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emgmin 03-04-2012 06:50 PM

OCD Medication: Cymbalta and Adderall interaction
Hi All,
I just canít seem to find any answers anywhere, so I decided to post here! I also, I am interested in seeing if there is anybody else out there that is experiencing the same problem!

I was diagnosed with ADHD about 5 years ago and I have tried multiple medications (to name a few: Vyvanse, Focalin, Metadate, Concerta, Wellbutrin, and Strattera) all of which have either been ineffective or the side-effects were so bad I had to stop taking them. Adderall is the only medication that seems to work well for me and my ADHD. Iíve been taking Adderall XR and IR off and on over the past three years (consistently since I started graduate school fall 2011). Last fall I was taking 25mg of Adderall XR and 10mg of the IR every morning with an occasional extra 10-20mg of IR throughout the day. Both Adderall XR and IR worked perfectly fine for me and I had absolutely no problems. Also note that I have been diagnosed with OCD (I think I got the official diagnosis 6 or 7 years ago). Iíve been on numerous SSRIs Zoloft, Prozac, Paxil, etc., and switched for various different reasons.

My psychiatristís told me that I could I eventually wean off the SSRI and I would be able to manage my OCD quite well using techniques learned in therapy. This has been the case for the last two years, until December 2011, when my OCD became unmanageable. I decided to go to my psychiatrist and get back on some medication that would help with the OCD and the accompanying depression/anxiety. She prescribed Cymbalta (starting initially with 30mg and ramping up to 60mg) and I stated taking it January 23rd 2012.

Initially, I had terrible nausea from Cymbalta, but after about a week the nausea went away and I thought my Cymbalta troubles were over! Skip ahead a couple of weeks, every morning, I was taking Adderall 25mg XR, 10mg IR, and 60mg Cymbalta and I began to notice changes in my focus. My Adderall seemed to almost completely lose its effectiveness (increasing the IR throughout the day didnít seem to make a difference) and (in the morning especially) I was bouncing off the walls (feeling like I couldnít contain myself in class, feelings of wanting to get out and do active things, etc.). I know Cymbalta is supposed to increase energy (or something to that extent) but I didnít even think it would effect Adderall. As soon as I realized it might be the Cymbalta causing the Adderall to be ineffective I put a call into my psychiatrist and then called my pharmacist. They both basically said the same thing: for some people, when Cymbalta and Adderall are taking at the same time the Cymbalta for whatever reason (canít remember) negates the Adderall and can make the patient feel overly jittery and unable to focus. They both suggested trying to split up the Adderall and the Cymbalta. Now I take the Adderall first thing in the morning and the Cymbalta around 2:30pm every afternoon. My psychiatrist also bumped me up to 35mg Adderall XR and told me to increase the morning IR to 20-30mg IR (amount taken as needed in the afternoon).

So it has been about a monthÖI HAVE seen some positive changes effects in splitting the two medications up, I am no longer climbing the walls, but my Adderall just isnít as effect as it used to be pre Cymbalta. Throughout a whole day I may take about 50mg IR. That is crazy to me considering pre Cymbalta I probably maxed out at about 30mg on an extreme day. When I take Adderall IR anytime after taking Cymbalta it doesnít seem to be effective AT ALL! I am so frustrated.
So here is my question (if youíre still reading): has anybody experienced Cymbalta negating Adderall XR and IR? If so please explain to what extend! Also please pass along any suggestion on how to get the most out of my Adderall and any information about the interaction of Cymbalta and Adderall! There is hardly any information about this particular type of interaction so any information would be much appreciated!

Below are the basic diagnostic, dosage, and medication facts:

Pre-Cymbalta medication and dosage:
-25mg Adderall XR in the morning
-10mg Adderall IR in the morning
-an additional total of10-20mg Adderall IR throughout the day as needed

Current Cymbalta dosage:
-60mg taken about 2:30pm

Current Adderall dosage:
-35mg Adderall XR in the morning
-20mg Adderall IR in the morning
-an additional total of 10-30mg taken throughout the day as needed

Thanks for your time and comments!

kamariinheaven 03-17-2012 01:41 AM

Re: OCD Medication: Cymbalta and Adderall interaction
Omg! I'm having the same issue! I've been searching online for two days now for
something that would explain this problem!

I tried my friends Adderall 30mg xr last November. I was basically self medicating from being depressed from the 1st trimester of my last pregnancy about three years before. It took me about a year and a half to even think that it could be depression. But what I did know was that adderall made me feel "normal" again. So I went to the doc and told him how I felt. He prescribed Cymbalta 30mg xr for depression, anxiety, & chronic pain that I've had for 6 years.

A month went by, I was happier, but still felt that something just wasn't right. He changed me to two of the Cymbalta a day. Then, I told him the following month that I had tried my friends Adderall 30mg xr and how it made me feel like "old me." He fussed about using someones prescription meds (which I completely agree with), asked lots of questions, which included my issues with committing to friendships, hating affection (hugging, kissing, touching, etc.), always thinking of 10 other things when someone is talking to me, not always understanding what someone is saying while they're giving me directions, etc. Most of it I'd just chalked up to being a loner but was diagnosed with ADD. Then he prescribed me Adderall 30mg xr and to see a specialist.

Anywho, I've been on the adderall for 3 days now, and can't even feel the effects as I did before (i.e. Get up and go, focus, loss of appetite...NOTHING!)

I didn't take my Cymbalta yesterday. By day three I'll start to feel the withdrawals from it (just found out that I'd had a few withdrawals because I would forget to take them for like 3 days in a row, but never put two and two together until some online research). It feels like the flu (aching all over, lying and sleeping for days, stomach cramps, diarrhea, etc.). Funny thing, my worst withdrawal was during the same time my two youngest children had Influenza A, so of course I assumed I did as well . It can get pretty bad. The first one I felt so low and down and just chalked it up to depression, took an adderall, and felt like brand new.

But I'm sad that after extensive research on my own, & finding people who do and feel the same way I do, and feeling like I finally have a diagnosis that makes sense, but can't start the treatment for the ADD until I get the crap out that I probably never needed.

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