Zoloft and vyvanse (A Complete Guide)

In this blog, we are going to talk about the two medicines that affect our brain, “Zoloft and Vyvanse”. We will take a closer look at both then separately and then will discuss if it’s safe to use them together or not. 

If yes, then how should you use it and if not, then why not. Stay with us through this complete guide.

Zoloft and Vyvanse: Is there any interaction?

Zoloft (sertraline) may increase the effects of vyvanse (lisdexamfetamine). It can result in side effects such as restlessness, nervousness, confusion, agitation, irritability, anxiety etc.

One major issue with combining these two meds together is the risk of serotonin syndrome. They both together can result in a sudden increased amount of neurotransmitters which can be too overwhelming for your body.

Both of these drugs are known to produce dependence, vyvanse much more intensely. Amphetamines are well known for producing addiction on their own. These drugs together can increase the chance of causing addiction in the user. 

Once addicted, it is extremely difficult to get rid of it and even if you manage to stop them altogether, you find yourself trapped in the symptoms of withdrawal syndrome, which is another battle in itself. 

Let’s take a closer look at zoloft

Zoloft is actually a brand name for the most commonly used antidepressant, called Sertraline. It is a prescription medication used to treat mild to severe episodes of depression. 

Zoloft belongs to the family of Selective Serotonin Reuptake Inhibitors, abbreviated as SSRIs. Now let’s get into the science of this class of drugs. 

These drugs actually inhibit the reuptake of serotonin from the synaptic cleft (space between a neuron and its target cell). So the neuron here releases serotonin and oftentimes there’s some leftover within the synaptic cleft that is retaken by transporters. 

With zoloft, these transporters are blocked, so the reuptake of neurotransmitter (serotonin) is prevented, which leaves more serotonin within the synaptic cleft to bind to its target cells and produce its effect

In short, zoloft increases the availability of serotonin in your brain. If you’re wondering what serotonin is, it is a neurotransmitter (a chemical) released by our brain which is responsible for modulating mood, cognition, reward, learning, memory, and various other psychological processes. 

Side effects of zoloft

The most common side effects of zoloft include:

• Loss of appetite
• Tiredness
• Feeling angry or agitated
• Weight gain
• Inability to digest food
• Nausea
• Diarrhoea
• Loss of libido
• Sweating/Night sweats
• Tremors or shaking
• Insomnia
• Decreased sex drive
• Impotence
• Inability to ejaculate

Zoloft, sometimes, causes serious side effects. Consult your healthcare provider as soon as you can if these symptoms occur:

• Seizure/convulsions
• Eye pain with vision problems
• Headache
• Confusion
• Agitation
• Memory problems/Dementia 
• Severe weakness and inability to move

Uses of zoloft

• Zoloft is widely used in the treatment of mild to severe depression. 
• It is known to reduce anxiety in people with obsessive compulsive disorder (OCD). 
• It is also used to tone down the intensity and frequency of panic attacks. 
• It is also approved to treat post-traumatic stress disorder (PTSD), relieving symptoms such as avoidance and intrusion. 
• It is known to reduce the symptoms of social anxiety disorder. 
• Zoloft is also used to treat premenstrual dysphoric disorder, including symptoms like mood swings, irritability, bloating, and breast tenderness.

Proper use of zoloft

• Do not suggest medications, unless you are a healthcare professional yourself. Do not share medications. You might think your conditions match but oftentimes they don’t. It’s actually pretty dangerous.
• If you fail to understand how to use the drug properly or have any other question, ask your doctor or pharmacist.
• In case of overdose, immediately reach out to the hospital. Make sure you properly guide them about how much drug you have taken and when. 
• If you experience unusual side effects, immediately contact your healthcare provider.
• Oral solution comes with a measuring device. Measure the amount accurately. You can dilute it in water. If water is too bland for you, you can mix it in some lemonade, ginger ale or lemon soda, to mask the taste better.
• Tablets can be taken with food or on an empty stomach. It’s best to eat something before taking it, in order to avoid acid reflux. Make sure you take it as directed by your healthcare provider. 

Now, let’s take a closer look at Vyvanse

Vyvanse, a brand name for lisdexamfetamine, is a central nervous system stimulant. It is basically a pro-drug (an inactive form of drug which, once inside our body, is converted into its active metabolite that gives therapeutic response). 

The parent drug, lisdexamfetamine, does not bind to the sites itself, but is converted into dextroamphetamine (an amphetamine), which is the active form. 

This dextroamphetamine blocks the reuptake of norepinephrine and dopamine into the presynaptic neuron and increases the release of these monoamines from their storage areas in nerve terminals. 

Side effects of vyvanse

Common side effects include:

• Dry mouth or decreased salivation 
• Vomiting
• Constipation
• Headache
• Stomach/abdominal pain
• Loss of appetite
• nausea
• Concussion or nervousness 
• Dizziness
• Inability to fall asleep
• Sweating
• Weight loss
• Agitation and irritability
• Fatigue 
• Increase in blood pressure

Serious side effects include:

• Vision related complications
• Arrhythmia and palpitations
• Behavioural changes and mood swings like anger, agitation, suicide attemps, picking up fights etc.
• Involuntary movements
• Tremors 
• Signs of decreased amount of blood flow in the fingers or toes including symptoms like cold and numb finger, pale in colour, tingling sensation
• Wounds and bruises on skin
• Loss of libido
• Swelling 
• Fatigue 
• Unnatural weight loss 
• Prolonged erections

Why is vyvanse prescribed?

