Kristine: not alone

[Kristine]

Just to add ...http://www.ourmed.org/wiki/Dextroamphetamine_and_Amphetamine

 

A quote from this page:  this information is backed up by various journal articles...at this point I can't access them without paying for them...just the Abstract

• Antidepressant substrates of 2D6 such as amitriptyline (Elavil), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor) may interact through competitive inhibition of Cytochrome p450 2D6
• Use special caution: Antidepressant blockers of 2D6 such as fluoxetine (Prozac), paroxetine (Paxil), will significantly block 2D6 over time and create accumulation of AMP with significant toxic implications

It is therefore my hypothesis, from what I have read so far, that since the introduction of dexamphetamine (20mg) December 2016 my body has slowly built up a level of dexamphetamine (amp)Toxicity due to the fluoxetine  being a substrate of 2D6...my plan is to taper the dexamphetamine more rapidly..perhaps 5% - 10% every 3 days (part of me is tempted to CT the remaining Dex) ..any thoughts are welcome. K 

[Kristine]

On 13/02/2018 at 5:18 PM, Kristine said:

• Every night vivid dreams and restless sleep. 3-5 hours sleep. Wake drenched in sweat but only wet PJ's..not sheets (better than before Prozac drop) wake with mild anxiety (ache in chest). Feel queasy. Extreme muscular weakness and fatigue (all day). Wake with low mood which continues throughout day. 
• 7am.  Medication - Fluoxetine 20mg, dexamphetamine 3.375mg, clonazepam 0.125mg
• 8am decreased appetite (again) 
• 9am  loose stools.  Bed, unable to stand for long, queasiness turns into nausea.(nausea has decreased slightly)
• 10am - 12pm headache, clammy hands and feet. Mild tremor in hands and legs
• 1pm Medication - dexamphetamine 2.25mg, clonazepam 0.125mg
• 2pm loose stools...headache and anxiety (tightness in chest, breathing difficulties, churning stomachs, clawing insides) ramp up in intensity..burning skin, muscular pain increases. 
• 3pm-5pm shivering (need to turn on electric blanket - it's summer here!).  Buzzing feeling in body and brain, pins and needles in palms of hands. Increasing irritability , very sweaty hands and feet
• 6pm - 9pm.  Anxiety decreases back to mild ache in chest, nausea (Queasiness) decreases slightly. Acid reflux (haven't had this symtom for a long time)...apple cider vinegar helps a little. Headache eases.
• 10pm - Medication clonazepam 0.125mg
• eventually sleep around 2am...acid reflux has been an issue. Try to sleep propped up. (One night terror on the 19th Feb 2018 4am) 

The above is my symptom pattern just prior to decreasing the dexamphetamine by 10%. Today is Day 4 since Dex taper. I have added in bold what has changed. Not that much. K 

[Kristine]

9 hours ago, Kristine said:

 

Just to add ...http://www.ourmed.org/wiki/Dextroamphetamine_and_Amphetamine

 

A quote from this page:  this information is backed up by various journal articles...at this point I can't access them without paying for them...just the Abstract

• Antidepressant substrates of 2D6 such as amitriptyline (Elavil), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor) may interact through competitive inhibition of Cytochrome p450 2D6
• Use special caution: Antidepressant blockers of 2D6 such as fluoxetine (Prozac), paroxetine (Paxil), will significantly block 2D6 over time and create accumulation of AMP with significant toxic implications

It is therefore my hypothesis, from what I have read so far, that since the introduction of dexamphetamine (20mg) December 2016 my body has slowly built up a level of dexamphetamine (amp)Toxicity due to the fluoxetine  being a substrate of 2D6...my plan is to taper the dexamphetamine more rapidly..perhaps 5% - 10% every 3 days (part of me is tempted to CT the remaining Dex) ..any thoughts are welcome. K 

 

I'm just hoping a moderator has seen this. There are two YouTube videos further up my thread by Dr Charles Parker discussing the dangers of amphetamine (stimulates) and Prozac (Fluoxetine). He began researching and writing about this topic in 1996.  Thank you K. 

[DMV64]

10 hours ago, Kristine said:

current medications through the drug interaction

Yes, I did this although I have to say it was ALOT to take in. It is somewhere in my thread but maybe I should do it again. How are you feeling today? 

