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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by sn00ty on November 26, 2020, at 22:02:12
I recently switched my anti-depressant (treatment for anxiety/ocd) from clomipramine to luvox due to side effects. I noticed an immediate reduction in overall effectiveness from my morning vyvnase and late afternoon adderall doses. I have spent hours scouring the internet and have come across one or two reports of similar experiences but no peer reviewed research studies of any kind that validate my experiences. I understand that luvox (fluvoxamine) is a strong sigma-1 receptor agonist which as I understand can interact with the dopaminergic system in some way. Additionally research I have read showed that using a powerful sigma-1 agonist was found to reduce the dopamine release from methamphetamine. Link to that study https://www.nature.com/articles/s41467-017-02087-x
Given that fluvoxamine is a strong sigma-1 agonist, could this be what is reducing the effectiveness of my adhd stimulant meds? Has anyone else experienced similar effects from luvox or other ssri's like Fluoxetine (prozac) that is another sigma-1 agonist, or others? Thanks.
Posted by rjlockhart37 on November 27, 2020, at 18:10:01
In reply to Luvox reducing effectiveness of Vyvanse/Adderall?, posted by sn00ty on November 26, 2020, at 22:02:12
fluoxtine is stimulating because it his norepinephrine, and it also enhances amphetamine. I read that in article years ago. But mainly is because of it's norepineprhine, its mainly serotonin but there is some noradrenaline activty. When i took prozac with dexedrine and vyvanse, i was on them at seperate times, it boosted the mood better and added to the NE kick
that's all i know, and can say
Posted by rjlockhart37 on November 30, 2020, at 21:04:47
In reply to Luvox reducing effectiveness of Vyvanse/Adderall?, posted by sn00ty on November 26, 2020, at 22:02:12
i don't know howw to scientifally explain it, but yes luvox is strong serotonin AD, it could lower the feeling of amphetamines because of excess serotonin
Posted by Christ_empowered on December 1, 2020, at 14:30:39
In reply to Luvox reducing effectiveness of Vyvanse/Adderall?, posted by sn00ty on November 26, 2020, at 22:02:12
luvox tends to be sedating and more apathy-inducing than, say, prozac...
so this makes sense. one reason ssri drugs are so commonly used in ocd and also in depression with ruminations is because of the apathy/emotional numbing factor. true story.
i don't know what to suggest. no one wants to switch meds constantly. prozac can be a good treatment for some people. half life is very long, though, so do be aware of that.
ssnri? maybe? cymbalta, pristiq..effexor xr...i dunno, the pro is that there's generally less sedation, a bit of help with concentration and energy to offset apathy, lethargy...
one -big- drawback is that discontinuation can be much, much worse than with many ssri drugs, and no one can tell you, beforehand, if drug x will meet your needs with fewer adverse effects than drug y, so...
there's that. doctors do sometimes add wellbutrin when ssri treatment presents serious problems, but...with both the luvox and an amphetamine on board, id be concerned about drug-drug interactions and the general risk of over-medication, etc.
i seem to recall a poster or two on here who took...antidepressant(s) + stimulant + mirapex, and that person (people?) had good things to say. again, drug-drug interactions, all that, but...just a thought.
sorry about your situation.
This is the end of the thread.
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