Does sertraline affect adderall? (3+ guidelines)

In this article, we are going to talk about the interactions between sertraline and Adderall are taken together. The paper will focus on the effects of combining both drugs

Does sertraline affect Adderall?

Yes, sertraline affects Adderall when taken concurrently by increasing its effects on the body. 

Sertraline is an antidepressant and is also used to treat post-traumatic stress disorder (PTSD), anxiety-related disorders, eating disorders, and attention deficit hyperactive disorder (ADHD) (1, 2). It can be taken as monotherapy or in combination with other drugs (2).

Adderall is a medication that is approved as a first-line choice for ADHD as well as narcolepsy (1). It helps to minimize impulsive thoughts and enhance focus and attention. It constitutes two major products, which include dextroamphetamine and amphetamine (2). When sertraline and Adderall are taken together, the dosage of Adderall should be reduced. This is because sertraline increases the effects of Adderall on the body.

What are the benefits of combining Sertraline and Adderall?

When sertraline and Adderall are taken together, the effect of Adderall on the body is potentiated (2). This interaction may consequently lead to increased efficacy in the management of ADHD. However, combining the two drugs can increase the risk of serotonin syndrome (3). 

In one research study conducted on ADHD and depression patients, a combination therapy of sertraline and methylphenidate was required for the treatment of ADHD (4). The combination therapy did not induce significant changes in blood pressure and heart rate. 

In another study, 24 ADHD patients were administered with oral Adderal 5mg (5).  Among the first responders to the medication, 3/4 were taking sertraline in fixed doses throughout the study. This research also proves that combining sertraline and Adderall improves clinical outcomes for ADHD. 

However, combining sertraline and Adderall can also lead to an increase in the side effect profile. Serotonin syndrome is one of the life-threatening syndromes associated with this combination and it requires immediate medical care (6).

What are the potential side effects of combining sertraline and Adderall?

Individuals combining sertraline and Adderall may develop multiple side effects. These are due to drug interactions, which lead to serotonin syndrome (6). Additionally, serotonin also interacts with Adderall, potentiating its effects (3).

Serotonin syndrome may present with symptoms such as fever, gastrointestinal upset, elevated heart rate, confusion, shivering and excessive sweating, muscle stiffness, and hallucinations (4, 7). The most fatal complications are death and coma (5).

Combining sertraline and Adderall also has the potential to increase blood pressure. Adderall increases heart rate which increases blood pressure (1). Sertraline may also increase blood pressure mildly especially when serotonin syndrome takes effect (2). When taken together, these two medications may induce hypertension and cardiovascular issues.

People taking this combination should immediately alert their healthcare provider in case they notice hypertension symptoms like severe headaches, dizziness, visual changes, chest pain, shortness of breath and fatigue. 

Other symptoms of increased Adderall effects include anxiety, thought disturbances, restlessness, and jitteriness. Patients should report to their psychiatrist if they experience these symptoms (3).

What are the guidelines for taking sertraline and Adderall together?

As stated above, combining sertraline and Adderall can result in life-threatening side effects. To prevent these, all patients should adhere to the following guidelines;

  • The dose of Adderall should be reduced to minimize the risk of serotonin syndrome (6).
  • Patients should avoid taking alcohol when taking sertraline and Adderall together. This is because alcohol interacts with both medications further increasing the risk of adverse effects (5).
  • Patients taking sertraline concurrently with Adderall should immediately report to a healthcare professional in case of side effects (2).
  • Patients with cardiovascular disorders should use the combined medications with caution as this increases the risk of sudden death and other fatal complications (4). 
  • Both medications should be tapered down to prevent drug dependence and abuse. 

What are the alternatives or considerations for individuals taking both medications?

Possible alternatives and considerations for individuals taking both medications include;

  • Use of monotherapy as this is associated with minimal risk of side effects (1).
  • Patients should have their dose of Adderall reduced by their psychiatrist before combining it with sertraline to prevent serotonin syndrome (2).
  • Another alternative is to use drugs that are well tolerated and with a reduced side effect profile (3).
  • Combining medications and psychotherapies can enhance treatment outcomes due to synergistic effects (3).

Conclusion and key takeaways

Both sertraline and Adderall can be used to manage ADHD. Combining the two drugs can potentiate Adderall’s effects on the body while increasing the risk of serotonin syndrome. Patients should get expert advice from their healthcare providers on how to combine the two drugs. In my opinion, it is better to use monotherapy than to combine sertraline and Adder for better treatment outcomes.

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References

1.-

Lee CS, Williamson LR, Martin SE, DeMarco M, Majczak M, Martini J, Hunter HL, Fritz G, Boekamp J. Adverse events in very young children prescribed psychotropic medications: preliminary findings from an acute clinical sample. Journal of Child and Adolescent Psychopharmacology. 2015 Aug 1;25(6):509-13.

2.-

Small TM, Dhat S, Faruqui Z. Dextroamphetamine-Amphetamine Augmentation in the Treatment of Treatment-Resistant Depression. Cureus. 2022 Aug 7;14(8).

3.-

Vo K, Neafsey PJ, Lin CA. Concurrent use of amphetamine stimulants and antidepressants by undergraduate students. Patient preference and adherence. 2015 Jan 22:161-72.

4.-

Findling RL. Open-label treatment of comorbid depression and attentional disorders with co-administration of serotonin reuptake inhibitors and psychostimulants in children, adolescents, and adults: a case series. Journal of child and adolescent psychopharmacology. 1996;6(3):165-75.

5.-

Horrigan JP, Barnhill LJ. Low-dose amphetamine salts and adult attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry. 2000 Jun 6;61(6):414-7.

6.-

Tardner P. Does Adderall increase serotonin levels?.

7.-

Selman J, Millard H. Recognizing and treating serotonin syndrome. dvm360. 2021 Feb 2;53.

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