[Kristine]

1 minute ago, DMV64 said:

 

10 hours ago, Kristine said:

current medications through the drug interaction

Yes, I did this although I have to say it was ALOT to take in. It is somewhere in my thread but maybe I should do it again. How are you feeling today? 

 

It can be a bit overwhelming! It's just past midnight in Australia but as usual I can't sleep! Very restless and jittery. I'd probably post the results again.  Love K xo

[Rosetta]

Hugs for you, Kristine.  Hang in there, honey.  -- Rosetta

[Kristine]

2 hours ago, Rosetta said:

Hugs for you, Kristine.  Hang in there, honey.  -- Rosetta

...and hugs for you Rosetta  thank you...and yes I am and will hang in there. I hope your day has been going well and your anxiety is at bay. Much Love. k xo

[JustCallMeJane]

On 2/19/2018 at 6:47 PM, Kristine said:

Oh Jane, I'm sorry you suffer from night terrors  I didn't have any issues last night (one off maybe?...who knows?!?) but still woke in a pool of sweat.  My husband suffers from frequent night terrors.  Awful stuff. Hubby and I are not exactly the best combo at the moment when it comes to sleeping.  At times we will have to sleep seperatly. Which I hate. 

I think it's a number of issues rolled into one.  I really feel I need to ditch the dexamphetamine at a faster rate because of its interaction with fluoxetine (this is what I think is causing the ongoing sweating and other issues).  Difficult to figure out!

 

biggest of hugs ((((Jane)))) love K xox

 

I understand how hard it is to sleep separately. I used to do that due to his snoring. That is until I learned how to sleep with earplugs, lol. I understand the need to ditch the meds fast. Just careful, as that can come back and bite you in the @$$. I hope a mod can give you some advice soon. HUGS hun 

[Kristine]

1 minute ago, JustCallMeJane said:

I understand how hard it is to sleep separately. I used to do that due to his snoring. That is until I learned how to sleep with earplugs, lol. I understand the need to ditch the meds fast. Just careful, as that can come back and bite you in the @$$. I hope a mod can give you some advice soon. HUGS hun 

Thank you Jane  you are so wonderful to me.  Every time I take these medications I subconsciously say the word poison...it just slips in there! Blah! I haven't made any changes yet. Just feel so so sick.  Hugs back to you. Love K xo

[Kristine]

Hey All, I have decided to decrease my afternoon dose of dexamphetamine by 20%...my blood pressure has steadily been increasing over the past year...used to be 125/80 and now on average is 170/90, my heart rate sits between 80-100 (all at rest).  I'm sweating, have nausea, vomited this morning. I am shaking.  Headache is relentless, I am so physically weak.  I am very concerned that I have been suffering from long term dexamphetamine toxicity.  I have explained my reasoning behind this in recent posts. I need to do something. Love K xo

[Kristine]

Current afternoon dose of dexamphetamine 2.25mg...decrease by 20% =  1.8mg = Reduce from 2.8ml to 2.3ml 

[Rosetta]

Maybe you will be able to laugh at this: our cat has nightmares.  She pretty neurotic in a lot of other ways, but she growls in her sleep.  She insists on being with me almost all the time, and if I don't put her out at night she ends up on the bed, growling.  This is quite alarming sometimes if I am asleep, of course, having my own bad dreams.  Is it any surprise that I have a cat that makes WD worse?  If I didn't laugh I would cry, and sometimes I do cry!

[Kristine]

11 minutes ago, Rosetta said:

Maybe you will be able to laugh at this: our cat has nightmares.  She pretty neurotic in a lot of other ways, but she growls in her sleep.  She insists on being with me almost all the time, and if I don't put her out at night she ends up on the bed, growling.  This is quite alarming sometimes if I am asleep, of course, having my own bad dreams.  Is it any surprise that I have a cat that makes WD worse?  If I didn't laugh I would cry, and sometimes I do cry!

Thank you Rosetta  yes it made me smile! bless you. K xo

[wantrelief]

1 hour ago, Kristine said:

Hey All, I have decided to decrease my afternoon dose of dexamphetamine by 20%...my blood pressure has steadily been increasing over the past year...used to be 125/80 and now on average is 170/90, my heart rate sits between 80-100 (all at rest).  I'm sweating, have nausea, vomited this morning. I am shaking.  Headache is relentless, I am so physically weak.  I am very concerned that I have been suffering from long term dexamphetamine toxicity.  I have explained my reasoning behind this in recent posts. I need to do something. Love K xo

Oh Kristine - I am very sorry you have been put in this position.  And so sorry you are feeling so ill.  You are truly courageous and an inspiration to me. I very much hope you experience some positive changes with the decrease.  

