Tuesday, April 16, 2024

Vyvanse For Treatment Resistant Depression

Vyvanse And Selegiline For Treatment Resistant Depression/adhd

Vyvanse (Lisdexamfetamine) Review For ADHD And Binge Eating Disorder | Dr. Aly

I’ve been dealing with treatment resistant depression for the last 10 years, after I was diagnosed with ADHD and started Vyvanse, I became a lot more productive, but that sense of apathy/anhedonia was still there. After trying almost every antidepressant available, I saw no improvements . Recently I found this article . The only issue is that I don’t have access to transdermal Selegiline here in Brazil. My question is: would be safe to try this combination with Selegiline pills while paying attention to diet and blood pressure? Sorry for my English and the long post, thank you guys!

Connection Between Adderall And Depression

Adderall and depression are linked in multiple ways. Adderall has been used as an off-label treatment for depression in patients who experience depression in combination with ADHD. Because stimulants can increase alertness, attention, and energy, they can feel like mood boosters for those experiencing depression.

But Adderall can cause depression, especially if a person is taking a high dosage of the drug and suddenly discontinues use. Adderall is also commonly misused and taken without a prescription. Non-medically deemed the “study drug,” Adderall is widely known for its ability to increase attention for long periods of time. Many high school and college students also use it recreationally.

The problem is that many people dont know how stimulants work, what side effects can occur, and how the drug impacts the body in the short and long term. Adderall dependence and withdrawal can be dangerous and can cause depression, suicidal thoughts, fatigue, sleep problems, and more.

Vyvanse And Other Medications

Below is a list of medications that can interact with Vyvanse. This list doesnt contain all drugs that may interact with Vyvanse.

Before taking Vyvanse, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Vyvanse and MAOIs

You shouldnt take Vyvanse with drugs called monoamine oxidase inhibitors . Taking Vyvanse with MAOIs can cause a dangerous increase in blood pressure.

Both Vyvanse and MAOIs can also increase your serotonin levels. Taking these drugs together can raise your risk for a serious side effect called serotonin syndrome. To learn more, see the Vyvanse and drugs that increase serotonin levels section below.

MAOI drugs you shouldnt take with Vyvanse include:

  • tranylcypromine
  • selegiline

Do not take Vyvanse if youve taken an MAOI drug in the last 14 days. If you currently take or have recently taken any of these drugs, talk with your doctor about different treatment options.

Vyvanse and drugs that increase serotonin levels

Vyvanse may interact with drugs that increase the level of serotonin in your body. Serotonin is a chemical in your body that affects mood, digestion, and sleep.

  • phenelzine
    • isocarboxazid

    Vyvanse and Lexapro

    Vyvanse and Prozac

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    Vyvanse And Herbs And Supplements

    Vyvanse can interact with certain herbs or supplements, including those listed below.

    Vyvanse and St. Johns wort

    Vyvanse may interact with an herbal supplement called St. Johns wort. This is because both St. Johns wort and Vyvanse can raise your serotonin levels.

    Taking Vyvanse with St. Johns wort can raise your risk for a serious side effect called serotonin syndrome. This can occur if levels of serotonin get too high in your body.

    If you take St Johns wort, talk with your doctor before taking Vyvanse. They may prescribe a lower dose of Vyvanse.

    Vyvanse and tryptophan

    Vyvanse may interact with tryptophan supplements. This is because both Vyvanse and tryptophan can raise your serotonin levels.

    Taking Vyvanse with tryptophan raises the risk of a serious side effect called serotonin syndrome. Serotonin syndrome can occur if levels of serotonin get too high in your body.

    If you take tryptophan, talk with your doctor before taking Vyvanse. They may prescribe a lower dose of Vyvanse.

    Treating Major Depression And Adhd

    Have any psychiatrists here used psychostimulants for treatment ...

