DXM preventing Adderall from working?

[Manix]

Hey, SWIM is relatively new to Adderall, SWIM has been using it for two weeks tops, starting from 10MG of IR and titrating all the way up to 50MG because of the lack of effects. It worked at first, then didn't work, then did. SWIM has been using NyQuil cold/flu once a night to help him sleep, however, it hasn't been working too well lately, which is normal for someone who's been using it on a daily basis. This morning, SWIM took four 10MG IR Adderalls and crushed a fifth one and snorted it--anything to just have the Adderal work. To no avail. The adderall did nothing but make SWIM smell bad. SWIM has only taken this high of a dose once before.

SWIM's question is, would the NyQuil he's been ingesting every night somehow stop the Adderall from working? Since the DXM in NyQuil is apparently a dopamine reuptake inhibitor, wouldn't it have the same effects of an SSRI on MDMA? SWIM has been googling this for hours and has failed to find any account of this.

SWIM has also been taking propoxyphene (Darvocet) daily for a few days now for pain. Could this have any potential bearing on the Adderall? SWIM has read in his father's medical books that propoxyphene eliminates the metabolism of tricyclic antidepressants, which work by blocking the reuptake of norephenephrine, which is similar to dopamine--which leads SWIM to believe it could diminish the Adderall's effects, but then again SWIM has little knowledge about this. Taking propoxyphene with Adderall is not recommended, but that's only because of the fact that overdosing on propoxyphene with Adderall with overstimulate the Central Nervous System (atleast from what SWIM's gathered). There's very little information about the interactions between Adderall and Darvocet.

SWIM is going to be substance-free for about a week, and will try again. Do you think that the dextromethorphan and/or the propoxyphene was to blame for the Adderall not working at all?

Thanks!

[Forthesevenlakes]

The effect of DXM on the dopamine reuptake mechanism could upregulate reuptake receptors in SWIY's brain, and thus up the tolerance for adderall. Adderall mainly inhibits dopamine reuptake (to SWIM's knowledge), so SWIY might be seeing a bit of cross-tolerance.

Propoxyphene probably wouldnt affect feeling the adderall either way. If the two are contraindicated, its to keep people from attempting a pharmaceutical speedball. Propoxyphene is an opioid agonist.

[Manix]

Originally Posted by Forthesevenlakes

The effect of DXM on the dopamine reuptake mechanism could upregulate reuptake receptors in SWIY's brain, and thus up the tolerance for adderall. Adderall mainly inhibits dopamine reuptake (to SWIM's knowledge), so SWIY might be seeing a bit of cross-tolerance.

Propoxyphene probably wouldnt affect feeling the adderall either way. If the two are contraindicated, its to keep people from attempting a pharmaceutical speedball. Propoxyphene is an opioid agonist.

Ah. So what you're saying is that both DXM and the Adderall are competing over the dopamine reuptake receptors? How long would this last? The DXM has to be completely inhibiting the reuptake receptors, not reversing their direction like dextroamphetamine does--otherwise, the DXM would potentiate the Adderall's effects instead of diminish them. Right?

[Forthesevenlakes]

Using the adderall for a couple weeks, and the DXM probably built up SWIY's tolerance for the drugs. The two drugs aren't competing, they have similar effects at the dopamine reuptake receptors (hence some of DXM's pleasant subjective effects), so using either of them will boost tolerance. Using any dopamine-affecting drug over time will build tolerance to the drug, and to the pleasurable/stimulatory effects of the drug.

SWIM would say that SWIY should take a break for a couple weeks from adderall, DXM, and any other drug that could impact dopamine reuptake, and then start again with the prescribed dose of adderall. This should be sufficient time to reverse some of the tolerance.

[Manix]

Originally Posted by Forthesevenlakes

Using the adderall for a couple weeks, and the DXM probably built up SWIY's tolerance for the drugs. The two drugs aren't competing, they have similar effects at the dopamine reuptake receptors (hence some of DXM's pleasant subjective effects), so using either of them will boost tolerance. Using any dopamine-affecting drug over time will build tolerance to the drug, and to the pleasurable/stimulatory effects of the drug.

