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Adding an Antidepressant to ADHD and Anxiety Meds

Halem1982 profile image

My psychiatrist constantly suggests adding Lexapro to all of my other medications (vyvanse, nuvigil, clonazapam, and sonata). I already feel like I take way too many pills as it is and I also don’t trust my pill dispenser of a dr’s judgement. Has anyone had a good experience after being on ADHD medication then adding an antidepressant? Is the antidepressant something you have to take indefinitely? I just don’t know what to do and I’m fighting my dr every step of the way because again, I don’t trust him.

31 Replies

My biggest concern with anything that raises serotonin levels is that this down-regulates dopamine release—in effect, “fighting” ADHD medication.

The same goes for anything that raises dopamine levels down-regulating serotonin release: these two neurotransmitters specifically counteract reach other—so your ADHD medication would also fight the antidepressant.

Those who do need both (yes, this does happen) often end up having to take higher doses of each; and I know that's probably a concern, for you, given history and some degree of persistent tolerance.


I can't predict your outcome, but will share an experience that illustrates my reasons for an extreme wariness of anything that can compromise dopamine function: in my case, an SSRI would probably intensify the “brain fog” I experience when my simulants wear off, if not make it continue through the day.

I know this from a time when poorly-chosen medication for other purposes apparently forced my brain to absorb enough carbohydrate to produce a perpetual satiety response—an endless flood of serotonin. At its worst, symptoms compared to those of acquaintances with Parkinson's—another dopamine-processing disorder.

By the time that medication ran out, my head cleared, and I realized what had been happening, my inability to function on what had been a dream job very likely had marked me already for a subsequent layoff.

The episode also made me temporarily unable to perform in other ways that may have cost me a new relationship: I couldn't get aroused enough, mentally to sustain the associated physical state without absolutely continuous stimulation—might as well have been folding laundry, for all I felt. This also cleared promptly, at the same time, and hadn't been remotely a problem less than two weeks before I first observed it. Its identical presentation to others' complaints with SSRIs were what tipped me off to what must have been happening.

While I happened not to be on any ADHD medication at the time (lack of a prescriber after relocation), I have since learned that continuous stimulant use (especially releasing agents, possibly producing receptor down-regulation persisting nearly to the next day's dose) can also provoke the latter effect, in me, as well as a deep lack of motivation in nightly withdrawal, so medication has become a bit of a tightrope walk.

Halem1982 profile image
Halem1982 in reply to HadEnuf

Ugh, I’m so tired of feeling like I’m playing Russian Roulette with medications. It scares me to add anything else.

HadEnuf profile image
HadEnuf in reply to Halem1982

I certainly “get” that!

As some others have noted, a low enough dose *not* to interfere with other meds *might* be enough, if anxiety has been an issue. There are also supplements (5-HTP, for example) that *sometimes* serve well, in lieu of low-dose anxiety medications.

Kingsley1 profile image
Kingsley1 in reply to Halem1982

OMG, I think I know what you mean when you say Russian Roulette. I am beside myself and live in an area where mental health support is horrible. I have almost given up. I am seeing a new psychiatrist and therapist this Wednesday and hope they can help. I am on an ADHD medication and an antidepressant and after reading your post and HadEnuf's post from a year ago, I will now check with my new psychiatrist about taking both medications. Hope you are doing better since your post is a year old and I am reading in now.

I take adderall as well as an antidepressant and an anxiety pill. I also take lyrica for fibromyalgia and a muscle relaxer and a anti inflammatory and a med for my nightmare disorder. I hate that I take so many but I have realized that I need each and every one of them. I would suggest talking to your pharmacist.

I’m taking a low dose of lexapro every morning and so thankful for my doctor for prescribing it to me. It took away a lot of my anxiety that I lived with for years. I don’t think I have any negative side effects from lexapro.

Elfje profile image
Elfje in reply to Lovinit

This med is horrible makes me sick Lexapro jeezes and verry restless

Not nice

Also nausea

No not nice !

Kingsley1 profile image
Kingsley1 in reply to Lovinit

Just reading your post from a year ago. I have high anxiety issues and take Xanax. Not sure if it is working. Having several attacks lately. Have you had any side effects from Lexapro? If so would you let me know? I have to do something and not sure if I trust my psychiatrist. Actually meeting a new one this week.

Lovinit profile image
Lovinit in reply to Kingsley1

Hi there! I didn’t have any side effects from the lexapro. Absolutely nothing and that was what made it so wonderful.

Kingsley1 profile image
Kingsley1 in reply to Lovinit

Thanks for getting back with me so soon. I will have to write the name down. Know my primary care physician wants me off Xanax. Said prolonged use is not good. Trust him. Not sure what old psychiatrists thinks. Don't trust him. Take care and thanks for your response. Best, Kingsley1.

