# SSRI + Methylphenidate: your experiences please



## Inshallah (May 11, 2011)

Speak up!


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## Inshallah (May 11, 2011)

No one who's been on this combo? Can't be


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## fg35 (Mar 21, 2012)

I have. I went to the max dose of concerta, 72mg, and i was wigged out alot even though I didn't know it. I'm down to 36mg concerta, 100mg luvox, 200mg wellbutrin, 12.5mg imiprimine, and im still a miserable SOB. But I'm learning to change my self talk, forgive myself and others, etc. Its HARD. But after having taken so many different pills it's the only thing left for me to try to get better.


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## Inshallah (May 11, 2011)

Thanks. Did the methylphenidate help with the sexual dysfunction?


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## fg35 (Mar 21, 2012)

it did at first. When I first started taking it I thought it was fricken amazing. I think now that feeling was simply a rush of dopamine that anyone would get from speed, which is what concerta is. After taking it for over a year I could tell when then rush of dopamine came on, about 30 mins after taking concerta, and then I'd crash hard, ie get pretty grumpy, sleepy, depressed,30 minutes after that. 
So yes i did feel some clarity of mind but looking back I think it was just from the dopamine and the feeling was short lived. It sucks the brain is so complicated.


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## Inshallah (May 11, 2011)

That was my experience with methylphenidate as well, even without the ssri to counteract it. Great for the first hour, sucks afterwards. Wouldn't this be purely a controlled release issue? Because it feels like it peaks hard during the first hour and then drops off only from there instead of giving 8h or 12h constant release.

Basically even the CR versions act like you'd expect non-controlled-release methylphenidate to act.


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## fg35 (Mar 21, 2012)

I think thats because that first rush you get is from the easily absorbed coating on the pill and after that the release is slower plus you're adjusted to it from the first rush. dunno for sure. I do know that I love the calm after a hardcore workout, and I hate working out


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## GotAnxiety (Oct 14, 2011)

I think the combination is really unhealthy for the penis depend's how healthy you are i guess banging for 4 hour's straight i think ssri + stimulant can damage penile tissue cause infection and that prolong boner no good for ya.


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## Inshallah (May 11, 2011)

So the methylphenidate doesn't help with the delayed orgasm/penile sensitivity problems?


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## GotAnxiety (Oct 14, 2011)

Sex was never ment too last a long time specially without ejaculation can lead too frustration and infection i've never had an orgasm on the combo but i've only had 1.5 orgasm is my life soo... SSRI still block alot of sensitivity Ritlin just help's with the motivation AMP's might be better for that one but i wouldn't recommend AMP cause of the tolarance crash/depression that come's with it.

Dex instant release for sex might be the best option for that but it will come with the cost above.

You can still ejaculate if your antidepressant is half the maxium dose usually any higher and it just a pain.


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## wxolue (Nov 26, 2008)

Never had a huge problem with anorgasm and SSRIs. What change I did notice really wasn't offset with adderall though. Also, I notice that stimulants tend to really make my penis shorter, both when hard and when flaccid, which is kind of embarrassing


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## upndownboi (Oct 7, 2010)

> Date: Mon, 3 Apr 1995 05:29:28 -0700 (PDT)
> From: Ivan Goldberg <[email protected]>
> Subject: Dopamine agonists for patients who lose response to an SSRI
> 
> It has been hypothesized by Don Klein and others that what looks like decreased antidepressant effectiveness is really a state of akinesia resulting from depletion of dopamine with continuing use of the SSRIs. Based on this understanding one can treat the apparent fall-off in SSRI effectiveness with DA agonists such as bupropion, amantadine, methylphenidate, dextroamphetamine, etc. I have done this on many occasions, often with excellent results.


the theory suggests it should be a good combo but i haven't heard many experiences of it, perhaps they've all had grand remissions and are out living?

PS. what i wouldn't do to have Ivan Goldberg as my pdoc..


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## OrieLoo (Feb 16, 2012)

As far as mentally, awesome combo. Loved it. I was on Citalopram and Concerta. But... physically, Concerta + Citalopram = abnormal heart rhythm for me.  

I don't think I will ever take a stim again. Not worth the risk.


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## TyrosineKinase (Jan 20, 2010)

This has nothing to do with SSRIs or Ritalin, but I have heard anectodotal accounts of people having outstanding responses to NDRIs like wellbutrin with adderall. So I'm sure something similar will happen with the original poster's combination.


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## euphoria (Jan 21, 2009)

I take Prozac 20mg with Concerta XL 27mg. The first couple of weeks of Concerta were up and down as you'd expect, but now it delivers a more or less consistent effect for 12 hours after dosing. The euphoria went away quickly during the first weeks, as well as the crash. I just get tired when it wears off.

If you are going to take methylphenidate, get the 12 hour Concerta XL pills. Ritalin sucks, you have to take about 4 doses a day, your mood rapidly changes, and it encourages chasing the high. Long term stimulant use is nothing at all like the high you get at the start. For me, it just helps me organise my mind and do things, but it doesn't make them more enjoyable. It's not like when you snort a load of Ritalin/Dexedrine and find cleaning your house the most compelling and fun thing in the world. All it does is help you find happiness, it doesn't give you it for free. So if you're going to take it, I recommend the XL formulation, and if you're not going to take it every day, I wouldn't bother taking it at all.

Also, if you have anxiety, SSRIs combine well with stimulants, so yep it is a good choice you made to take the SSRI.