    What should people with both ADHD and MDD do? Which should be addressed first? The decision is usually made by the patient based on what he thinks is the most urgent or impairing condition. Given the choice, I treat ADHD first with a stimulant. This is based on my experience that a high percentage of patients report that their mood lifts when they have achieved optimal doses of stimulant-class medication.

    If the depressive symptoms persist, an antidepressant is usually added to the ADHD medication. Many clinicians opt for fluoxetine , since it has no effect on ADHD and its long duration in the body makes it an ideal drug for patients who forget to take it.

    Some clinicians may use a second-line medication alone for cases of mild to moderate depression plus ADHD. It should be noted that, while antidepressant medications have published studies to show that they help with ADHD symptoms, none have shown robust effects. They have demonstrated detectable benefits but only as second-line medications when the use of stimulants or an alpha agonist is not appropriate.

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    Stick To Your Treatment Plan

    Even if you feel better, its advisable to keep taking your medications as prescribed and continue going to therapy. Depression symptoms could return if you stop treatment.

    If you have concerns about your medications, such as side effects that you dont like, your psychiatrist may have other options.

    Distinguishing Between Depression And Adhd

    So the question is: Are depressive symptoms due to ADHD, Major Depressive Disorder , or both. A significant number of people are unlucky enough to have both conditions. The National Comorbidity Replication Study found that having either condition makes having the other about three times more likely. The two disorders can be distinguished from each other based on six factors:

    1. Age of onset.ADHD symptoms are present for a lifetime. The DSM-V requires that the symptoms of ADHD be present by 12 years of age. The average onset of MDD is 18 years of age. Symptoms that began before puberty are almost always due to ADHD. A person with both conditions is usually able to see the presence of ADHD in early childhood, with the symptoms of MDD appearing later in life, usually in high school.

    2. Consistency of impairment and symptoms. ADHD and its frustrations are always present. MDD comes in episodes that ultimately stabilize to more or less normal mood levels in about 12 months.

    4. Rapidity of mood shift. Because ADHD mood shifts are almost always triggered, they are often instantaneous complete turns from one state to another. Typically, they are described as crashes or snaps, which emphasize the sudden quality of their passage. By contrast, the untriggered mood shifts of MDD take weeks to move from one state to another.

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    Alcohol Use With Vyvanse

    You should avoid drinking alcohol while youre taking Vyvanse. This is because Vyvanse can mask the effects of alcohol in your body, which can make it hard for to know how much youve had to drink.

    People who have misused or become dependent on alcohol are also at higher risk for misusing or becoming dependent on Vyvanse. Make sure your doctor is aware of any history you have of misuse or dependence.

    Alcohol can also make certain Vyvanse side effects worse. These include nausea, diarrhea, and dizziness.

    If you drink alcohol, talk with your doctor about whether its safe for you to drink while taking Vyvanse.

    How Does Vyvanse Compare To Adderall For Depression

    Do stimulants help with depression Stimulants for treatment resistant depression

    In the past, many psychiatrists utilized Adderall for depression as a psychostimulant adjunct. Adderall is very similar to Vyvanse in that it contains dextroamphetamine , but also contains levoamphetamine . Vyvanse is a prodrug, meaning it is biologically inactive until orally ingested. Upon ingestion, the drug takes nearly 2 hours before it is metabolized into dextroamphetamine and l-lysine.

    Vyvanse is considered to have a slightly lower potential for abuse, is slightly less potent, and a longer duration of effect by comparison. For more information, you can check out the comparison article I wrote called Adderall vs. Vyvanse. Neither Vyvanse nor Adderall should be regarded as superior to the other for depression responses are largely subject to individual variation.

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    Vyvanse For Binge Eating Disorder

    Vyvanse is FDA-approved to treat moderate to severe binge eating disorder in adults. BED is an eating disorder that involves repeated episodes of extreme overeating. It often occurs alongside other mental health conditions, such as anxiety or depression.

