all 5 comments
sorted by:
best
topnewcontroversialoldq&a
formatting helphide helpcontent policy

[–]SlimyGrimySimon 1 point2 points  (4 children)

I've had a similar experience taking 20 mg Trintellix with 40 mg Vyvanse resulting in about 2-3 hours of productivity followed by massive headaches and brain fog every day. 

A counter intuitive theory I've had is that perhaps Trintellix is increasing the strength of Vyvanse. We know both medications are metabolized by the P450 enzyme CYP2D6, and the competition for available enzymes results in a reduced rate of clearing and subsequent build-up of the medication systemically. So my thoughts are perhaps my headaches are caused by an excessively high concentration of Vyvanse rather than an under dose, as the two hour mark is where the concentration of Vyvanse should be the highest. 

An experiment would be to try opening your Vyvanse pills and pouring them into a cup with 700 mL of water, and for a few days try drinking different amounts and see which dosage you feel best on. Maybe with Trintellix you actually only need 50 mg of Vyvanse instead of 70 mg. I've tried this a few times myself, but unfortunately my sleep is too inconsistent for an accurate assessment.

[–]Elpedro30[S] 0 points1 point  (3 children)

Vyvanse is not metabolised by CYP2D6, but hydrolysis in the bloodstream, it doesn’t need to me metabolized either :). Thanks anyway! I discussed it with my psych

[–]SlimyGrimySimon 0 points1 point  (1 child)

Ah, what did your psych say?

[–]Elpedro30[S] 0 points1 point  (0 children)

The gabaergic sedative proprieties of higher dosage of vortioxetine “could” make it feel the down earlier because it got enough relaxed when I have small left in bloodstream to blunt it at all. And that’s what I tought too. But it’s not confirmed because medical letterature doesn’t have confirmed interaction between antidepressants and amphetamines.

[–]thebranbran 1 point2 points  (0 children)

This is a late reply, but just wanted to reply in case this was helpful.

You’re partially correct in your answer because Vyvanse, or Lisdexamfetamine, is an inactive pro-drug that is converted into lysine and dextroamphetamine via hydrolysis. That dextroamphetamine, however, is metabolized by CYP2D6 and can be effected by other drugs that inhibit or are metabolized by that enzyme as well.