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Best Ritalin augmentation? (Antidepressant)


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This is more of a poll to see everyone's favorite med that augments Ritalin? Unfortunately, I don't have access to Adderall, Dex, or any other stimulants (not available/authorized here). So..... I'm debating on switching out my A/D... I'm leaning towards going back to Effexor.

My pdoc also suggested Abilify to augment, but seems that would be counterproductive, I'm not thrilled about the side effects.

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4 hours ago, Blahblah said:

This is more of a poll to see everyone's favorite med that augments Ritalin? Unfortunately, I don't have access to Adderall, Dex, or any other stimulants (not available/authorized here). So..... I'm debating on switching out my A/D... I'm leaning towards going back to Effexor.

My pdoc also suggested Abilify to augment, but seems that would be counterproductive, I'm not thrilled about the side effects.

What symptoms are you wanting to treat with the augment? 

I see you've tried quite a lot of ADs.....I noticed you haven't tried Viibryd, though....It is considered to be an SSRI.

Also noticed you haven't yet tried Luvox (Fluvoxamine) or Paxil......They are also SSRIs.

The Prozac dose you are on (10mg) is a pretty low dose.....If the Prozac agrees with you, you have plenty of room to go up on it, if pdoc agrees.

Edited by CrazyRedhead
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4 hours ago, Blahblah said:

This is more of a poll to see everyone's favorite med that augments Ritalin? Unfortunately, I don't have access to Adderall, Dex, or any other stimulants (not available/authorized here). So..... I'm debating on switching out my A/D... I'm leaning towards going back to Effexor.

My pdoc also suggested Abilify to augment, but seems that would be counterproductive, I'm not thrilled about the side effects.

depends on what the problem symptoms are. FWIW- very low doses of abilify may not cause all of the shitty side effects, or at least have a lower profile. Obviously not a given there. What was your experience with effexor the first time around and why are you leaning towards that? 

if youre treating more of the depressive symptoms and not anxiety rexulti may be an option if thats around where you live 

oh- what about paxil, less activation that prozac might be good for anxiety centric issues 

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19 hours ago, CrazyRedhead said:

What symptoms are you wanting to treat with the augment? 

I see you've tried quite a lot of ADs.....I noticed you haven't tried Viibryd, though....It is considered to be an SSRI.

Also noticed you haven't yet tried Luvox (Fluvoxamine) or Paxil......They are also SSRIs.

The Prozac dose you are on (10mg) is a pretty low dose.....If the Prozac agrees with you, you have plenty of room to go up on it, if pdoc agrees.

I'd love something that will boost the effects of the Ritalin. And stop this Anhedonia..... ! While my "major" depression and anxiety is (for the most part) covered, I have persistent, longterm apathy, no motivation, no engagement in anything. Nothing is pleasurable. Lethargy. I am ALWAYS mentally and physically tired - (despite having no other physical reasons to be).

I forgot, I was actually considering Viibryd (if they even have it here) I will ask my pdoc. Typical SSRIs all make me more flat/ tired.

 

19 hours ago, Iceberg said:

depends on what the problem symptoms are. FWIW- very low doses of abilify may not cause all of the shitty side effects, or at least have a lower profile. Obviously not a given there. What was your experience with effexor the first time around and why are you leaning towards that? 

if youre treating more of the depressive symptoms and not anxiety rexulti may be an option if thats around where you live 

oh- what about paxil, less activation that prozac might be good for anxiety centric issues 

 

(See above for my residual symptoms, mostly anhedonia, lethargy)...  I stopped Effexor because of the short half-life (sometimes I accidentally miss doses, get brain zaps). Plus my eye doctor said it was causing my extreme dry eye and stressed that it can lead to issues with my eyesight (which was perfect until 3 years ago)

It's a real shame because I've heard here that high-dose Effexor actually works more on Dopamine (versus low dose, being more like an SSRI) I had only gone up to 150mg because of the increased dry eye issue at higher doses 😞

At the same time, she says Ritalin exacerbates dry eye also. I think I've been experiencing some paradoxical effects from it (like I take it afternoon and immediately feel zoned out and super drained, can just stare at a wall for hours...almost worse than when I don't take the afternoon dose)

Edited by Blahblah
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1 hour ago, Blahblah said:

I'd love something that will boost the effects of the Ritalin. And stop this Anhedonia..... ! While my "major" depression and anxiety is (for the most part) covered, I have persistent, longterm apathy, no motivation, no engagement in anything. Nothing is pleasurable. Lethargy. I am ALWAYS mentally and physically tired - (despite having no other physical reasons to be).

I forgot, I was actually considering Viibryd (if they even have it here) I will ask my pdoc. Typical SSRIs all make me more flat/ tired.

I'm curious about why you stopped Trintellix and Wellbutrin......And also, what doses did you try with those?

How long did you try them?....It can take up to six weeks for full effect of an antidepressant.

Both of these meds are considered good for anhedonia.....Here's an article on Trintellix:

https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00017/full

And Wellbutrin:

https://www.sciencedirect.com/science/article/abs/pii/S0165032702003063

I can't find anything on how Viibryd affects anhedonia, but it would certainly be worth a try if it's available in your area.....Although, here's a link comparing Trintellix vs Viibryd:

https://www.singlecare.com/blog/trintellix-vs-viibryd/

_______Also, I forgot about Fetzima...It is a newer SNRI, approved here in the U.S. in 2013....Don't know if it's available where you are, but it's worth mentioning.