    With BED, episodes of overeating tend to occur in response to emotional or mental health issues. Symptoms of BED may include:

    • eating excessive amounts of food in a short time
    • eating when youre not hungry
    • binge eating in secret
    • feeling unable to stop eating during a binge
    • feeling guilty or ashamed about your eating

    People with BED dont try to reverse episodes of overeating by vomiting, using laxatives, fasting, or exercising.

    BED is considered moderate if you have four to seven episodes of binge eating per week. Its considered severe if you have 8 to 13 episodes per week.

    Vyvanse is a stimulant medication. It can help reduce the number of binge eating episodes you have. Its typically used alongside psychotherapy. Psychotherapy can help you understand and control the thoughts, feelings, or behaviors that trigger your episodes of overeating.

    Note: Vyvanse reduces appetite and can cause weight loss. However, its not FDA-approved or recommended for weight loss or to treat obesity. To learn more about weight loss associated with Vyvanse, see the Vyvanse side effects section above.

    Effectiveness for binge eating disorder

    * A binge day is a day with at least one episode of binge eating.

    What Medication Strategies Can Treat Treatment

    Different antidepressants work in different ways to affect specific chemicals that send information along brain circuits that regulate mood. If your current medicine isn’t helping — or isn’t helping enough — other drugs might. There are two basic approaches:

  • Switching medicines. There are a number of different classes of antidepressants, including SSRIs. Another option is to switch from one drug to another in the same class. A person who wasn’t helped by one SSRI could still benefit from a different one.
  • Adding a medicine. In other cases, your doctor might try adding a new medicine to the antidepressant you’re already using. This is called adjunct therapy. This can be especially helpful if your current drug is partly helping but not completely relieving your symptoms.
  • One option is to add a second antidepressant from a different class, called combination therapy. Another approach, called augmentation therapy, adds a medicine not typically used to treat depression, like an antipsychotic, or an anticonvulsant such as lithium.

    Aripiprazole , brexpiprazole , or quetiapine are FDA-approved as add-on therapies to an antidepressant for treatment-resistant depression.

    Olanzapine/fluoxetine is a combination drug that contains the active ingredients in fluoxetine and olanzapine together in one tablet and is approved for the acute treatment of treatment-resistant depression.

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    Is Anger A Side Effect Of Vyvanse

    Anger wasnt reported as a side effect by people taking Vyvanse in clinical studies. Irritability was a commonly reported side effect, though. Sometimes irritability can lead to anger.

    Also, its important to note that anger was a rare withdrawal side effect in children ages 6 to 12 years old. Withdrawal refers to effects that occur after stopping a drug that your body has become dependent on. Vyvanse has a

    Learn more about some of the side effects that Vyvanse may cause.

    What Medications Are Used For Treatment


    Different antidepressants work in different ways to affect specific chemicals that send information along brain circuits that regulate mood. If your current medicine isn’t helping — or isn’t helping enough — other drugs might. There are two basic approaches:

    Switching medicines. There are a number of different classes of antidepressants, including SSRIs, such as:

    • Citalopram
    • Tranylcypromine

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    Research Timeline: Vyvanse For Depression

    The drug Vyvanse was slated to become an FDA approved adjunct treatment for depression, but was found ineffective in late stage clinical trials. That said, there have been numerous studies suggesting that Vyvanse may help with certain aspects of depression. It may be particularly beneficial for those with major depression and: comorbid ADHD, executive dysfunction, or lingering depressive symptoms during antidepressant treatment.

    2011: A study published in 2011 investigated the safety and efficacy of Vyvanse among individuals with ADHD that had a history of depression and/or substance use. Researchers gathered data of comorbid depression from medical history reports filed by clinicians. The study incorporated a randomized, double-blind, placebo-controlled design with forced titrations of Vyvanse.

