Adderall and Prozac Combo

Hi. I am a guy who is 26 years old and I am taking Prozac for my problem with depression. It has helped me very much (if we deduct a few side effects). I am using Adderall as a appetite suppressor (it helped too!). I am getting nauseas and dizzy lately, and I have a feeling that Prozac has something to do with it. I am taking Aspirins too from time to time (when I am sick). Is there some interactions?

Hi. I work at a pharmacy, so I know all about drug interactions. The only interactions Aspirin has is with alcohol. You are using Prozac and Adderall at a same time-which are practically a same drug. That means you are taking it double. You should quit one of them, and report this to your doctor. Plus, watch out, because both of them, as any other antidepressants are addictive.

Where did you get the information or data that anti depressants are addictive? I need this information for a court case. The defenses medical expert said that anti depressants are not addictive.

latrena wrote:

Hi. I work at a pharmacy, so I know all about drug interactions. The only interactions Aspirin has is with alcohol. You are using Prozac and Adderall at a same time-which are practically a same drug. That means you are taking it double. You should quit one of them, and report this to your doctor. Plus, watch out, because both of them, as any other antidepressants are addictive.

Latrena, at what pharmacy do you work!?!?! The information you gave the original poster is absolutely FALSE. They are NOT the same drug.

Prozac is FLUOXETINE and an SSRI (type of anti-depressant).

Adderall is AMPHETAMINE SALTS and a stimulant (NOT an anti-depressant, but sometimes used off-label for treatment of depression).

They are EXTREMELY different drugs and have extremely different effects on the brain and body.

To the original poster, please do a Google search of drug interactions between Prozac and Adderall. There is a rare but serious risk for serotonin syndrome when mixing the two. While serotonin syndrome is treatable, it can be FATAL. Make sure your doctor(s) know about every single drug, vitamin or supplement you ingest because they are the experts and they will know what to look for when monitoring your treatment.

Latrena, just because two drugs may be used to treat the same problem it absolutely does not mean they have the same chemical profile or even that they have similar reactions within the body.

By "work" at a pharmacy, what exactly do you do there?

Research your information, even if you're 100% sure it's fact before you dispense advice to someone regarding medication! That's the ethical thing to do.

I have been on Prozac for nearly a year and in the last month started Adderall XR twice daily. I take the Prozac at 30 mgs a day for Panic Disorder and Adderall XR at 15 mgs twice a day for concentration. My Doctor prescribed this the drowsy side effects of being on Atarax for eczema and the Prozac for the panic attacks. Niether of which I can do without. It needless to say was impacting my school work greatly. The Adderall has improved my ability to function 10 fold. The side effects I experienced with Prozac was euphoric at first and overtime developed into the feeling of being in a mist of sorts, I was unable to focus. I experienced weight loss on both Prozac and Adderall. The medicines are completely different.

Adderall is a stimulant that effects dopamine and norephinephren in the brain.

Prozac effects the reuptake of seratonin in the brain.
Each of these neurotransmitters do different things.

By increasing dopamine in the brain your effecting your concentration..
Prozac and seratonin effects mood and anxiety.

They can have adverse effects on different people, they didn't for me. The improved lifestyle I live now was worth the risk. I had gone through some different SSRI's in the past and although they do the same thing, the are different chemicals and effect everyone differently. IE Lexapro made me anxious and when I drank I became violent. Prozac effects me the least, while doing its job. It is important to realize the FUNCTION of the drug is not necessarily how you REACT to it. The previous poster stating they are basically the same is completely wrong. I'd recommend however doing research on all the medicines you are on, because you are dealing with the chemistry of your brain. OH before I end this post, watch your consumption of grapefruit juice... I haven't looked into it, but I was warned by my doctor.

Wow... nice advice. Being a pharm. tech doesnt qualify you as an expert in pharmacology. Taking adderrall (a stimulant, amphetamine) along with prozac (SSRI, antidepressant) may cause a fatal drug-interaction known as Serotonin Storm (or Serotonin Syndrome, Serotonin Toxicity)... call your pharmacist and MD before taking these together.

I am currently on 40mg prozac and 30mg adderall per day. the risk of seratonin syndrome is not that high as you would need to take a LOT of adderall to produce enough seratonin to cause it. Some ppl react differently though so make sure your doctor knows what doses ur on and stuff.

anti-depressants are not addictive, you were mis-informed....

First of all, maybe you should watch what you say about "pharm. techs"..some of us actually went to school, and do possess a knowledge of pharmacology. Although it is ABSOLUTLEY not the depth of knowledge a pharmacist may possess, cpht's should not be treated as the lay person as far as medicine goes. Further more, no pharm tech should be giving falls facts about drug uses or chemical makeup. Adderall and Prozac are absolutley NOT the same drug! Thank you! That being said has anyone (with notable knowledge of medicine) heard of adderall and prozac combo. causing suicidal idealization? thanks

First off, I agree with CPHT -- and in an even broader way: there are many of us who didn't go to med school and don't have any pharmaceutical training, but can still outpace both when it comes to a specific set of issues. I'll come back to this point at the end of my note.

