Lexapro & Adderall: Can You Take Them Together?

What Is Lexapro?

Lexapro, with the active ingredient escitalopram, is a selective serotonin reuptake inhibitor (SSRI) used to treat a range of mental health issues. Lexapro is FDA approved to treat depression in patients 12 years and older and anxiety in patients 7 and older. It may also be used off-label for other mental health disorders like obsessive compulsive disorder (OCD), panic disorder, PTSD and eating disorders like bulimia nervosa.¹ An off-label use has not been specifically approved by the FDA, but a prescriber may decide to use a medication off-label in special circumstances.

Lexapro is a part of the SSRI drug family that includes other medications like Citalopram, Fluoxetine, and Sertraline. All SSRI medications work in the nervous system to increase the amount of active serotonin. This action may help improve sleep, appetite, and/or energy, as well as reduce fear and anxiety. The most common dose for adults and children is 10 mg taken once daily.¹

How Does Lexapro Work?

Lexapro works in the nervous system to increase the amount of active serotonin. As the body adjusts to new levels of active serotonin, anxiety symptoms or depression symptoms begin to lessen. Since serotonin helps to regulate mood, sleep, and appetite, symptoms related to these feelings should also improve. Lexapro and other SSRIs do not work immediately and it is important to take the medication each day even if your symptoms haven’t improved yet, and even after symptoms improve. You can expect full effects of Lexapro to be felt after 4 to 6 weeks of taking the medication regularly.¹

What Is Adderall?

Adderall (mixed amphetamine salts) is a stimulant medication that is a specific combination of dextroamphetamine and amphetamines salts. It is FDA-approved to treat narcolepsy and attention deficit/ hyperactivity disorder (ADHD) ages 3 and up.^2,3 Adderall affects levels of neurotransmitters in the brain which lessens symptoms of ADHD and narcolepsy.

It is a medication available as an immediate release tablet and an extended release capsule and can be found as brand or generic. Adderall is part of the amphetamine family of medications and it is important to remember that there is a high potential for abuse, especially with long term use.^2,3

How Does Adderall Work?

Adderall and all other amphetamine containing medications work by affecting the levels of body chemicals, such as dopamine and norepinephrine, in the brain. ADHD is thought to occur when lower than normal levels of dopamine and other chemicals exist in the brain. The increased levels of chemicals then stimulate receptors in the brain to manage ADHD symptoms.^2,3

Can You Take Lexapro & Adderall Together?

Yes, Lexapro and Adderall can be taken together, but they should only be combined if the benefits outweigh the risks. The two may be prescribed together for patients who are diagnosed with both ADHD and another disorder like anxiety or depression. One study suggested that about a quarter of adults with ADHD also have anxiety.⁴

The two should only be taken together if prescribed and directed to take both by a licensed healthcare professional. Those taking Lexapro should not take Adderall from a friend even if it’s just once in a while. Combining the two without medical supervision can be dangerous.

What Happens When You Use Lexapro & Adderall Together?

Using both Adderall and Lexapro together increases the risk of a patient experiencing a life threatening condition known as serotonin syndrome. Additionally, each medication can interfere and change how well the other medication works.

One example is that Adderall can cause feelings of anxiety and depression, which is counterproductive for a patient taking Lexapro. Another example is that Lexapro can cause drowsiness, which could be counterproductive for a patient taking Adderall. Finally taking each drug together can increase the intensity of side effects from both drugs. While a side effect might be mild from Lexapro or Adderall taken alone, combining the two could cause that side effect to be more severe.^1,2,3,4

What Are the Side Effects of Using Lexapro & Adderall Together?

Taking Lexapro and Adderall together can cause any one of a long list of side effects. Each medication on its own has risks of side effects, and combining the two adds on even more risk. It is important to understand the risk of these effects and know when to seek help. Discuss with your doctor a plan if any side effects occur. Each person will experience side effects differently and not every patient will experience the same side effects.

Common side effects of using Lexapro and Adderall together may include:*^1,2,3,4

• Increased anxiety
• Trouble sleeping
• Weight loss
• Increased blood pressure
• Changes in sexual function and libido
• Loss of appetite
• Worsening depression
• Drowsiness
• Dry mouth
• Nausea

*All medications, including Lexapro and Adderall, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serotonin Syndrome: A Serious Potential Side Effect

The main concern when combining Adderall and Lexapro is serotonin syndrome. This is a life-threatening condition brought about by taking multiple drugs that increase serotonin levels at the same time. Serotonin syndrome is more likely to occur with higher doses, multiple drugs that increase serotonin, and increasing medication doses too quickly.

serotonin syndrome can also be caused by other medications including triptans, antidepressants, lithium, tramadol, buspirone, and others. If you are unsure if serotonin syndrome may be a risk with the drugs you currently take, talk to your doctor or pharmacist. Recognizing this syndrome quickly and seeking medical care immediately is crucial to reducing harm and the risk of death.

