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Cymbalta and Adderall XR
Cymbalta and Adderall XR
I have been Rx both of these drugs by my Psy and I was curious about the drug interactions between the two. I am on 20 mg of adderall XR and 60 mg of cymbalta daily. Do i need to worry about anything? Also what is the normal dosage for Cymbalta to help with with chronic pain? I do have a back injury and quit Norco 10-325 due to it controlling my life for too long. Would a higher dose of Cymbalta help? I also felt very focused the very first time using Adderal IR 10mg but never had that feeling since then and I am now on 20 mg xr. Is it me or am I possibly needing a higher dose of Adderall? Im a big guy 6ft 1 in 245 lbs.
In theory there is the possibility of an interaction.
However in practise an interaction is very low.
There are lots of people who take this combination with no problems.
I take Cymbalta (60mg) with Adderall (40mg) daily. I think may Adderall dose may be a touch high because it tends to make me very sleepy/quiet/serious....but I think when it's making you feel "speedy" that means you aren't adjusted to it yet. As I understand it, you are not supposed to "feel" much when you are on the correct dose. You should feel more focused and calm and directed, but not speedy and "high" nor TOO sedated/slow/sluggish. It's hard to find a good balance, but since I'm a 130lb female taking 40mg of the Adderall (plus Buspar and Lorazepam daily, as well), I'd say you probably need around 30mg if it's XR and try that for awhile until it regulates and see whether you feel the happy medium or the extreme slowness/extreme speediness. The initial speedy feeling is fun because you feel ultra energized and confident, but that's not really what you are going to get after you adjust. Mostly people who take it for sport and take high doses for random reasons get that effect. So we have to settle for "more focused and directed", then.
Anyway, the reason Cymbalta and Adderall have "warnings" is because they both work on the same brain chemicals (Norephinephrine and Dopamine, which go hand in hand), so basically the concern is that you're doing "double-duty" on both of these brain chemicals. If the doses are too high, you could have more of the negative side effects of the "fight-or-flight" hormones released by these drugs. It could increase Anxiety because of the Adrenaline and Cortisol released by dopamine/norepinephrine, as well as things like increased heart rate, mood swings, and muscle pain/tension (from the Adrenaline release causing vasoconstriction + tightening of muscles). There's many reasons why it has to be dosed carefully, but keep in mind that Cymbalta also works on Serotonin which is the precursor to Melatonin (sleep chemical) and Adderall does not.
So you have a bit of the calming effect mixed in there as well as the fact that Cymbalta is a medication that slowly builds up (6-8 weeks) in your system and stays steady as long as you take doses correctly, while Adderall is "as needed" (as in short-acting) and does not build up over time in your system.
Your best bet is to always take (any antidepressant, really) your Cymbalta at night/in the evening a couple of hours before bed (since occasionally they cause drowsiness) and that way during the morning/daytime the drug has already been in your system 8-12 hours and is "stabilized" before you have to take your daytime meds (Adderall). I'd say it's important to NOT take them together at the same time of the day. I always split up my meds into different times of the day (my antidepressant at night along with a Lorazepam for bed, and then the Adderall during the day and my Buspar during the day and the after noon) to keep from taking too much at once and also to prevent possible stomach irritations and such.