[JustCallMeJane]

1 hour ago, Kristine said:

Hey All, I have decided to decrease my afternoon dose of dexamphetamine by 20%...my blood pressure has steadily been increasing over the past year...used to be 125/80 and now on average is 170/90, my heart rate sits between 80-100 (all at rest).  I'm sweating, have nausea, vomited this morning. I am shaking.  Headache is relentless, I am so physically weak.  I am very concerned that I have been suffering from long term dexamphetamine toxicity.  I have explained my reasoning behind this in recent posts. I need to do something. Love K xo

 

Good luck and good thoughts with you on this decrease. HUGS 

[Kristine]

Ok, so I've just got off the phone from the nurse at my GPs practice.  Blood results are normal except for calcium levels.  I have hypercalcemia...another side effect of amphetamine toxicity (could be other causes) I had just heated some soup in the microwave when the call came. Finished the call and then spilt the soup all over my bed. It was borscht. I cursed...threw my phone across the room...cursed some more...screamed...I've fallen in yet another heap and I'm bawling.  This is BS. Sorry everyone. I don't know what to do   I'm just so very over it all. Love K xo

[Rosetta]

Oh, Kristine, I wish I could be there to help you.  I'm so sorry.  Try to breathe.  I would hold you if I could.

[Kristine]

Thank you WR, Jane and Rosetta,  I'm breathing...at least through the mouth, cause I'm all snotty xo

[Downbutnotout]

36 minutes ago, Kristine said:

Ok, so I've just got off the phone from the nurse at my GPs practice.  Blood results are normal except for calcium levels.  I have hypercalcemia...another side effect of amphetamine toxicity (could be other causes) I had just heated some soup in the microwave when the call came. Finished the call and then spilt the soup all over my bed. It was borscht. I cursed...threw my phone across the room...cursed some more...screamed...I've fallen in yet another heap and I'm bawling.  This is BS. Sorry everyone. I don't know what to do   I'm just so very over it all. Love K xo

I am so sorry! 

[Downbutnotout]

I am so sorry! 

[Kristine]

Hi LGH, Thank you for your lovely message. Your bath salts sound devine! I've put peppermint oil in my diffuser...pounding headache. I think the phone call and then the spilt soup was the straw that broke this camels back. I don't make a habit of throwing things 😞 Anyway, thankfully my phone landed in the mountain of laundry I haven't put away, so no damage 

51 minutes ago, Longestroadhome said:

Good news first, the blood test were all normal. Breathe slowly, that is good news. Hypercalcemia.........not sure what that is but hopefully it is fixable.

Hypercalcemia is high calcium levels in the blood.  It is concerning. I need to find the cause. If it is not due to the medication issues...there are other causes which I'm trying not to think about.  Sometimes ignorance is bliss.  Must find a new GP.  All too much at the moment. 

 

SBS is a good idea.  I've got Swedish blood so maybe I should watch Vikings! 

 

Much Love K xo

ps. I tried to get the stain out...now in the washing machine  ....note to self: don't eat borscht in bed  

[wantrelief]

Hey Kristine - I would have the blood test repeated....it could just be an error.  I saw this all of the time when I worked as a nurse practitioner.  Levels would be off and then we would redraw the blood and it would come back normal.  So it very well could be fine - at least that is very much my hope!!

[Kristine]

2 minutes ago, wantrelief said:

Hey Kristine - I would have the blood test repeated....it could just be an error.  I saw this all of the time when I worked as a nurse practitioner.  Levels would be off and then we would redraw the blood and it would come back normal.  So it very well could be fine - at least that is very much my hope!!

Thank you so very much WR  I'll do this. I got myself in a bit of a panic (understatment). Not thinking clearly. I just wish I knew for sure what was causing all these issues.  Got that "lost and frightened" feeling. I've managed to settle myself..cup of tea, clean sheets and peppermint oil! Much Love.K xo

[wantrelief]

Totally understandable, Kristine, as it is yet another thing to have to worry about - as if you didn't already have enough on your plate.  I am glad you are feeling better now and have clean sheets - yay!