ADHD and bipolar in many cases go together. I'm not talking about type 1 bipolar. But I'm more gentle type 2. I take Adderall for the ADHD a low dose of Lamictal which is a mood stabilizer as well as Lexapro. The combination of these three seem to work really well. I do have trouble falling asleep before 2 or 3 in the morning but I am a professional Potter so work on my own time schedule. I generally sleep from 2 to 10 so I do get my 8 hours even though I fall asleep late. But yes I do take the Lex a pro with the ADHD meds as well the mood stabilizer Lamictal. I've been taking them Lexapro and Lamictal for 15 years and the adderal was just added about 6 months ago. It was the magical part of the triangle. The three together and my life's been changed.

Elfje profile image
Elfje in reply to Itsonlyme4

What ? Adhd and bipolar goes together ??

Itsonlyme4 profile image
Itsonlyme4 in reply to Elfje

Many times they do. Bipolar is about the mood swings from crazy happy Two Crazy low. ADHD is about the inability to focus. They're two separate animals and can many times be found in conjunction with each other.

Elfje profile image
Elfje in reply to Itsonlyme4

My adhd yes is the do with less focus and mine is adhd together with anxiety

That is what my psychiatrist told me

Halem1982 profile image
Halem1982 in reply to Itsonlyme4

I wouldn’t say they go together but they are often misdiagnosed as one when it’s actually the other and vise versa. The extreme highs and lows are normal with adhd but the main difference is how long those feelings last. Adhd highs and lows have a quick onset and can disappear just as quickly as it showed up. From what I understand, bipolar is different in that regard. I wonder if I should try lamictil? A mood stabilizer sounds like something I could use.🤷🏼‍♀️

Itsonlyme4 profile image
Itsonlyme4 in reply to Halem1982

I am aware of the differences. I have experienced the extreme highs and lows for many years. I was Ritalin child and As I Grew Older I recognized the inability to focus it had nothing to do with the mood swings. My doctor finally put me on low-dose adderal and it was just enough to balance out the attention span. And the ability to think before I have diarrhea of the mouth So now all bases covered

Itsonlyme4 profile image
Itsonlyme4 in reply to Halem1982

Lamictal is what I take for the bipolar

Elfje profile image
Elfje in reply to Itsonlyme4

Omg they gived too me also ones

But I really confused I have not high and low

So I don't understand that they always offer me meds like this

Than olanzapine than serogeul pfff not for adhd and anxiety ???

Squirrel39 profile image
Squirrel39 in reply to Halem1982

I can feel my mood last shift a lot of times and my doctor told me that, being on the bipolar spectrum, there are some the cycle more frequently than others. Bipolar actually has many subcategories to it than what I had realized. Again, just another reason that every case has to be treated individually.

I was going to a psychiatrist (first time) that had me walk out with 5 prescription last on my first visit! I thought that was strange but, since I had never been, didn’t really know what to expect. Only went back to him 1 time and then realized he was just a dispensary. I changed to another one in the same office and he was the TOTAL opposite! He got me straightened out in a much more conservative manner. There’s no telling HOW messed up I would have been because he was giving me medications that were causing issues that I needed other medications to fix! CRAZY!

I have ADHD and I’m on the bipolar spectrum as well. For me, it’s definitely been the case! Adderall was incredible but I got acclimated to it really quickly and it started causing more problems than what I had to begin with. I don’t know if it “poked the bear” of my bipolar issues or what? I’m on Vyvanse now and it’s not as bad but I only feel like it helps for a little while in the morning and that’s just because it gets me hyper focused on tedious things. Then I start falling off the wagon about 2 pm and I’m just sluggish and irritable the rest of the day.

Sometimes I just want to stop all meds and hit the test button because I don’t know WHO I am anymore and what part of me is a byproduct of the meds. So frustrating!

Kingsley1 profile image
Kingsley1 in reply to Itsonlyme4

Thank you for explaining the difference between bipolar and ADHD. I have ADHD and depression in which I am struggling with while on Prozac and Concerta. Now concerned if I may be bipolar too or if it is just a "mood swing" affect from ADHD. I have alot to learn and it's scary. I will ask that question to my psychiatrist this Wednesday. Thanks again for your post.

Lovinit profile image
Lovinit in reply to Itsonlyme4

Thank you for sharing I relate so much except it was the adderall I’ve been on for 15years and lex a pro and mood regulator for about a year it really was amazing how much it helped me. My doctor said i too could possibly have bipolar, I know nothing about bipolar I didn’t know there is a 1 or 2. But he said let’s try this and see because based on what I’ve told him he thought this might help and boy it totally did for me. My friend has other issues and lex a pro she said she can not take because it affects her differently. So it can take time working with you doctor finding what hopefully work for you

I'm taking Wellbutrin. Doctor said it's to help with pain (nerve pain) not a fan at all the only time I notice it is when I stopped taking it which is quite often. Get Gnarly headaches when I do so. Also taking Vyvanse and Xyem(GHB). 14k per month for the Xyem. I remember when it was legal. It was used for work out recovery and I would buy the same amount for $75. Total scam. Also taking Kratom which is been a miracle for me in many ways.