• Vyvanse is used in the treatment of attention deficit hyperactivity disorder, along with educational and psychological treatments.
• It is also used for the treatment of bulimia nervosa or binge eating disorder. Studies show that it significantly decreases cravings in adults.

Proper use of vyvanse

• Always make sure you thoroughly read the medication guide or leaflet before you start taking vyvanse. 
• You can use this medicine with food or without food in your stomach.
• Avoid taking the med in the evening, as it may cause difficulty in sleeping.
• Dose is suggested by your healthcare provider. Do not deviate from it. If you have any confusion, talk to your doctor or pharmacist.

Zoloft + Vyvanse induced Serotonin Syndrome

The use of zoloft and vyvanse together possess the risk of serotonin syndrome, which can lead to extreme nerve cell activity and dangerous symptoms. 

Symptoms of serotonin syndrome include:

• Excessive sweating 
• Restlessness and fatigue
• Headache, which often feels like your head is pounding
• Changes in blood pressure and/or temperature
• Nausea
• Vomiting
• Diarrhoea
• Bradycardia
• Tremors
• Muscle twitching and muscle pain

Serious side effects include:

• High fever with chills
• Seizures
• Arrhythmia 
• Unconsciousness  

Why drug interactions should always be considered

Drug interactions should be an important consideration before taking two or more medicines together. Yes, drugs in combination are often used to achieve better therapeutic response but this is not the case with every interaction. 

Some drugs are highly incompatible with one another. They often cancel out each other’s effects or antagonise them. Some drugs are so incompatible that they end up changing the entire chemical composition of one another. 

Some interfere with metabolism or bioavailability (the rate and extent at which the active drug moiety enters systemic circulation/blood). This can lead to drug accumulation in different parts of the body. 

It is always advised to inform your healthcare provider of any medicine you take before getting a new prescription. Your doctor will make sure not to prescribe any such drug which might interfere with those you are already taking. 

Conclusion

In this blog, we learned that zoloft is a most commonly used antidepressant and vyvanse is a central nervous stimulant. Zoloft directly starts producing its effects, once inside our body. 

Vyvanse, on the other hand, is a pro-drug which means that it is converted into its active form first and then starts producing its effects. Amphetamines are well known for producing addiction. These drugs together can definitely increase your chance of getting addicted. 

If it is necessary to use them together, their doses might need adjustment. Always consult your healthcare professional before using any of such meds together.

FAQs: zoloft and vyvanse

Can you take ADHD meds with Zoloft?

Always talk to your doctor before starting zoloft and ADHD meds together. Their concomitant use might result in side effects like restlessness, nervousness, confusion, agitation, irritability, anxiety etc. One major issue with combining these meds together is the risk of serotonin syndrome.

Can you take an antidepressant with Vyvanse?

Vyvanse can have serious interactions with antidepressants, including selective serotonin reuptake inhibitors (SSRIs), monoaminoxidase inhibitors (MAOI) and tricyclic antidepressants (TCAs) etc. make sure you consult your healthcare provider before starting these meds together.

What should you not take with Zoloft?

Zoloft should not be used with the following medication:

• Do not use zoloft with any irreversible monoamine oxidase inhibitors (MAOIs). Concomitant treatment is highly contraindicated due to the risk of serotonin syndrome with symptoms like agitation, tremor and hyperthermia. 
• Do not use zoloft with pimozide. Combining these medications can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.
• Avoid using zoloft with central nervous system (CNS) stimulants. Concomitant use can increase the risk of serotonin syndrome and can result in extreme addiction.
• Zoloft also interacts with tryptophan, St. John’s wort, meperidine, tramadol, cimetidine etc. Use of Zoloft during the 3rd trimester of pregnancy can cause adverse effects in the newborn. 
• Zoloft and other SSRIs possess a risk of bleeding when used with non-steroidal anti-inflammatory drugs (NSAIDs), warfarin or other anticoagulants. Avoid using them together.

What can you not take with Vyvanse?

Avoid taking antidepressants with vyvanse, like monoaminoxidase inhibitors. Concomitant use of these can result in serotonin syndrome.

Does Vyvanse make you age faster?

Few studies suggest that amphetamines can accelerate the ageing process.

What happens if you drink coffee on Vyvanse?

Research found no interaction between vyvanse and caffeine (coffee). 

References

• Drug Interactions between Vyvanse and Zoloft https://www.drugs.com/drug-interactions/vyvanse-with-zoloft-1475-2533-2057-1348.html#:~:text=Combining%20these%20medications%20can%20also,or%20shaking%2C%20blurred%20vision%2C%20muscle
• Vyvanse – Uses, Side Effects and More https://www.webmd.com/drugs/2/drug-148324/vyvanse-oral/details
• Vyvanse https://www.drugs.com/vyvanse.html
• Lisdexamfetamine https://go.drugbank.com/drugs/DB01255
• David W. Goodman, MD (2010) – Lisdexamfetamine Dimesylate (Vyvanse), A Prodrug Stimulant for Attention-Deficit/Hyperactivity Disorder https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/
• Samantha J Thomas 1, Mirae Shin, Melvin G McInnis, Jolene R Bostwick – Combination therapy with monoamine oxidase inhibitors and other antidepressants or stimulants: strategies for the management of treatment-resistant depression (2015) https://pubmed.ncbi.nlm.nih.gov/25884531/
• James M. Ferguson, M.D. – SSRI Antidepressant Medications: Adverse Effects and Tolerability https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/