As noted above, Adderall and Prozac are entirely different drugs, from entirely different lines of chemical and pharmacological development. They do not operate in the same way, nor are they generally used to treat the same specific set of problems (with one exception).

I'm somewhat surprised by a couple of aspects of the original questions:
1. Later developed anti-depressants extending from Prozac appear to be as effective (or more so) with side-effects that are fewer and less severe. It would be worthwhile asking your doctor about why Prozac was selected for you and whether Lexapro or Cymbalta (which are as effective as Prozac) may reduce your side-effects. In particular, Cymbalta or other SNRI's may be helpful if tiredness and soreness are aspects of your depression. SNRI's have been shown to help a wide variety chronics "myalgias" and fatigue related syndromes. With decreased fatigue and soreness, you may be able to do without an appetite suppressant.
2. There are appetite suppressants other than Adderall that have fewer side effects overall, and in particular have less interaction with other neurotransmitters including seratonin (the primary mode of operation of Prozac).
3. If medication is needed for both, I think it's worth pushing your doctor to give you a trial of bupropion (Wellbutrin), especially given your age. Bupropion can be used alone to treat non-seratogenic depression, and in combination with SSRI's (Like Prozac or Lexapro) to reduce the side affects of SSRI's by increasing the availability of dopamine and norepinephrine. Wellbutrin should help with appetite suppression with lower likelihood of increased bloodpressure and heart rate, both of which reduce your energy level.
4. (Not a formal medical opinion): If you are not doing so already, you need to get outdoor exercise. If your climate makes than impractical (like Houston in August), split them up: exercise indoors and get at least 30 minutes a day in the sun. I won't go into the long biochemistry of why this helps, but it will help your depression, the effectiveness of your antidepressant, and indirectly your appetite control. It may well reduce the needed dosage of antidepressant and/or enable you to slowly phase off of anti-depressants over time.
5. If the choice is made to leave you on Adderall, be sure you are taking Adderall/XR. Beyond it's extended release effect, many have found it to be qualitatively more effective than original Adderall.

Something to keep in mind is that the body's endocrine system has a complex set of control mechanisms. These control mechanisms result in seratonin and dopamine being set in a "reflexive" relationship. Increasing seratonin levels (Prozac) tends to decrease dopamine levels; increasing dopamine levels (Adderall) tends to decrease seratonin levels. (That's why Adderall helps reduce prozac's side effects including weight gain and sexual dysfunctions.) Because SSRI's get more press (and marketing) doctors tend to treat diagnosed depressive disorders with seratogenic drugs without establishing clearly that the depression is due to a seratonin deficit. Depression can also be due to a shortage of dopamine. In that case, treatment with an SSRI can WORSEN depression. Determining the neurochmical foundation for depressive disorders in a particular individual is difficult and time consuming. You can help that, however, by mastering your own health care.


Mastering your own Health Care

Every individual needs to understand his or her own health and health care. Assuming that you have one or more "chronic conditions" you may see your doctor every quarter, or perhaps even once a month. The average clinical visit is six minutes (thanks to our insurance system). But let's say your lucky and your primary care doc is a philanthropist and sees your for 10 minutes a visit. In total, your doc will see you 120 minutes a year -- a total of 2 hours out of the 8760 hours in a year. Your doctor gets to observe you for 1.37% of the year -- probably a lot less. Meanwhile, you get to observe you all 8760 hours.

As you probably are aware from your own medical issues, many health conditions manifest differently over time -- both over the course of days and even over the course of hours. Your doc won't see that, and unless they are particularly observant & careful listeners, they will tend to discount verbal reports of symptoms that they have not personally observed. If you are going to work effectively with your PCP as a partner in your healthcare, you need to:

1. Understand the current diagnoses
2. Understand the medications you've been prescribed
3. Be honest with yourself and your PCP
4. Understand the tests you've taken and their results.
5. Document your health.

Here are some tips on doing the above.

1/2: For most drugs and diagnoses researched, Wikipedia and RXList.com are excellent resources. In particular, Wikipedia is helpful because copious in line hypertext allows you to dig deeper into a word or topic you don't understand. Although I haven't found a problem yet with Wikipedia medical information, it is a user edited encylopedia and thus it is possible (though unlikely) to contain incorrect information. (Studies show however that scientific articles, Wikipedia is as accurate or more accurate than any other encyclopedia and is invariably more current with its information.)
Don't throw your hands up and say "I'm not a doctor, I can't understand this." Work at it. If there are things you simply can't understand, write them down and ask your doctor to explain them.

