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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by ReginaTerrae on July 9, 2009, at 17:45:29
Hi, everyone -- I'm new here. I've got ADD (inattentive type), PMDD, and a tendency to depression going back to age 9. Right now I'm under a lot of stress (unemployed), and also at age 42 the hormonal changes are really having an effect.
I was taking nefazodone when I started on Adderall recently, not having ever really been treated for the ADD before. The Adderall seemed to do me some good. Switched to fluoxetine from nefazodone over a 10-day titration period, hoping it would help with the PMDD.
Within a few days of getting up to 20 mg fluoxetine I was having bad palpitations. Really a very tense feeling like an anxiety attack (which I've had rarely).
I remember years ago, on Prozac, having palpitations. Pdoc didn't have an answer, but the pharmacist pointed to the combo of Prozac and Sudafed. I quit the Sudafed and felt better.
Now I've quit the Adderall, dropped back down to 10mg Prozac, the pdoc wants me to stay off Adderall until I've seen a cardiologist, I've set up an appointment but earliest available was next month. I want to switch back to Serzone because I'm convinced the Prozac is the problem, or at least, the combo of Prozac with any kind of stimulant is the problem.
Does that make sense to any of you? I don't really get it -- I thought Serzone was supposed to be an SNRI, and wouldn't more norepinephrine be more likely to cause this problem? But there you go -- I'm fine with the Serzone, can't take the Prozac. Any ideas?
Posted by morganpmiller on July 10, 2009, at 4:06:26
In reply to Fluoxetine + Adderall = Palpitations, posted by ReginaTerrae on July 9, 2009, at 17:45:29
My best advice would be to(this is what I would try to do, which really means nothing) stay with prozac for another month or so, find the right dose-the one you feel best on without noticeable side effects, and see how you feel overall. You may find that you no longer need an ADD medication. I have a very strong opinion of ADD/ADHD and medications used to treat it. You really don't want to hear my opinion and my arguments to back it up, you would probably just get pissed off.
Prozac actually is considered by many to be an atypical SSRI. It is now believed to significantly increase striatal levels of dopamine and norepinephrine, though not through the reuptake inhibition of those neurotransmitters(at least I think from what I can remember). It's possible that Serzone was not effecting dopamine levels the way that Prozac is. Maybe the interaction of adderall increasing dopamine in it's own way combined with prozac may increasing dopamine in it's own way, is why you are experiencing the heart palpitations.
Personally, I hate Adderall. I am biased though. My best friend died of a massive heart attack at 28, he had been on Adderall for years. He had just lost a lot of weight in a fairly short period of time and he was also taking celexa for depression. Plus, he had heart issues in his family. Still, at 28, the doctors were pretty sure that Adderall contributed to his massive heart attack.
So how did you feel years ago when you were just on Prozac? How was were your ADD symptoms then? You could have bad reactions when you combine prozac with anything that is a stimulant.
Why did you get off Serzone? Why did you get off Prozac a long time ago?
Sorry, I'm asking a bunch of annoying questions?
Posted by ReginaTerrae on July 10, 2009, at 9:47:54
In reply to Re: Fluoxetine + Adderall = Palpitations, posted by morganpmiller on July 10, 2009, at 4:06:26
Prozac was the first anti-depressant I ever took, and it was wonderful. A revelation! Eventually it stopped working. I took Paxil and Zoloft, but switched to Serzone because the others messed with my sleep. I love Serzone ... no depression, no side effects. I switched to Prozac just now hoping that it would have some effect on PMS. So far no good, but it's really too soon to tell about that. But I'd rather take Yaz for the PMS and switch back to Serzone.
I don't love the Adderall, either. But I really need something to help me keep it together for the time being, job hunting is just overwhelming. Hopefully I won't have to be on it long-term. I don't remember Prozac having much effect on ADD, but then I didn't really understand ADD back then. I can say that I always felt it addressed the sadness of depression but not the lack of motivation and energy -- which I now understand to be maybe ADD-I instead.
Posted by morganpmiller on July 10, 2009, at 15:04:00
In reply to Re: Fluoxetine + Adderall = Palpitations » morganpmiller, posted by ReginaTerrae on July 10, 2009, at 9:47:54
>the sadness of depression but not the lack of motivation and energy -- which I now understand to be maybe ADD-I instead.
I think in the majority of people they are interrelated and they all come from the same place. JMHO. Are you sure you didn't feel more energy and motivation on prozac the first time around? I would be leery of popping a pill for motivation. I know right now, especially given your depression and other needs, you could use some extra help.
It may be a little rough, but if Prozac begins to help you feel that much better, you may find that you will have the strength to make yourself move and motivate. Remember, things that we "have to" do are not supposed to be easy for us find motivation and energy to do.
Hopefully Prozac helps with depression and PMS. And, if one day you find yourself not feeling as great on it, don't be too quick to give up on it. If suddenly it feels like Prozac is only working 50 percent as opposed to 80 or 90 percent, remember, there may be other factors in life making you feel bad that need to be depressed. You may be able to stay on prozac or up the dose for a bit and find that you eventually start feeling better again. Like ADD, I'm not a huge believer in "poop out", though I acknowledge that both exist and happen.
You just want to avoid being on too many different AD's and getting on and off the same AD too many times. This could have an impact on how well you respond to treatment in the future. You're brain could become less "fresh" and you may find it harder and harder to find something that works. These changes can also take place as we experience more depression and get older. Anyway, try to be cautious and somewhat conservative. It does not sound like you have too bad a case of depression or ADD. I don't know you of course, it just appears this way. Good luck. Hope you start feeling better on Prozac.
Have you tried any natural remedies for pms? I'm guessing yours may be pretty bad.
Posted by ReginaTerrae on July 10, 2009, at 15:47:37
In reply to Re: Fluoxetine + Adderall = Palpitations, posted by morganpmiller on July 10, 2009, at 15:04:00
Thanks. My doctor e-mailed me today with titration instructions to switch back to the Serzone. I'm relieved. No offense to Prozac, but in my case Serzone seems better -- I have NO noticeable side effects on it. And it's not a matter of believing or not believing, Prozac "pooped out" on me after a while. Years, not months, but it did eventually stop working. And Prozac with any kind of stimulant, even an otc decongestant, gives me heart palpitations. Serzone doesn't. That tells me that if there is any concern about my heart, then even without Adderall, I'd rather be taking Serzone than Prozac.
Yaz is a birth-control pill, so it will hopefully address the hormonal issues directly. It's actually approved for PMDD (AKA severe PMS). I haven't tried too many natural remedies for PMS, although I do feel a little better since I've been taking a B-complex supplement.
Posted by morganpmiller on July 10, 2009, at 15:58:14
In reply to Re: Fluoxetine + Adderall = Palpitations » morganpmiller, posted by ReginaTerrae on July 10, 2009, at 15:47:37
Yeah you can't beat an AD that works and has no noticeable side effects. Good luck.
This is the end of the thread.
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