasure in things on the combination than on SSRIs alone?
Posted by floatingbridge on January 21, 2011, at 18:56:04
In reply to Re: combining stimulants with SSRIs, posted by g_g_g_unit on January 21, 2011, at 18:33:01
For me, yes, absolutely. Until it wears off....
I would be interested in vyvnase (personally). Haven't tried it.
Best.
Posted by g_g_g_unit on January 21, 2011, at 20:33:58
In reply to Re: combining stimulants with SSRIs » g_g_g_unit, posted by floatingbridge on January 21, 2011, at 18:56:04
> For me, yes, absolutely. Until it wears off....
>
> I would be interested in vyvnase (personally). Haven't tried it.
>
> Best.Thanks for all your help fb! One final question (I promise): do you mind telling me which SSRIs you tried in combination with stimulants, and which was your favorite combination overall?
Posted by floatingbridge on January 22, 2011, at 1:08:49
In reply to Re: combining stimulants with SSRIs » floatingbridge, posted by g_g_g_unit on January 21, 2011, at 20:33:58
ggg,
I don't mind answering questions at all; besides it's you :)
I have only tried one stimulant, dexedrine in SR capsules and IR tabs. Both generic and brand. I've decided on brand 'spansules' by gsk and generic tabs.
(Does provigil count? I didn't like it.)
Let's see. With pristiq, cymbalta, prozac, lexapro and abilify, strattera.
The best run was with pristiq.
What are you thinking about combining?
Many on board like adderall. I am interested in vyvnase. Dex can create peaks, valleys, and irritable crashes for me, hence the spansules.
Good luck! Doesn't seem like you've gotten many experiences here. It'd be nice to here from others about adderall or vyvnase.
Posted by g_g_g_unit on January 23, 2011, at 6:16:30
In reply to Re: combining stimulants with SSRIs » g_g_g_unit, posted by floatingbridge on January 22, 2011, at 1:08:49
> ggg,
>
> I don't mind answering questions at all; besides it's you :)Thanks, I'm flattered =)
>
> I have only tried one stimulant, dexedrine in SR capsules and IR tabs. Both generic and brand. I've decided on brand 'spansules' by gsk and generic tabs.Well, Dexedrine IR is the only amphetamine-type stimulant available in Australia (Ritalin and its various analogues didn't agree with me).
>
> (Does provigil count? I didn't like it.)>
> Let's see. With pristiq, cymbalta, prozac, lexapro and abilify, strattera.
>
> The best run was with pristiq.
>
> What are you thinking about combining?Hmm, well to date I've tried Prozac (couldn't sleep), Lexapro (felt foggy and numb) and Luvox (pretty similar to Lexapro).
I would like to try Zoloft or maybe Pristiq, but I thought they might be too stimulating for my OCD, especially in combination with amphetamine. The problem is that the more sedating SSRIs do my ADD no favors, which is why I'm wondering if stimulants might offset the side-effects.
Did you find Pristiq quite gentle on the whole?
>
> Many on board like adderall. I am interested in vyvnase. Dex can create peaks, valleys, and irritable crashes for me, hence the spansules.
>
> Good luck! Doesn't seem like you've gotten many experiences here. It'd be nice to here from others about adderall or vyvnase.Thanks . . yeah, I guess I was interested in the dynamic of AD-stimulant combinations overall, but like I say, the only amphetamine available here is Dexedrine.
Posted by floatingbridge on January 23, 2011, at 16:45:12
In reply to Re: combining stimulants with SSRIs » floatingbridge, posted by g_g_g_unit on January 23, 2011, at 6:16:30
ggg,
Pristiq was 'gentle' for me. More that effexor and cymbalta (!) for sure.
I'm rethinking zoloft. Folks have been mentioning it again. That was my first med (nostalgia factor) which was pleasant but also stupifying. I cold-turkeyed it. I did dumb things at the
beginning of my treatment. I didn't have a stimulant on board.It would be easier to try zoloft first, and if you weren't satisfied, bump 'up' to pristiq, then cymbalta. That's the rock, paper, scissors order imho :)
fb
Posted by g_g_g_unit on January 24, 2011, at 0:56:41
In reply to Re: combining stimulants with SSRIs » g_g_g_unit, posted by floatingbridge on January 23, 2011, at 16:45:12
Thanks fb! Zoloft seems to be a really common 'first love'/gateway med from what I've picked up . .
I appreciate the algorithm you've designed for me. I'll see what my psychiatrist has to say on Friday.
Be well. .
> ggg,
>
> Pristiq was 'gentle' for me. More that effexor and cymbalta (!) for sure.
>
> I'm rethinking zoloft. Folks have been mentioning it again. That was my first med (nostalgia factor) which was pleasant but also stupifying. I cold-turkeyed it. I did dumb things at the
> beginning of my treatment. I didn't have a stimulant on board.
>
> It would be easier to try zoloft first, and if you weren't satisfied, bump 'up' to pristiq, then cymbalta. That's the rock, paper, scissors order imho :)
>
> fb
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