Hi doctor, I am currently on Adderall 30 mg twice a day for narcolepsy with cataplexy and Lexapro 20 mg for resistant major depressive disorder. My previous psychiatric nurse practitioner tried me on many antidepressants that did not work. Lexapro helps some but not much at all. I have very bad anxiety and low mood with irritability. Is there another antidepressant I can take with Adderall (as it interacts with so many). Please help.
Hello. It looks like you have been tried on several different types of antidepressants already but did not help. Since you are on Adderall for treating narcolepsy, taking antidepressants will potentially lead to an increase in side effects. This applies to all SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) type of antidepressants. So you will need regular follow up by your prescribing doctor to monitor your response to the medication combination. Since you are saying Lexapro (Escitalopram) helps to an extent, it will be worth trying to continue it and have additional psychological therapy like CBT (cognitive behavioral therapy) to manage anxiety and depression. If Lexapro is not effective at all, there are other options like Sertraline and Fluoxetine but they belong to the same class of medicines (SSRIs). Risk of potential interaction applies to these medications as well. Also, ensure that narcolepsy is optimally controlled. It will help to improve your mood and help you to function better. I hope this helps.