 

[DMV64]

Hi Kristine,

How are you doing today.

I would see about getting those bloods redone. Like others have said...

So...I woke up with a little less anxiety than yesterday so that's good. 

My doc spoke with me about hospitalization to come off meds. I have to admit I  did not ask many questions because I was in a brain fog. Ugh. I can't really understand how in 9 days (or maybe more) the medical community can safely get a person off these meds.

-D

[Rosetta]

Hi Kristine, 

 

About the calcium test -- I feel that these tests are often wrong for people in WD, and I think it's because from day to day and hour to hour our endocrine systems are fluctuating wildly.  I have noticed recently that my vision does not black out if I stand up too fast.  My blood pressure is more steady.  The are numerous other little feelings and emotions that come and go.  My blood sugar is all over the board.  I have no doubt that at any given time my blood has higher than normal levels of all sorts of minerals, hormones and alarming substances that would indicate this illness or that.  I agree that a re-test is in order, but I hope you don't worry if there yet another odd reading for some other indicator.  

 

I hope that that today is one of rest for you.

 

Peace, Rosetta

 

 

[Kristine]

8 hours ago, DMV64 said:

Hi Kristine,

How are you doing today.

I would see about getting those bloods redone. Like others have said...

Hey DM, I'm better than yesterday! Unlike you I am ok first thing in the morning...I get worse as the day progresses and then symptoms ease slightly during the evening.   I have popped over to your thread to comment on the remainder of your post..Love K xo

[Kristine]

3 hours ago, Rosetta said:

Hi Kristine, 

 

About the calcium test -- I feel that these tests are often wrong for people in WD, and I think it's because from day to day and hour to hour our endocrine systems are fluctuating wildly.  I have noticed recently that my vision does not black out if I stand up too fast.  My blood pressure is more steady.  The are numerous other little feelings and emotions that come and go.  My blood sugar is all over the board.  I have no doubt that at any given time my blood has higher than normal levels of all sorts of minerals, hormones and alarming substances that would indicate this illness or that.  I agree that a re-test is in order, but I hope you don't worry if there yet another odd reading for some other indicator.  

 

I hope that that today is one of rest for you.

 

Peace, Rosetta

Thank you Rosetta,  I have managed to calm myself and today is an improvement over yesterday.  You are so right about the blood test (also WR and DM)...yesterday I started to go into "catastrophic thinking" which is such a waste of precious energy.  My other concern is my regular GP, who I trust, has moved to another state and I have to find a new GP.  A few weeks ago my gynaecologist gave me a list of female GPs that she recommended..who are open minded and willing to learn from their patients.    So that is my next step.  If only this fatigue were not so debilitating. One step at a time, that is all we can do! Thank you for all your wise words and encouragement.  It helps me take those steps! Much Love and hugs. K xo

[Downbutnotout]

On 2/20/2018 at 7:45 PM, Kristine said:

Thank you Rosetta  yes it made me smile! bless you. K xo

That made me smile too. 

[DMV64]

14 hours ago, Kristine said:

better than yesterday

That is great! So far this morning I am medium. Let's hope it gets better.

I hate morning dread.

-D

[manymoretodays]

On 2/19/2018 at 8:45 PM, Kristine said:

Just to add ...http://www.ourmed.org/wiki/Dextroamphetamine_and_Amphetamine

 

A quote from this page:  this information is backed up by various journal articles...at this point I can't access them without paying for them...just the Abstract

• Antidepressant substrates of 2D6 such as amitriptyline (Elavil), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor) may interact through competitive inhibition of Cytochrome p450 2D6
• Use special caution: Antidepressant blockers of 2D6 such as fluoxetine (Prozac), paroxetine (Paxil), will significantly block 2D6 over time and create accumulation of AMP with significant toxic implications

It is therefore my hypothesis, from what I have read so far, that since the introduction of dexamphetamine (20mg) December 2016 my body has slowly built up a level of dexamphetamine (amp)Toxicity due to the fluoxetine  being a substrate of 2D6...my plan is to taper the dexamphetamine more rapidly..perhaps 5% - 10% every 3 days (part of me is tempted to CT the remaining Dex) ..any thoughts are welcome. K 

 

Hi Kristine,

Ha.  Found this.  And I saw the videos you posted as well. 

I am certainly not going to encourage you to CT your dexamphetamine. 

