I'm only theorizing here, but since serotonin is on a seesaw like mechanism with dopamine (for the most part) then something like an SSRI would be notorious at blunting the dopaminergic action of a stimulant.
Since Effexor has a greater affinity for serotonin than say, Cymbalta, I hypothesis that Cymbalta (with a more balanced ratio of Sert to NA reuptake would allow amphetamines to work better.
From what i understand, Effexor is strongest on Sert followed by NA and then at higher dosages DA.
So therefore, trying an SNRI that has a better ratio of Sert to NA may allow DA to work better...
However, i could see Effexor at the 300+ mark being more synergistic with amphetamine, due to the induction of its effects on DA. But, im guessing this would put quite a strain on the cardiovascular system and BP monitoring would be recommended.
Dx: Bipolar I, ADD Inattentive
- GAD + Panic attacks
- Migraine Headaches
Clonazepam 2mg prn (once a week)
Previous meds: Amitriptyline 200mg, Dexamphetamine 60mg, Dosulepin 50mg, Lithium 900mg, Lexapro 20mg, Lyrica 100mg, Methylphenidate IR 40MG LA 60mg, Moclobemide 450mg, Prozac 60mg, Saphris 10mg, Seroquel 300mg, Sodium Valproate 1500mg, Thorazine 500mg, Temazepam 20mg, Topamax 100-150mg