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Re: Combining stims and antipsychotics? Yes/No?

Posted by Christ_empowered on January 20, 2023, at 9:42:38

In reply to Re: Combining stims and antipsychotics? Yes/No?, posted by rjlockhart37 on January 12, 2023, at 12:01:13

ThoraDex was one of the neuroleptic+upper combination pills (modified "goof ball," I suppose) available from the 50s-early 80s. Eskatrol was more popular I think...low dose compazine and dexedrine. Ever looked at vintage psych drug ads? to me, they're fascinating...speaks volumes about psychiatry, plus all the social aspects (social class, gender, etc.).

I saw a vintage ad for one that sounded like a whole med cocktail in 1 pill...Ritalin plus rauwolfia alkaloids (somewhat popular in the 50s, it seems), plus a low dose of some sort of anticholinergic (to help counter any adverse effects from the rauwolfia alkaloids...those work through dopamine depletion), plus meprobamate.

Sociohistorical ramblings aside...

I think it comes down to dosing, the drugs involved, and the needed effects. I would personally -not- advise mixing a high potency neuroleptic (old or new) with an amphetamine. Ritalin...maybe. Again...some old ads for Ritalin advise using it in hospitalized inpatients on stable neuroleptic protocols (back then, that almost always meant high doses).

I had an acquaintance who was on seroquel at night and adderall in the AM, both (if I recall correctly) at lower end of therapeutic doses. That actually lines up with thoradex...low potency, sedating neuroleptic plus amphetamine.

I seem to recall reading that the TD risk can go up, which makes sense intuitively, but I can't find the info now.

Adding in a GABA sedative seems, intuitively, that it might help further reduce the neuroleptic dosage and mitigate adverse effects from the upper and smooth out any problems between (and after) upper doses, but...

benzodiazepines obviously carry a number of risks. gabapentin at low to moderate doses might present a viable alternative (?), but again: the additional risks are not 0.

I guess...well, its between you and your treatment provider(s), obviously. I'd advise to take some b-vitamins and antioxidants with any neuroleptic. The big, big, big question becomes: is a neuroleptic necessary in this situation? and that's between you and the prescriber.




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