 

Am trying to catch up with the rest of your recent changes as well.

[AliG]

I would agree with MMT, that this is not going to necessarily be encouraged here, particularly on the heels of the last 50 % drop ~ This is a bit of an "out there" hypothesis.

 

It's far too much to be dealing with this all at once. You're already struggling ~ why add more to the mix? It would be wiser to just hold without changing anything else.

 

( posted at the same time as MMT)

Edited February 22, 2018 by AliG
added comment about timing

[manymoretodays]

On 2/20/2018 at 5:03 PM, Kristine said:

Current afternoon dose of dexamphetamine 2.25mg...decrease by 20% =  1.8mg = Reduce from 2.8ml to 2.3ml 

 

So 3 days after your 10% decrease of dexamphetamine, you have decreased another 20%?  Did this all come about after your research and watching videos on the topic of toxicity?  I'm a little concerned.   Neuroemotions may also be at play here.  I mean of course they are.  And then the effect from whopping decrease of  fluoxetine had just come into play as well. Is your total daily dose of dexamphetamine at 5.65 mg. right now?

 

 

I'm somewhat in agreement with some of the comments above....... that your blood test might be worth a redraw.   Flucuations do happen.   And did see your mention of some BP changes over a years time.

 

Can you post a bit about your daily symptom pattern again, with medications/drugs, and time of day?  That should be helpful.

 

http://survivingantidepressants.org/topic/1008-before-you-begin-tapering-what-you-need-to-know/

 

 

Just posting the link as it may be helpful right now.

 

And this:

http://survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stab 

 

Love, peace, healing/inrecovery, and growth,

mmmt

 

Edited February 22, 2018 by manymoretodays

[Kristine]

8 hours ago, manymoretodays said:

On 20/02/2018 at 2:45 PM, Kristine said:

Just to add ...http://www.ourmed.org/wiki/Dextroamphetamine_and_Amphetamine

 

A quote from this page:  this information is backed up by various journal articles...at this point I can't access them without paying for them...just the Abstract

• Antidepressant substrates of 2D6 such as amitriptyline (Elavil), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor) may interact through competitive inhibition of Cytochrome p450 2D6
• Use special caution: Antidepressant blockers of 2D6 such as fluoxetine (Prozac), paroxetine (Paxil), will significantly block 2D6 over time and create accumulation of AMP with significant toxic implications

It is therefore my hypothesis, from what I have read so far, that since the introduction of dexamphetamine (20mg) December 2016 my body has slowly built up a level of dexamphetamine (amp)Toxicity due to the fluoxetine  being a substrate of 2D6...my plan is to taper the dexamphetamine more rapidly..perhaps 5% - 10% every 3 days (part of me is tempted to CT the remaining Dex) ..any thoughts are welcome. K 

 

Hi Kristine,

Ha.  Found this.  And I saw the videos you posted as well. 

I am certainly not going to encourage you to CT your dexamphetamine. 

 

Am trying to catch up with the rest of your recent changes as well.

Hey MMT, I promise I won't CT the Dex.  I wrote that when I was frustrated (must not post when in that frame of mind ) after a cascade of events that lead me to feelings of intense anger directed at the psychiatrist who prescribed many medications with major drug interactions.

 

8 hours ago, manymoretodays said:

On 21/02/2018 at 11:03 AM, Kristine said:

Current afternoon dose of dexamphetamine 2.25mg...decrease by 20% =  1.8mg = Reduce from 2.8ml to 2.3ml 

 

So 3 days after your 10% decrease of dexamphetamine, you have decreased another 20%?  Did this all come about after your research and watching videos on the topic of toxicity?  I'm a little concerned.   Neuroemotions may also be at play here.  I mean of course they are.  And then the effect from whopping decrease of  fluoxetine had just come into play as well. Is your total daily dose of dexamphetamine at 5.65 mg. right now?

Sorry MMT, I haven't explained this very well.  I decreased only the afternoon dose by 20% but not the morning dose (rational: try to improve sleep and the Prozac & Dex interaction. So in total I have decreased by a total of 10%.  Therefore I am currently taking 5.2mg.  I'll update my signature.  I have read further information involving liver metabolism (or lack of) of amphetamine when Prozac is added to the mix.  I will post more information...I will not make any more changes at this point in time. 