Why do you take GHB? It seems like that would make attention problems worse, unless you use it for insomnia or something to go straight into REM sleep? I used to have a friend who was an attorney who did GHB so he could be completely refreshed with only a 2-3 hours of sleep every night.

I’m taking adderall Lexapro low dose and risperidone low dose. The last two drugs I wrote I started a year ago and for me it works great. It doesn’t feel like I’m on anything at all just my negative symptoms stopped. My doctor did try to increase my risperidone from 0.5 to 1 and after 2 to 3 months it was clear to me that the dose was too high. I felt bland and not very motivated. I felt like I could careless about getting my work done.

Why does your doctor want you to go on lexapro? Do you feel your medications are not treating your symptoms correctly? If so, maybe you can have him go over all your medications one by one explaining the reason for taking them and maybe after discussing maybe you are taking two medications to treat the same thing and see if you can eliminate so of the medications and replace it or something. I don’t want to take too many medications. I do know and my doctor discussed with me what each one does and I’m okay with taking the three. I feel like that’s a lot for me but seeing how each one serves its purpose and it’s helping me I’m okay about it

My doctor has me on Vyvanse for ADHD and Wellbutrin and Zoloft for the rest. I have been on Wellbutrin by itself and Zoloft by itself but, for me, the work better together since they target differently.

Ye had the same med Lexapro

Drive me too the edge

I stopt

Because first they told me no anti depressant

Than sudden this Lexapro

I whas sick

Not normal

Never I taken this never anymore

I know that they normally give a stimulant a benzo and off course like olanzapine or serogeul for sleep in verry low dose 2.5 mg

Or less

Too much meds no

You must lissen to what you feel

It's your body and head

And nobody can feel what you feel

People with ADD/ADHD often have other related psychological issues like depression, anxiety, bipolar, etc. It is fairly common to be prescribed a med for the ADD/ADHD and the psych issue. You have to treat both or you are wasting your time. I have been on some form of ADHD med and an antianxiety med for more than 20 years. I am currently taking Mydayis(long acting ADHD med similiar to Adderall SR) and Effexor.

I also have insomnia and was on sleep meds for awhile. Sleep meds will give you a hangover(sleep med not alcohol) making you tired and brain foggy the next day. What i found was i needed more ritalin-stimulant type med the next day to counteract the hangover from the sleep meds then i needed more sleep meds to overpower the stimulants. Basically up/down rollercoaster. I stopped taking the sleep meds and suffered through over a month of insomnia but i was able to take less stimulant meds and i didnt feel as tired and my brain wasnt foggy.

ADD/ADHD often has one or more associated disorders. I saw a slide on another site, ADDitude magazine maybe. It layed out many of the medical issues associated with ADHD and ADD. The medical issues were grouped with similiar disorders and listed some symptoms. I dont remember if it listed some common meds for each group. It sort of looked like a big venn diagram. I will see if i saved it and post it. Also try googling it or checking out that site.

I know this is an old post but I am compelled to comment. I have not been diagnosed with ADD or ADHD but I do share many symptoms including a lack of impulse control and an inability to plan properly. I joined this board and paid the subscription to the CHADD to see if I could learn any strategies that would help me. I was shocked to read comments whereby people talk about playing russian roulette with their medications. Yeh I wouldn't trust any doctor either who would keep on prescribing meds on top of meds because the first one doesn't work or gave me too many sideeffects. All medications are foreign substances to the body. Side effects is the body talking to you and saying - I don't like that. If any medication is to be successful, then wouldn't you at least be more calmer after taking it. Waking up feeling like you have a hangover would be extremely stressful on the body. Likewise if your mood swings back and forth like a rollercoaster, or getting headaches etc would be equally stressful. Seems like the medication compounds the issue. I only take heart medication but even taking that over years, changes the dynamics of the body chemistry without fixing the issue, now a private heart rythm specialist has said my medication could actually be making the problem worse. They are not interested in any cause or cure, just medications to control the symtoms because you have to keep buying them again and again. There is so much money in the pharmacutical industries, its scandalous!

Halem1982 profile image
Halem1982 in reply to Fordette

It’s exhausting, isn’t it?

I take 10 mg of Lexapro that is working wonderful for the light depression and anxiety. I want to change Lexapro for another class of anti-depressive, some that can act on Dopamine and Serotonina. I haven't been any research into it yet. Since I added Venvance 50 mg to the anti-depressive I saw great improvement. My be is worth trying. LExapro is a very secure medication, start with 5 and go up to 10 tor 15 if your doctor agrees to to it.

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