3. We human beings are imperfect, and most of us like to project that we are "less imperfect" than we really are. Vanity will not help your health care. If you got off your prozac because you didn't want to deal with the sexual side effects on your anniversary, be honest about it.

4. Most doctors are happy to share the results of bloodwork and the narrative summaries of other kinds of tests. Get these and read them. I'll admit, the average blood test report looks like gobbledygook; but with a little detective work you can figure it out. Note: Quest and some other diagnostic labs now have the capability to get your your test results electronically; ask your doctor about it.)

5. Documentation. This is EXTRAORDINARILY important, especially if a) you are battling a chronic condition; b) you have more than one chronic or acute conditions; c) not all of your symptoms are adequately explained by current diagnoses; d) you are under the care of more than one doctor; e) you take any medications (prescription or over the counter) or any vitamins/food-supplements. (If you don't fit any of the above, you're probably dead anyway.)

If your conditions a few or simple, a notebook and a "page a month" calendar will do. If they are complex, consider getting "page a day" planner. (If you use a planner for work anyway, you may be able to use it for your health notes as long as your work planner isn't available for others to look at. I don't recommend using a PDA or online planner owned by your employer -- not just for privacy issues: if you lose your job, you don't want to lose your entire health history too.) A planner that easily fits in your pocket or purse will make it more likely to be used.

The process below is designed for documenting more complex conditions; you can adjust it of yours are less complex.

At the end of the day (or after dinner) note:

1. The time you awoke, and the amount of time it took to become fully alert.

2. Any morning pain, stiffness or other morning symptoms. Rate these on a 1 to 10 scale, one being "not enough to consider an asprin for" and 10 being "give me morphine or euthanasia -- but eith one quickly"

3a. The times that you took your daily meds;
3b. Times you took non-daily meds (ie, a presribed anti-biotic or cough medicine)
3c. Times you took vitamins, food supplements

4. The times you ate and what you ate (affects medications);

5. Any exercise (time, duration and activity)

6. Pain or other symptoms which started or increased during the day (note start time, duration, severity)

7. Unusual bowel or urination observations

8. "Rate your day" ie, "Exceptionally stressful" "Very relaxing" ...

9. "Rate your reaction" ie "so stressed I nearly threw up"

10. Note what you were doing when and immediately before an increase in pain, stress or other symptoms.


At the beginning of each day (perhaps during or after breakfast), finish the previous day observations:

11. What time did you go to bed (lights off, trying to go to sleep)

12. How long did it take to go to sleep

13. Did you wake up during the night; if so, how long did it take to go back to sleep?

14. Do you remember dreaming? If so, do you remember any details.

This may seem like a lot, but you'll find that you can abbreviate most of it. It takes about 5 minutes or less in the evening and two minutes or less in the morning.

I'd recommend writing in the front or back of your notebook your often needed info, including:

* Doctors (names, specialty, addresses, phone/fax numbers, hours)
* Pharmacies (name, phone, address, fax, hours), local & mail-order
* Insurance (Company name, plan name, group id, member id, name/ssn of policy holder, all phone numbers, coverage details, a photocopy (front & back) of your insurance card.
* Diagnoses: who made them & when, current treatment(s)
* List of medications: (name -- brand & generic name, for what diagnosis/symptom, dose size, dose frequency, times of day taken, date started, date ended & why, date of last prescription)

Notes:
1. The FDA has some templates you can use to save the information on your computer and print out a copy to keep with you. http://www.fda.gov/cder/consumerinfo/my_medicine_record.htm
2. A number of online services (some of them free) have also emerged which allow you to enter the information online in a way that it can be available to an authorized healthcare provider & EMS. Be sure to research these services before putting your life medical history in there. I believe google has one such application linked to a collection of resource providers. One of the benefits of using the online systems is that they can alert you to important information (like a discovery of a drug problem) probably before you'd discover it on your own. I haven't evaluated which of them is best; : [url]https://www.google.com/health/html/tour/index.html[url] has an overveiw of the "Google Health" features. One aspect of this application I like is that it allows you to choose pre-certifed healthcare partners with whom information can be exchanged and updated automatically
3. If you are going to use electronic resources of any sort, I highly, HIGHLY recommend that you get a copy of "PortableApps" ( ) and GeekMenu ([url] https://www.google.com/health/html/tour/index.html[url] and install these on a flash memory drive that you keep on your key chain. Together, these applications a) assure that information you enter on anyweb site stays on the memory flash drive; b) assure that your data is secure if the flash drive should get lost or stolen. (As alternative to the more complex but free Geekmenu/TrueCrypt, you can buy a secure flash memory drive from BlockMaster. These drives are password protected and encrypted to MilSpec standards.]


Mike C.