 

[Kristine]

9 hours ago, AliG said:

 

I would agree with MMT, that this is not going to necessarily be encouraged here, particularly on the heels of the last 50 % drop ~ This is a bit of an "out there" hypothesis.

 

It's far too much to be dealing with this all at once. You're already struggling ~ why add more to the mix? It would be wiser to just hold without changing anything else.

 

( posted at the same time as MMT)

 

Hey Ali,  Thank you for your concern.  As I said to MMT I'll post more information about my research (preferably a journal article). This interaction between Prozac and dexamphetamine greatly concerns me.  When I was on the 20mg dose of Dex and 40mg of Prozac (August 2017) I suffered severe chest pain, nausea, sweating and vomiting.  I was taken to hospital via ambulance (I thought I was having a heart attack) but they were unable to find the cause. It happened two hours after my second 10mg dose of Dex. Nausea, vomiting and sweating have been ongoing issues for the past year.  I often have mild chest pain.  Since the 50% decrease in Prozac the dystonia symptoms are almost gone.  Since decreasing the Dex my nausea has eased a little more (not gone but better).  I think I'll be in a much better place once I remove the dexamphetamine.  Then slow and steady with the Prozac and clonazepam. Hugs K 

[Kristine]

The following quote is from Dr Charles Parker (neuroscientist and psychiatrist specialising in ADHD)...I don't have "ADHD" but was prescribed the dexamphetamine for fatigue. I'm rolling my eyes.  Much of this research commenced in the mid 1990's (there are many journal articles but interest seems to have decline in the mid 2000's - I'm sure there is a reason...because it is not due to lack of evidence) However, Dr Parker seems to be the only physician who is sill concerned about it.  I find this mind boggling! 

 

http://docparker.typepad.com/corepsych/2006/11/how_that_ssri_a.html#more

 

 

"To follow up: Psych drug interactions are nothing less than pandemic. 

The overall lack of appreciation regarding the seriousness of these interactions is creating a great negative buzz that results in profound negative consequences for those who either need treatment or are currently taking stimulant meds with antidepressants.

The reference books in the previous post will be helpful, and if you want to really get more into it check out this one on the Cytochrome P450 metabolic pathways. Bottom line, think of pipes, working drains that take meds from one form to another more useful form. 

[By the way these drugs are not "broken down" by these liver pathways, but are built up so they can be used, metabolized and excreted.] The amphetamines all come up through this one pipe, the 2D6 pipe [the CYP450 2D6 pipe].  Prozac and Paxil significantly block that specific pipe [and others].

This dramatic cooling of the prefrontal cortex is what we have seen as a result of med interactions:

 

 

If the amphetamine [Adderall, Dextrostat, dextroamphetamine] is poorly metabolized because the pipe is plugged by drug like Prozac or Paxil, or because of genetic variants [meaning you didn't get that particular pipe in the first place - more later], -if is not metabolized at all - big problems drift downstream, down our own inside stream. 

You or your loved ones can become relatively toxic, either slowly in the first week or so, or can have a big ongoing problem months down the road. The drug slowly builds up because it isn't being burned properly. It sneaks up on you, you start cycling, and what does everyone say... she's bipolar! How many have heard that one before? Most characteristic is the feeling of great overfocus for short periods, getting almost too much done, and then it's as if the lights go out. 

Can't think, can't complete sentences. Cognitive abilities are worse! Let's see, what should we do? Use more amphetamines? No, just change the antidepressant" 

 

In relation to the last line in Dr Parkers quote....no, I would not change the antidepressant....I need to get rid of the Dexamphetamine.  I hope this explains my rational @manymoretodays And @AliG ...in no way am I deliberatly steering away from SA's 10% every 4 week guideline due to stubbornness or other reasons. Does this make sense? It is a deep (rational) concern that the dexamphetamine has built up in my system due to fluoxetine blocking the 2D6 pathway. I feel I am being harmed by this drug. In how many ways? I don't know....I also don't know exactly what to do....pros and cons again 

 

My thought process stemmed from reading the below interaction which I've put in bold.  Then I wanted to know 'Why' fluoxetine may increase the effects of dextroamphetamine....I think I found the answer. 

Major

fluoxetine  dextroamphetamine

Applies to: fluoxetine, dextroamphetamine

Talk to your doctor before using FLUoxetine together with dextroamphetamine. FLUoxetine may increase the effects of dextroamphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.