SWIM would say that SWIY should take a break for a couple weeks from adderall, DXM, and any other drug that could impact dopamine reuptake, and then start again with the prescribed dose of adderall. This should be sufficient time to reverse some of the tolerance.

SWIM gets what you're saying, and he'll do just that. But--SWIM doesn't understand this:

If a selective serotonin reuptake inhibitor completetly diminishes the effects of an MDMA dose within a few days of the SSRI dose(which SWIM tested on himself, it really does)....shouldn't the DXM, which is basically doing the same thing as the SSRI but with dopamine at a much lower level, diminish the effects of Adderall, which, like MDMA, reverses the reuptake transporter's direction? If a person has taken an SSRI, MDMA cannot reverse the direction of the reuptake transporter to fill the synapse with serotonin because the SSRI has completely inhibited its movement. Thus, the person feels absolutely no euphoria. Shouldn't the same principle apply to SWIM's case? Just because it's a different neurotransmitter doesn't exclude it from the same principles does it? Dextroamphetamine is believed to give its effects by turning the dopamine reuptake into a pump instead of a vaccum. Dextromethorphan has simply been shown to be a dopamine reuptake 'inhibitor'... Sorry to ask so many questions, but SWIM wants to know what's going on in his head. Thanks for your help btw

[Forthesevenlakes]

Ahh, SWIM is seeing where the confusion is arising, methinks. Both DXM and Adderall (and cocaine and other drugs) inhibit the reuptake of dopamine into cells from the synaptic junction by binding to reuptake receptors. Dopamine in the synaptic junction will continue to bind to dopamine receptors (but not the reuptake ones) and exert an effect. So basically, DXM and Adderall are allowing dopamine to perform its normal action for a longer duration. DXM has other effects but I won't get into that here.
SSRI's do something similar, but with serotonin, correct. MDMA also has some SSRI activity, but also directly releases serotonin into the synapse. However, this direct release has nothing to do with reversing the reuptake receptors. It takes place via a different mechanism.
When reuptake receptors are blocked with drugs, however, the cells will create larger numbers of reuptake receptors to compensate for the blockage. This is tolerance to a drug on a cellular level. Keep in mind that the adderall is doing the SAME thing as DXM, inhibiting DA reuptake...adderall doesnt actually trigger a rush of new dopamine into a synapse like MDMA does. So, SWIY's dopamine cells have created more reuptake receptors in order to counteract the excess dopamine in SWIY's system from DXM and adderall use. When the adderall was taken today, it probably wasn't enough to compensate for the increase in reuptake, and SWIY didn't feel anything.

SWIM just checked out wikipedia, and it looks like it states that adderall directly stimulates the DA receptors (which goes against what SWIM was taught in his pharmacology class), so SWIM can see where the confusion would arise.

Also, not sure that your explanation of the SSRI blocking MDMA phenomenon is correct, although I can see logically how that would work out. I don't think MDMA reverses the reuptake transporter's direction, I think it just blocks reuptake altogether and allows release of more serotonin through a different set of vesicles.

People can feel free to correct ol' SWIM on his pharmacology if this explanation of tolerance is erroneous, he's just working with what he remembers from school oh-so-long-ago.

[Manix]

MDMA also has some SSRI activity, but also directly releases serotonin into the synapse. However, this direct release has nothing to do with reversing the reuptake receptors.

Every source which SWIM has read has stated otherwise...

www.mdma.net :
"Here MDMA acts to reverse the normal direction of the so-called serotonin reuptake pump...."

www.bluelight.ru/vb/showthread.php?t=79027 :
"MDMA causes the 5-HT reuptake transporters to work in reverse, simultaneously stopping reuptake and dumping serotonin into the synapse."

And tons more which would take forever to cite. These sources say that MDMA's inhibiting of the serotonin reuptake is because of the fact the reuptake transporter is busy pumping out neurotransmitters.

