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Need a psychiatrist in the Chicagoland area who gets it

Hi Everyone,

A few weeks ago, I posted I was losing it on the recent combo of Adderall and Prozac.  I quit the Prozac immediately.  It’s been over 2 weeks now and I feel MUCH better, so far.

I’m only taking Adderall and Levoxyl for a thyroid issue.

Neither my psychiatrist or therapist knew about this potentially lethal combo for someone like me. 

I realized i have been on antidepressants in some form since my early 20’s.  I’ve never been on Adderall without anything else until now.

I need to be prepared with someone who gets and understands this fully and who I’m not teaching the severe ADHD basics to. 

Any thoughts or ideas on how I should proceed?

Melissa

Replies

Hi Melissa!

I’m so glad you are feeling better! That issue with the combination of Prozac and amphetamines is little-known. In fact, the only person I’ve ever come in contact with who knows it is the doc who “discovered” it, Dr. Charles Parker. I suspect only doctors who are familiar with his work know about this for the most part. Sadly.

I wish you luck in finding the right doctor! grin

Penny
ADDconnect Moderator & Mom to Tween Boy with ADHD and LDs

Posted by adhdmomma on Apr 04, 2014 at 4:42pm

COMMENT REPOSTED BY MODERATOR TO COMBINE DUPLICATE THREADS

My psychiatrist is in Naperville, actually Lisle, and is great. Paul Capriotti, MD.
Good luck!
Posted by CadillacDave on Apr 03, 2014 at 6:40pm

Posted by adhdmomma on Apr 04, 2014 at 4:50pm

The interactions among drugs (and even certain foods) which are metabolized by, are substrates of, or are inducers or competitors of the cytochrome P450 enzyme system are well know to ALL medical professionals.  It is estimated that over 75% of all clinically significant drug-drug interactions involve this one particular enzyme system. 

If you’ve ever heard of a medication that will interact with grapefruit juice (so the two should not be taken together) then you’ve heard of just one of the many different chemical interactions involving this enzyme.  What often takes time, is figuring out just how strongly or weakly certain drugs/substances are in their interactions with each other—then how clinically significant that interaction might be.  Sometimes it’s only after some extended period of time that clinicians will start noticing that a particular drug seems to not work well in a small subset of people OR that a particular drug causes a massive toxic reaction in a small subset of people that drugs get added to this extensive list of CYP450 metabolites.

That’s probably not the best description (or an exhaustive one) but it is essentially how it all works…just wanted to give a general idea of what’s behind this all. 

As I said, it is often simply clinical observations which get drugs/foods added to this list. Hope this hypothetical example will help.  If you are treating a patient with a potent blood thinner (and with that comes regular monitoring of lab values) and the labs come back telling you that your patient is showing little or no response to this usually very effective blood thinner, an immediate search for What Is Up With That can begin…eventually somebody will note there’s some other drug or food involved…

In the case of Paxil & Prozac, what has kept the interaction with amphetamines (but not with methylphenidates) in relative obscurity for a fairly long period of time is that the symptoms of toxicity produced by the drug interaction looks a lot like the neurobiological disorders that the drugs are being used to treat.  It doesn’t “look like” a “typical” drug reaction.

Does that make sense?

Posted by BC on Apr 05, 2014 at 7:08am

Makes sense to me. I was losing it and had an episode where I sat on the bathroom floor with my hands over my ears screaming for about a half our.  Pure insanity, never had anything like it even remotely happen.  It was a completely inappropriate response for what was going on.

I’m still just on the Adderall.  So far so good.  Wondering if the combo of Adderall and whatever I’ve been taking as far as anti depressants go has been part of the anxiety.  Right now, I’m on task, I’m productive as hell.

It’s been about a solid week of that.  Fingers crossed it keeps up!

Posted by msnuggie on Apr 08, 2014 at 5:04pm

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