[BrianMac]

Our 17 yr. old teenage son is currently on Adderall (approx. 2 yrs) to treat his ADHD.
Recently, he has also been diagnosed with severe depression and is now also taking Prozac.
Should we be concerned with any negative impacts due to the combining of these two medications?
We have seen various articles and write-ups that this combination is not advisable- but would like to see responses that reference medical reports, etc.
Thanks in advance.
-Concerned father

[CANDC]

Hi BrianMac. Welcome to Psych Central. Sorry your son is suffering from challenges.

Severe depression is also a symptom of Bipolar Disorder. I cannot say what their diagnoses is so speak to your doc and ask them if bipolar is possibly what they may have. You could mention these things next time you see their doctor and your concerns and see what they say. If you want to read more about possible concerns you may find this article of interest: https://blogs.psychcentral.com/bipol...bipolar-mania/

[still_crazy]

hi. adderall, of course, is an amphetamine combination. Prozac is one of the 1st of the SSRI-type drugs for depression, OCD, etc. available in the US.

Serotonin syndrome is a situation in which, usually because of psych drugs, the brain+body are overloaded w/ serotonin. This can happen with any antidepressant that affects serotonin, although from what little I've read about it, serotonin syndrome seems to be much more common with ssri and ssnri drugs (drugs such as cymbalta) than with the older tricyclic drugs (tca antidepressants), even many tca drugs have a definite effect on serotonin reuptake inhibition.

amphetamines are interesting, in that they're now used mostly for add/adhd, but they were once fairly common for depression, either used alone or in combination with the other drugs available at that time (barbiturates, meprobamate, the old school antipsychotics, etc.).

these days, the various antidepressant are far more common for depression, but amphetamines and other stimulants, such as ritalin, focalin, provigil and nuvigil, now and then even some milder stimulants used primarily as diet pills, are sometimes used to help people with some forms of depression. from my own experiences and what i've observed with others, it seems that stimulants are mostly used with other, more standard forms of treatment.

so, if a person is going to therapy and taking an antidepressant and they have problems that might respond to a stimulant (low mood, fatigue, concentration problems, apathy, etc.), then a stimulant is sometimes added to the other drug(s).

sorry to ramble. I guess I'm trying to say that yes, there --is-- a risk of serotonin syndrome here. the risk of serotonin syndrome from antidepressants goes up when there's a stimulant in the mix, btw. still, serotonin syndrome is relatively uncommon, even when stimulants are in the mix. of course, there's all sorts of variable involved there...individual susceptibility, the doses of the drugs involved, any street drugs that might be involved, etc., so...yeah. do be aware of the serotonin syndrome risk, please.

this sort of combination can be very effective and useful for a lot of people. ssri drugs commonly cause (or exacerbate...) apathy, concentration problems, fatigue, emotional numbing, etc. some doctor will add in wellbutrin, a more stimulating antidepressant, to ongoing ssri treatment, to help with both the depression and problems from ssri-treatment. adding a stimulant can also help, and stimulants often work quickly, can be discontinued quickly (if needed...), and don't have as many drug-drug interactions as many other psych drugs.

ok. sorry this got so long, lol. i hope this helps. i hope your son gets safe+effective treatment and can move forward.

[Americano]

1) stop the adderall and see if that’s what’s making him depressed, as it is very common to happen with amphetemines
2) I’ve seen where Prozac interacts with the same liver enzymes as adderall and can cause flunctuations in blood levels of the drug
-do some more research before deciding your sons health based on some strangers on the internet.