However, you're probably right about the dextroamphetamine not reversing the reuptakes, because the only source that has so far said that has been Wikipedia. SWIM never knew neurons actually create more reuptake transporters...that would explain a lot. But it also opens more questions, SWIM has been using Adderall at a 10MG level for awhile, and the NyQuil like every other night with only one cup full so SWIM could sleep, SWIM has never felt any euphoria from either, not once. SWIM has felt the Adderall work in the sense where SWIM was interested in doing schoolwork and could work for hours, and that itself is gone now. In other words, SWIM has been using Adderall at a low dose for only (not even) two weeks now, with the recommended dosage of NyQuil...no where near the recreational dose of DXM. If tolerance really came that fast to the point where all the Adderall did was make him smell, how do people go for months, take a "drug holiday" for two weeks, then go for several more months? SWIM has even seen people talk about taking DXM to prevent Adderall tolerance right on this forum. Here to be exact: http://www.drugs-forum.com/forum/sho...t=DXM+adderall

Somthing isn't making sense. If you're saying SWIM should wait two weeks before using Adderall again, are SWIM's dopamine neurons just going to lose reuptake transporters? Once the regular dosing has started again, will the reuptake transporters start getting created again so that SWIM has to take yet another holiday within such a short amount of time?

Thanks

[Forthesevenlakes]

In regards to the last question, yes, the neurons should lose some reuptake transporters or receptors, and tolerance would build again, necessitating another holiday away from drugs to allow for the pleasant effects to come back. Adderall builds tolerance quickly, but people can go for months because they keep upping the dose. Keep in mind SWIY's experience was a one-time thing, and that other factors (absorption, stomach pH, food contents in the stomach) could have influenced the experience too.

SWIM doesnt believe that DXM will reverse adderall tolerance by any means, but since they have similar actions at the dopamine receptors, perhaps DXM could act as a potentiator. To SWIM's knowledge, the only credible info he's seen for DXM reversing any sort of tolerance is with opiates/opioids.

As for MDMA's actions, SWIM was using wikipedia's description: "MDMA is a semisyntheticentactogen of the phenethylamine family, whose primary effect is believed to be the stimulation of secretion, as well as inhibition of re-uptake, of large amounts of serotonin as well as dopamine and norepinephrine in the brain" Although SWIM does believe its possible that MDMA could promote vesicular release of 5-HT as well as reverse the pump.

[Manix]

Keep in mind SWIY's experience was a one-time thing, and that other factors (absorption, stomach pH, food contents in the stomach) could have influenced the experience too.

SWIM didn't have any acidic juice or vitamin C, the adderall was taken on an empty stomach. SWIM has also been using L-Phenylalanine off and on for the past few weeks, incase the Adderall wasn't working because of the lack of dopamine or some other underlying reason. SWIM is still sort of refusing to believe that the Adderall fails to work because of an amphetamine tolerance--it may be because SWIM doesn't want to face the truth, or, it may be because of somthing he ingested like SWIY said. SWIM is tempted to try 2x 10MG IR the day after tommorow to see what effects it yields, when the NyQuil and Darvocet are almost completely out of his system. If it doesn't work, SWIM will take a two week long holiday before trying again. If the pills do increase SWIM's focus and help him to stay on task somewhat, he will set up an experiment to see if taking NyQuil the night before actually diminishes the Adderall's effect. SWIM will post his findings once he's certain.

Thank you very much for your help.

[Daytona71]

SWIM does not get a euphoric feeling from the dextroamphetamine he is prescribed which is 40mgs/day, instant release tabs. It had been 20 years since SWIM had gotten an amphetamine and remembered the effect back when and was terribly dissapointed. Here is SWOM's other meds; Methadone(just 10-20mgs/day), Hydromorphone(Dilaudid)/60+mgs/day, 40mgs of diazepam(Valium(40mgs/day), Ambien CR(1-12.5 mg tab for sleep. Morphine/1mg/hour-intrathecally.
Cymbvalta which SWIM is not very knowlkedgeable about but it an anti depresent with associated pain and it helps with the pain anywways and SWIM thought that perhaps after many years on the above and others that his dopamine receptors are "shot" so to speak. He is eliminating the methadone soon and will try to leep without the Ambien and try to cut the Valium to 3/ay and cut the hydromorphone to something less. However an old friend visited anhd took 70mgs. and also did not get the remembered feelimng but it did keep him awake beyond the usual time.
Too bad it is not feasible to remove the fillers or make it smokeable, anything to get it to work stronger. I will ask SWIM to let you know if less of the other meds have an effect.