Cymbalta and Adderall (IR and XR) interaction?

Question

This is my first time posting on one of these message boards but because I just can’t seem to find any answers anywhere, I decided to post! 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. I’ve 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). I’ve been on numerous SSRIs Zoloft, Prozac, Paxil, etc., and switched for various different reasons.

My psychiatrist’s 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 didn’t seem to make a difference) and (in the morning especially) I was bouncing off the walls (feeling like I couldn’t 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 didn’t 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 (can’t 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 month…I HAVE seen some positive changes effects in splitting the two medications up, I am no longer climbing the walls, but my Adderall just isn’t 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 doesn’t seem to be effective AT ALL! I am so frustrated.
So here is my question (if you’re 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:
Diagnosed:
-ADHD
-OCD

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!

Answer

It is normal .Nothing wrong. Your doctor knows what they are doing.

Answer

So I realize this thread is about ten years old but has there been any updates? Any others with similar experiences?
I've been trying to find any mention of this topic online just like the OP and it seems just as hard to find still nearly ten years later.

So, here's my situation. Sorry it's so wordy. I have been taking adderall IR 20mg for around a decade. Before I was prescribed adderall I was taking effexor xr 150mg once a day. Then Due to my depression and anxiety being much better, I had already weaned off the effexor months(at least) prior to being prescribed adderall. The adderall worked great, exactly what I needed. 10mg at 10am and 10mg around 4pm. After a few years that needed to increase to 20mg and I started taking them less. Lazy Sundays id skip the entire day and be fine. Up til now I don't take them every day, just when I really need them to focus etc.

Expand...

I ended up going back on the same dose of effexor and had zero problems.

Fast forward to last month. I feel like i need an SNRI back in my diet for several depression related things. Last time I took effexor (try number 3) it did nothing but turn me into a zombie. Never had that problem before but couldn't make it passed two weeks and gave up. So. Because of that I figure cymbalta is the way to go and I ask for that. Took some convincing that effexor no longer worked for me and was given a months supply of 30mg cymbalta. The first 3 weeks it didn't interfere with the adderall at all. In fact I thought it actually increased the adderall effect.

Two days ago I ask for the full effective 60mg dose of cymbalta and now the adderall is like sugar pills. Most I'd have ever previously taken in a day was 40mg and that was an almost unhidable to others kind of dose/effect for me. Today after day 2 of 60mg cymbalta which is always taken around 830AM, I found myself taking a total of 65mg of adderall between 1230pm and 430pm and it had zero effect.

Now I should mention it's now 1230 in the morning and I have to be up for work in 5 hours. So, if anything, it seems to have a very, very delayed effect. I don't have the usual stamina/energy rush at all that I'd sometimes get within an hour of taking less than half this dose when I wasn't on cymbalta.
I'm wondering if as I get more used to the cymbalta, will the adderall return to working as normal?
Why did it work find with effexor (very similar SNRI I thought) but not cymbalta?
Any thoughts or insight is greatly appreciated.

Thanks. And extra thanks for making it to the end of this.

Answer

I&rsquo;ve recently was diagnosed with MDD and PTSD and ADD. I started with Wellbutrin XL and Adderall IR of 20 mg. Wellbutrin seemed ineffective for depression and ptsd. So I got on cymbalta and Wellbutrin XL and adderall which was super jittery and my nerves were ready for a nervous breakdown almost everyday in the afternoon.   The 3 together were no good for me. So I bumped off Wellbutrin all together, which took the edge off after a week and it seemed to fit like a glove.  I am I between script for adderall IR but suggested to be put on XR 30mg with Cymbalta at 30mg. Still am waiting for adderall to be refilled but noticed this posting.   Cymbalta on its own in the morning for the last 2 weeks has been all I believe I might need, but suggested to get a refill of Adderall XR to see what happens.   Currently when I take cymbalta it&rsquo;s right in the morning, usually with a cup of coffee and seems to get my day going well. Which, makes me think maybe I might just have a misdiagnosed OCD as a leading cause of the other behavioral health diagnosis.   I will update and see what happens when adding Adderall XR (which I might start with 1/2 amount in capsule 15mg), before going to 30mg all in. I will also follow your directions of splitting the 2 meds up 12 hours apart to see how effect this is.  Thank you for posting this article!

Answer

I have been taking 60 mg Cymbalta for years, for fibromyalgia & depression but I&rsquo;m so tired all the time and thought Adderall might help. Any thoughts?

Answer

I started taking 20 mg of Cymbalta for my fibromyalgia, I also have been on adderall for the past 6 eyars, current dose: 45 mg in morning and 30 in the afternoon. I started experiencing alot of side effects from cymbalta (headaches, bruising, confusion, loss of memory) I also did notice my adderall was no longer working.

Of course my side effects took prescedence over the adderall so i had to stop it. Once i stopped taking Cymbalta my adderall barely works.

Answer

I have suffered severe depression & diagnosed with ADHD. I am presently taking Adderall 10mg n the morning & Cymbalta 30mg at night, I recently started about a month ago taking Adderall & having so much anxiety, jittery feeling inside & dizziness at times.
I'm wondering if these two are too much & should take Cymbalta 30mg down.
Any advice, I am not handling this severe anxiety well at all.

Answer

Hello friend! I am on the same boat that you are. What works for me is Cymbalta at night and Adderall XR in the mornings and it works wonders.

Answer

I have not had personal experience with Cymbalta/Adderall, but...
the only thing I would really see as a choice would be to find other medications instead of Cymbalta. Possibly an SSRI such as Fluoxetine Hydrochloride or Paroxetine Hydrochloride for the OCD symptoms. :)

Cymbalta and Adderall (IR and XR) interaction?

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