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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 morgan26 on June 26, 2002, at 11:16:26
Has anyone had problems when taking Effexor (or other SSRI's) and Ritalin together?
I have been on Effexor XR for 2 years with excellent results at a relatively low dose (75 mg QD). My doctor started me on Concerta (Ritalin) 2 weeks ago and I am now having recurrence of all symptoms that were present before I started the Effexor (crying, low-level anxiety, mild paranoia).
Has anyone had this problem? Does increasing the SSRI help? I am going to be forced to stop the Ritalin if I cannot resolve this, which would be a shame since it seems to be helping with attention issues...
Posted by katekite on June 26, 2002, at 18:29:41
In reply to Problems with Effexor and Ritalin together?, posted by morgan26 on June 26, 2002, at 11:16:26
Sometimes crying indicates too high a dose of ritalin. If you are taking concerta the lowest concerta dose is 18 mg which is about equivalent to 5mg of regular ritalin 3 times a day.
You could try going to the regular ritalin and take just 2.5 mg three times a day to see if that helps. Not everyone needs the same dose.
Or you could try Adderall or dexedrine which may be better, just start at a very low dose.
About 20% of people with ADD are not helped by the traditional stimulants.
If it turns out you try a good dose of all the main stimulants and they make you too anxious, you might try atomoxetine when it comes out (supposed to be the new cool non-stimulant ADD drug, maybe out this fall or next year).
Have you ever tried Wellbutrin?
kate
Posted by Fuscia on June 27, 2002, at 15:00:28
In reply to Problems with Effexor and Ritalin together?, posted by morgan26 on June 26, 2002, at 11:16:26
Hi,
Why did your doctor add the Ritalin? Oh, okay, attention problem from the Effexor XR.
Why not try decreasing the Concerta?
Your attention problem might be fixed by increasing the Effexor dose without the addition of Ritalin. This will increase the effects of drug on norepinephrine and dopamine transmitters. At low Effexor dose serotonin is main transmitter tweaked.
Personally, I find that a cup of hot tea does the trick. Green, semi-fermented, or black - doesn't matter. I'm taking name brand Prozac, 20mg twice weekly. My attention span was much worse while taking low dose of Zoloft (25mg), and then Celexa (20mg).
You might consider the following supplements that help with brain function: Vitamin B complex, 50mg or 100mg ratio.
Coenzyme Q10, 30mg. Coenzyme Q10 is oil soluble and is best absorbed when taken with oily or fatty foods. A liquid or oil form combined with a small amount of Vitamin E is preferable. Wal-Mart sells a very good product called Twinsorb CoQ10 from Twinlabs.The best to you, Fuscia
Posted by morgan26 on June 28, 2002, at 7:38:47
In reply to Re: Effexor and Ritalin together?, posted by Fuscia on June 27, 2002, at 15:00:28
Thanks to both who responded.
In answer to the first, I have tried Wellbutrin with disastrous results. Crying constantly, unable to leave the house. Kept telling the doc it was not working and he kept increasing the dose. Did not realize the Wellbutrin was actually the problem until I missed a dose and felt a thousand times better. Switched docs right away. Also, tried Adderall two years ago - extreme agitation, unable to sleep for three days, significant physical tremors, and withdrawal symptoms at the end of the day. Scared me so much I was not willing to try the Ritalin until recently when I started having problems at work and was thinking of going back to school. Suggestion about the non-XR formulation is a good one - he did give me a script for both in case I needed a "boost" in the latter part of the day. Maybe I will try just that.
In response to second, Ritalin was for attention problems separate from Effexor, but never tried increasing the Effexor more because sexual side effects were bothersome and 75 mg seemed to do the trick. This was why I was wondering about known interactions - if Ritalin deactivates the Effexor, dose increase of the Effexor might be a nice compromise. Can't go any lower on the Concerta (18 mg is the lowest formulation and the way the sustained release works means you cannot break the tabs), but as above, I may try the short acting variety. Will look into the vitamins as well.
Thanks to all for the thoughts.
This is the end of the thread.
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