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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by jerryTRD on October 18, 2010, at 5:03:24
Months ago I switched from Lexapro to Effexor thinking the "dual" action of Effexor might help me better with motivation. At the same time I was started back on Adderall. I began Effexor XR at 150mg and stayed at that for about 3 months. Then my doc added Adderall 20mg IR 3x daily which is what I have been taking for years.
I was doing great - the Adderall was working again and had relatively few problems minus some insomnia. So the doc added Seroquel which I've been on before as well.
In the past month and a half my doc has increased my Effexor XR to 225mg and since then my blood pressure has gone up, I'm having a horrific time sleeping - even with the Seroquel, I've been nauseated and having a lot of bowel problems (IBS) including a lot of diarrhea.
Adderall has never had any of these effects on me. But I have taken Effexor in the past and it has increased my blood pressure and heart rate and caused nausea. I feel as if I'm overstimulated because of the Effexor - NOT because of the Adderall.
Here's my current med cocktail:
Effexor XR 225mg
Adderall IR 20mg 3x daily
Klonopin 1mg 3x daily and then 2mg at night
Seroquel 200mg XR
Seroquel 100mg IR if needed for sleep/insomniaI'm also on Synthroid 125mcg
So here it is 5am and I'm wide awake and pulling my hair out. My last dose of Adderall was at 3pm.
Basically what happens is I set my alarm to go off at 8am, I take my Effexor, Synthroid, and Adderall - then go BACK to sleep because I've usually been up like tonight until the wee hours of the morning. Then I wake up around noon and I take my 2nd dose of Adderall and then my 3rd around 3pm. By then I'm completely nauseated and in the bathroom with diarrhea. I never had this problem with the same amount of Adderall +SSRI like Lexapro.That's what leads me to believe it's the Effexor.
I want to ask my doc to switch me back to Lexapro as I have never had diarrhea or nausea from it but I'm afraid he'll think the overstimulation is due to the Adderall and either reduce the dosage or take me off it. Adderall is the one med that keeps me going. I've already tried cutting the dosage down (of Adderall) but doesn't seem to help.
Like I said this has never happened with Adderall +SSRI and currently with the Effexor + Adderall it's gotten out of hand and is effecting my daily life - getting out, going to support groups, grocery shopping, etc.
What do you guys think??
Thanks
Jerry
Posted by Phillipa on October 18, 2010, at 11:03:08
In reply to Effexor + Adderall = overstimulation? Help!, posted by jerryTRD on October 18, 2010, at 5:03:24
Hopefully the synthroid as you wrote in below thread and other problems will help this as well. Not too many changes at once. Phillipa
Posted by creepy on October 18, 2010, at 22:28:09
In reply to Re: Effexor + Adderall = overstimulation? Help! » jerryTRD, posted by Phillipa on October 18, 2010, at 11:03:08
Its the NRI in effexor kicking in at that higher dose I bet. Beyond a point it stops increasing serotonin and works to boost norepinephrine levels. unwanted adrenergic effects like increased heart rate and BP can happen when you boost NE.
When you combine that with adderall its no wonder its too much. And at 3x a day? wow. I do 10mg at 8am and 10mg at 12pm. Sometimes a little more in the morning. Much more than that and im on a mood rollercoaster.
I wonder if something like prazosin might help you sleep? Id be wary of blood pressure ups and downs that might cause headaches though.
Posted by bearfan on October 18, 2010, at 23:51:25
In reply to Effexor + Adderall = overstimulation? Help!, posted by jerryTRD on October 18, 2010, at 5:03:24
20mg 3x a day as in 60mg adderall daily? That is quite a lot. You may to think about going to the xr version on a lower dose or something like vyanse. Effexor does a lot and can be overstimulating especially when adding stimulants to the mix.
Posted by jerryTRD on October 19, 2010, at 12:39:35
In reply to Re: Effexor + Adderall = overstimulation? Help!, posted by bearfan on October 18, 2010, at 23:51:25
> 20mg 3x a day as in 60mg adderall daily? That is quite a lot. You may to think about going to the xr version on a lower dose or something like vyanse. Effexor does a lot and can be overstimulating especially when adding stimulants to the mix.
I used to be on the XR form until my insurance stopped covering it. now I'm stuck with the IR form.
Posted by jerryTRD on October 19, 2010, at 12:42:19
In reply to Re: Effexor + Adderall = overstimulation? Help! » bearfan, posted by jerryTRD on October 19, 2010, at 12:39:35
I talked to my pdoc about this and he agreed that there might be some overstimulation especially with the Effexor's adrenergic effects. So he lowered my Effexor down to 150 and added lexapro 10mg and has me tapering off the Effexor slowly.
Posted by jerryTRD on October 19, 2010, at 12:43:53
In reply to Re: Effexor + Adderall = overstimulation? Help!, posted by bearfan on October 18, 2010, at 23:51:25
> 20mg 3x a day as in 60mg adderall daily? That is quite a lot. You may to think about going to the xr version on a lower dose or something like vyanse. Effexor does a lot and can be overstimulating especially when adding stimulants to the mix.
I've been on 20mg 3x daily for years. It's been the perfect dose for me. I agree it may be too much in this situation - but I think getting rid of the Effexor will help greatly.
Posted by utopizen on October 20, 2010, at 1:30:42
In reply to Re: Effexor + Adderall = overstimulation? Help!, posted by creepy on October 18, 2010, at 22:28:09
> Its the NRI in effexor kicking in at that higher dose I bet. Beyond a point it stops increasing serotonin and works to boost norepinephrine levels. unwanted adrenergic effects like increased heart rate and BP can happen when you boost NE.
>>>I've found taking Effexor + a stimulant product an effect that neither drug alone creates-- they ultimately do in fact bounce off one another, uniquely working stuff that is being re-uptaked and then re-uptaking that, who knows; but it is potentiation.
You may do well by first going to the smallest dose possible with Adderall; 90mg/day is high when you're not on anything at all.
Effexor taking in the morning alone is not going to make you feel amphetamine toxicity (frankly, that's what is going on when you describe 2am non-sleeping). If you don't believe me, go a day without Adderall, and you will sleep just fine...
Anyhow, you need to just exercise to potentiate the Adderall, vigorously, for 30 minutes/day. Most people don't do this, so they think upping their dose to 90mg/day is going to help their cause. It doesn't exactly decrease BP, so, yeah.
As for serotonin: not sure where that's coming from... Dopamine + SE at the higher levels both kick in; it's not one or the other... it's just the dopamine re-uptake isn't terribly substantial at the lower doses 150 and below.
Many have success with going off stimulants by simply taking 225-300mg of Effexor...
This is the end of the thread.
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