Edited by CrazyRedhead
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@CrazyRedhead I was on Trintillex for a good 3 months I think. I didn't notice any difference from effects of SSRIs (Prozac). In fact, I think people referred to it as the "new Prozac" because it is so similar in function. I usually do trials of 2-3 months (unless intolerable side effects). It was very expensive I recall, dunno if there's a generic?

Wellbutrin I've done 3 different trials. I had such high hopes for that one! The only effect I noticed was Tinnitus, increased heartrate, restless legs. Didn't seems to effect my mood or motivation. But I've never tried in combo with ritalin (docs seem concerned about heart issues with these)

Ugh. I'm so tempted to just titrate off everything & do a wash-out. I've never been on more than like 3-4 meds at one time, but I hate when you don't feel like things are cutting it or working well enough... I just want to feel good...

Edited by Blahblah
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1 hour ago, Blahblah said:

@CrazyRedhead I was on Trintillex for a good 3 months I think. I didn't notice any difference from effects of SSRIs (Prozac). In fact, I think people referred to it as the "new Prozac" because it is so similar in function. I usually do trials of 2-3 months (unless intolerable side effects). It was very expensive I recall, dunno if there's a generic?

Trintellix is still brand only, no generic yet....(I take it, and it is expensive, although my insurance pays most of the cost).

Are you still taking the 10mg of Prozac?..........If so, you could try going up on the Prozac a bit, if pdoc agrees.....10mg is a pretty low dose.

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1 hour ago, CrazyRedhead said:

Are you still taking the 10mg of Prozac?..........If so, you could try going up on the Prozac a bit, if pdoc agrees.....10mg is a pretty low dose.

i think this a good suggestion too

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On 6/18/2021 at 2:22 PM, Blahblah said:

I'd love something that will boost the effects of the Ritalin. And stop this Anhedonia..... ! While my "major" depression and anxiety is (for the most part) covered, I have persistent, longterm apathy, no motivation, no engagement in anything. Nothing is pleasurable. Lethargy. I am ALWAYS mentally and physically tired - (despite having no other physical reasons to be).

I forgot, I was actually considering Viibryd (if they even have it here) I will ask my pdoc. Typical SSRIs all make me more flat/ tired.

 

 

(See above for my residual symptoms, mostly anhedonia, lethargy)...  I stopped Effexor because of the short half-life (sometimes I accidentally miss doses, get brain zaps). Plus my eye doctor said it was causing my extreme dry eye and stressed that it can lead to issues with my eyesight (which was perfect until 3 years ago)

It's a real shame because I've heard here that high-dose Effexor actually works more on Dopamine (versus low dose, being more like an SSRI) I had only gone up to 150mg because of the increased dry eye issue at higher doses 😞

Was it IR or XR Effexor you were on?  I find the XR versiom to be better than the IR I started out on.  Plus no issues if I miss a dose.  (Albeit I am taking baby dose 2 times a day)  

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Wellbutrin has been a miracle God send antidepressant. I was abusing Ritalin, because I also experience anhedonia, apathy and tired all the time so I was taking daily a box of methylphenidate with 30 tablets each one, taken orally, snorted and sublingual. Yes 300mg per day, I was out of money everytime just thinking for my next dose. That wasn't life. My psychiatrist suggested me Bupropion (Wellbutrin) 150mg XR in the morning and 150 at night. The real change was when I upped my dose by myself to 450mg (2-0-1) and incredible subtle works amazing now I can see more clear what a disaster I was and believe me at the max recommend dose is where I literally don't crave ritalin snorted or whatever the route of administration, I unbelieve how much Wellbutrin gave me joy of life, when there was light in the end of the road. 

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On 6/22/2021 at 2:32 PM, CrazyRedhead said:

Are you still taking the 10mg of Prozac?..........If so, you could try going up on the Prozac a bit, if pdoc agrees.....10mg is a pretty low dose.

Yep, Prozac stops me crashing into dysphoria, but it seems the higher you go on A/Ds, the more flat, numb and tired I become. I just feel like it's too much.... it's not "mood brightening" for me like Ritalin was...

 

On 6/23/2021 at 2:06 AM, helenllama said:

Was it IR or XR Effexor you were on?  I find the XR versiom to be better than the IR I started out on.  Plus no issues if I miss a dose.  (Albeit I am taking baby dose 2 times a day)  

I think I've tried both, as the XR came out after the IR was on the market.

 

12 hours ago, Equilibrium022x said:

Wellbutrin has been a miracle God send antidepressant. I was abusing Ritalin, because I also experience anhedonia, apathy and tired all the time so I was taking daily a box of methylphenidate with 30 tablets each one, taken orally, snorted and sublingual. Yes 300mg per day, I was out of money everytime just thinking for my next dose. That wasn't life.

My psychiatrist suggested me Bupropion (Wellbutrin) 150mg XR in the morning and 150 at night. The real change was when I upped my dose by myself to 450mg (2-0-1) and incredible subtle works amazing now I can see more clear what a disaster I was and believe me at the max recommend dose is where I literally don't crave ritalin snorted or whatever the route of administration, I unbelieve how much Wellbutrin gave me joy of life, when there was light in the end of the road. 

This is really encouraging to hear. Yikes, how were you getting 30 boxes of ritalin each month (I assume not legally). The issue with stimulants I've found, you need to keep increasing the longer you are on them. Taking even a month-long break has not made much difference. i can barely feel it kicking in and don't feel energized any more. Maybe it fries the pathways over time?

I think I only took up to 300mg Wellbutrin (because docs never would increase over the max due to possible heart effects and increased chance of seizures). What effect did you notice when you first started it? Did you feel effect right away? Are you currently taking any other meds along with it?

Edited by Blahblah
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