    Results from the study were analyzed based on ratings from the ADHD Rating Scale and Clinical Global Impressions Scale. Data was collected prior to treatment with Vyvanse, and following the treatment of 30 mg, 50 mg, or 70 mg. Outcomes indicated that Vyvanse produced the same effect among individuals regardless of whether they had a history of depression, substance abuse, or no comorbid condition.

    Esketamine Helps The Brain Form New Connections

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    Research suggests that untreated depression causes long-term brain damage and is a risk factor for dementia. Studies show that people with depression have up to 20% shrinkage of the hippocampus, a region of the brain critical for memory and learning. But esketamine may counteract the harmful effects of depression.

    Animal studies indicate that connections between brain cells diminish under chronic stress, but esketamine reverses these stress-related changes. Esketamine is different than any other antidepressant in that it not only prevents the neurotoxic effects of depression on the brain, but it also seems to have a growth-promoting effect, explains Kaplin.

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    Do Stimulants Work For Treatment

    Many people dont know that stimulants can be used for treatment-resistant depression. Stimulant medication is primarily used to treat attention deficit hyperactivity disorder , while other stimulant-like drugs are often prescribed to ease the effects of narcolepsy, obstructive sleep apnea, and other sleep disorders. However, stimulants have also been used to treat patients with major depressive disorder particularly those who do not respond to traditional antidepressants. So how do stimulants for treatment-resistant depression work, and are they safe?

    Vyvanse For Attention Deficit Hyperactivity Disorder

    Vyvanse is FDA-approved to treat ADHD in adults and in children ages 6 years and older.

    Vyvanse is a stimulant medication for ADHD. It helps people with ADHD focus, concentrate, and control their behavior. Its typically used alongside behavioral therapy for this condition.

    About ADHD

    ADHD is one of the most common mental health conditions that affect children. But it can also last into adulthood. In fact, ADHD isnt diagnosed until adulthood in some people.

    Symptoms of ADHD can include:

    • Hyperactivity. People who are hyperactive find it hard to be still and calm. They may fidget, move around, or talk excessively.
    • Impulsivity. People who are impulsive act without thinking first. They may do inappropriate, or sometimes dangerous, things without thinking about the consequences.
    • Inattention. People with inattention have trouble concentrating and paying attention. These problems can cause them to lose focus quickly, be easily distracted, or make careless mistakes.

    Because of these symptoms, people with ADHD may have trouble making friends or forming relationships. And they may struggle at school, at work, or in social situations.

    Effectiveness for ADHD

    Multiple clinical studies have found Vyvanse to be effective for treating ADHD.

    In 4-week clinical studies, the average ADHD-RS score was reduced by:

    Vyvanse was also effective in longer studies in adults and children. To learn more, see Vyvanses prescribing information.

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    Vyvanse Misses Endpoint In Major Depressive Disorder Trial

    Shire announced results from two pivotal Phase 3 studies evaluating the efficacy and safety of Vyvanse Capsules vs. placebo as an adjunctive treatment for major depressive disorder in adults with inadequate response to antidepressant monotherapy with SSRI or SNRI.

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    Study SPD489-322 and Study SPD489-323 were two identically designed multi-center, randomized, double-blind, parallel-group, placebo-controlled, dose-optimized studies that assessed the efficacy, safety, and tolerability of Vyvanse in patients aged 1865 years who met DSM-IV-TR criteria for a diagnosis of MDD. The primary efficacy endpoint for the studies was defined as the change from augmentation baseline to Week 16 in Montgomery-sberg Depression Rating Scale total score.

    Vyvanse did not meet the primary efficacy endpoint vs. placebo for either study .

    Results from Study SPD489-322:

    • Subjects experienced a mean reduction of 6.1 in MADRS total score for Vyvanse compared with 6.3 for placebo.

    Results from Study SPD489-323:

    • Subjects experienced a mean reduction of 7.3 in MADRS total score for Vyvanse compared with 6.8 for placebo.

    Vyvanse is already approved for the treatment and maintenance of ADHD.

    For more information call 536-7878 or visit Shire.com.

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