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## Inshallah (May 11, 2011)

Was going to use long acting Ritalin so I get 16h daily coverage. I also considered using Concerta 2 times a day to get the full 24h coverage but I assume this is never done by psychiatrists and I won't manage to get it prescribed.


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## sincerensassy1 (May 28, 2006)

*re: SSRI with Concerta (Methylphenidate)*

I've just spent over 6 hours reading studies, videos etc re: this subject.
The bottom line: If you are only ADD/ADHD, of course, you only need a stimulant, if that is the route you want to go.
The reason there are comorbid symptoms with ADD, is overactivity in the cerebral cortex, the frontal lobe.
Most people with ADD have depression and/or anxiety.
The anxiety can be, basically put, cognitive (worry, overthinking, OCD) which is in your frontal lobe, or effective/emotional (usually feeling/panic/shakes, etc.)
If you only take a stimulant, it causes an imbalance of the "scale", in your cognitive processing, so to speak.
For example, you take a stimulant, dopamine, feel a little better, then your depression/anxiety slowly bottoms out, serotonin ...
Or you take an SSRI, and your depression/anxiety is slowly better, serotonin, but your ADD worsens, dopamine ...
These are symptoms of needing both the SSRI and the Stimulant together to
balance out, like a scale.
Researching articles, they were mentioning Luvox on the "anxiety" end of the spectrum, Prozac is the worst with stimulants, but no "excellent" match for the depression end. Of course everyone reacts differently to SSRIs/SNRIs.
I like the Concerta XR, because it is slowly released and seems to have less side effects than Adderall. I think i am going to go with Lexapro or Zoloft with the SSRI end, because of less side effects for me personally.
Regarding information on ADD/ADHD and Depression/Anxiety spectrum disorders, this UTube vid by Dr. Charles Parker, a leading researcher in this subject really explains it better than I can. _Definitely interesting to watch!!_


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## T800 (Jun 13, 2013)

That's also one of my concerns. I have depression and adhd symptoms. I tried ritalin xl and it didn't really seem to do much. Now I'm taking lexapro but now I worry what if taking a SSRI will make the possible adhd stuff worse? Would it be better to simply take ritalin with it even if ritalin alone doesn't do much?


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## wealldead (Jun 20, 2014)

I took ritalin + paroxetine(paxil) and I Cependant, was good but just good and no works for sexual dysfuction of SSRI and no for anxiety too.
I'm conviced that speed doesn't work for anxiety, but only for depression that's could be a good way.


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## watertouch (Nov 4, 2013)

T800 said:


> That's also one of my concerns. I have depression and adhd symptoms. I tried ritalin xl and it didn't really seem to do much. Now I'm taking lexapro but now I worry what if taking a SSRI will make the possible adhd stuff worse? Would it be better to simply take ritalin with it even if ritalin alone doesn't do much?


Its different Noradrenalin decresses Dopamine signaling... Dopamine give u focus,
The Serotonin signalinging will degress Noradrenaline signaling, thus increase Dopamine... Problem with ADHD/ADD is that noradrenaline works as a transport for Dopamine to different brain areas...
So try the SSRI with Ritalin, weigh them against eachuther till it feels right.
And yes it takes time.


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## T800 (Jun 13, 2013)

Does this mean that SSRI + Ritalin is still not enough cause you still need NE for it to work? Does this mean I should add wellbutrin to the mix or directly switch to SNRI + Ritalin? But SNRIs kinda scary me cause of the withdrawal issues. I have virtually no side effects from lexapro but at 10mg also no real effect yet. I have been on 10mg for 3 weeks now. I am sceptical that it simply needs more time. I am planning to maybe try vortioxetine if lexapro doesn't work. Vortioxetine sounds really interesting.


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## A Sense of Purpose (May 8, 2011)

T800 said:


> Does this mean that SSRI + Ritalin is still not enough cause you still need NE for it to work? Does this mean I should add wellbutrin to the mix or directly switch to SNRI + Ritalin? But SNRIs kinda scary me cause of the withdrawal issues. I have virtually no side effects from lexapro but at 10mg also no real effect yet. I have been on 10mg for 3 weeks now. I am sceptical that it simply needs more time. I am planning to maybe try vortioxetine if lexapro doesn't work. Vortioxetine sounds really interesting.


You're in Australia right? How would you get Vortioxetine (PM me) here???


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## watertouch (Nov 4, 2013)

T800 said:


> Does this mean that SSRI + Ritalin is still not enough cause you still need NE for it to work? Does this mean I should add wellbutrin to the mix or directly switch to SNRI + Ritalin? But SNRIs kinda scary me cause of the withdrawal issues. I have virtually no side effects from lexapro but at 10mg also no real effect yet. I have been on 10mg for 3 weeks now. I am sceptical that it simply needs more time. I am planning to maybe try vortioxetine if lexapro doesn't work. Vortioxetine sounds really interesting.


Its the languege barrier... No you would try upping or lowering both meds till you find your sweetspot...

Wellbutrin works primarely as an NRI, the dopamine effect is probly not mentinable.

SNRI withdrawl, bolts of o lightning in your head specially from Efexor... Its not that bad, normal painkillers help.


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## T800 (Jun 13, 2013)

I'm not sure if there even is a sweet spot with ritalin for me. On some days when I take 10mg I feel nothing on other days I think I'm more aggitated.


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