Drug interaction Adderall & Effexor XR

[Meghen]

I work at a group home. Out of curiosity, I began checking the client's prescribed medications in the drug interaction search engine. One interaction that worried me was a major drug-drug interaction between Effexor XR (SRI) and Adderall (amphetamine) The management instructions advised, "In general, amphetamines should not be combined with serotonin reuptake inhibitors." Is this something to worry about? If it were dangerous to the client in any way, I assume the perscribing Dr. would not have prescribed it. However, Dr.'s are not perfect, some are even careless. Should this be brought to someone's attention?

[tool8er]

quote:Originally posted by Meghen

I work at a group home. Out of curiosity, I began checking the client's prescribed medications in the drug interaction search engine. One interaction that worried me was a major drug-drug interaction between Effexor XR (SRI) and Adderall (amphetamine) The management instructions advised, "In general, amphetamines should not be combined with serotonin reuptake inhibitors." Is this something to worry about? If it were dangerous to the client in any way, I assume the perscribing Dr. would not have prescribed it. However, Dr.'s are not perfect, some are even careless. Should this be brought to someone's attention?

It would seem that the SSRI in question Venlafaxine is an SNRI which blocks 5HT and NE reuptake. Amphetamine (Adderall) increases NE release [u]and</u> its reuptake. I would look at blood pressure, ECG (pre and post drug synergy), hydration status and sleep cycles (Has patient required PRN or regimental sleep aid post drug incurrance). How long has pt been on each drug?

Good Luck Meghen!

T. Blando, BS, RRT PharmD Candidate

[Meghen]

Has patient required PRN or regimental sleep aid post drug incurrance? How long has pt been on each drug?

The patient has not had a medication change in the 15 months that I have worked here. She does have a PRN- Ambien- but has only taken 5 tablets in the past 15 months or longer. She never goes to sleep before 1 a.m., but she also sleeps late in the day, and consumes lots of caffinated beverages. Does that give you anything to work with?