Symptoms of serotonin syndrome may include:*^1,2,3,5

• Changes in mental health status
• Hallucinations
• Fast heart rate
• Dizziness
• Flushing
• Hyperthermia (high body temperature)
• Tremors
• Muscle rigidity
• Loss of muscle function
• Nausea, vomiting and/or diarrhea

*All medications, including Lexapro and Adderall, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

How Is Serotonin Syndrome Treated?

Serotonin syndrome is a serious condition that should be treated by a team of healthcare professionals. If you or someone you know is experiencing symptoms of serotonin syndrome, call 911 and seek medical attention immediately. The syndrome is treated by immediately stopping any serotonin related medications that the patient is taking. Treatment will then vary based on symptoms.

The focus of treating serotonin syndrome is managing hydration, breathing, blood pressure, temperature, and cardiac function. In some cases, patients may be sedated with benzodiazepines, or the antidote cyproheptadine may be used.⁶

Alternatives to Mixing Lexapro & Adderall

Because taking Adderall and Lexapro at the same time brings about increased risks, it may be a good idea to explore alternative options. Both Adderall and Lexapro can be replaced with alternative treatments, or you and your doctor may decide to begin with only one treatment. In some cases just one medication can help reduce symptoms of multiple disorders. The goal is always to find effective treatment while reducing the risk of experiencing harmful side effects.

Lexapro Alternatives

Lexapro can be used to treat numerous disorders, and based on its use, there are many possible alternatives. Of course Lexapro can be replaced by another SSRI, but this will likely not lower the risk of serotonin syndrome. Perhaps a non-SSRI antidepressant could offer benefits and reduce the risk of serotonin syndrome. While the risk may be reduced, there is still a significant risk for serotonin syndrome with most antidepressants.⁷

Drugs like Strattera, Wellbutrin, and Clonidine can be effective in treating depression or anxiety while also being an effective treatment for some symptoms of ADHD. If two disorders can be effectively managed with one medication, this can greatly reduce the risk of serotonin syndrome. It is important to remember non-medication options such as cognitive behavioral therapy (CBT) for depression are always ideal and should be explored first.⁷

Adderall Alternatives

Adderall is one of many stimulant medications used to treat ADHD. While switching to an alternative stimulant medication like Vyvanse, Focalin, Concerta, or Dexedrine is an option, all stimulants carry a risk for serotonin syndrome. There are numerous non-stimulant medications that can be used to treat ADHD that may have less risk of serotonin syndrome (most still carry some risk of serotonin syndrome). Drugs like Strattera, Wellbutrin, and clonidine can all treat ADHD and even can be effective in treating depression or anxiety.

Treatment options like these that reduce the number of medications, if effective, are ideal. The less medications that increase the amount of serotonin in the body, the lower the risk of serotonin syndrome. Finally, it is always important to explore non-medication treatment options like CBT for ADHD.⁸

How to Reduce the Risks of Taking Lexapro & Adderall

If you and your prescriber decide that taking Adderall and Lexapro together is the right treatment for you, there are many steps you can take to reduce the risks from taking both together. It is always important to follow your prescriber’s directions exactly. Taking too much of either medication at one time can cause dangerous side effects. Additionally, stopping either medication abruptly may lead to other complications like antidepressant discontinuation syndrome or Adderall withdrawal. ^1,2,3,6

Ways to reduce the risks of taking Lexapro and Adderall together include:

• Discussing all medications and substances you use with your prescriber: Taking the time to do this can help identify other medications that can affect how Lexapro and Adderall may interact.
• Taking medication as prescribed: Adderall and Lexapro work in different ways and affect your body differently over time. Following your directions exactly, especially dose amount, dose changes, and time of dose, is all crucial to reducing risks.
• Getting a dosage adjustment: Changing either dose can help reduce the risk of side effects, but should only be done at the direction of your prescriber. This may be done initially or after treatment with both drugs has started.
• Adjusting the timing for taking each medication: Taking the two medications at specific times in the day can reduce some side effects. This will often be based on how you respond to each medication, so be sure to update your prescriber throughout treatment.

Questions to Ask Your Health Team About Using Lexapro & Adderall Together

It’s important that you understand your prescribed medications, including their intended use, potential side effects, and what to do if side effects occur. Take the time before starting new medications to discuss any questions and concerns you may have.

Questions to ask your doctor about Lexapro and Adderall include:

• What are the potential risks of taking Lexapro and Adderall together, and how common are they?
• What are the warning signs or symptoms I should watch for while using both medications?
• Are there lifestyle changes or self-care practices that can help lower potential risks associated with combining Lexapro and Adderall?
• What should I do if I think I am experiencing serotonin syndrome?
• I want to stop taking some or all of my medications, how can I do that?
• Are there alternative options for treatment?
• Should I tell my therapist I am starting new medications?
• I am having trouble sleeping, what can I do?
• I have lost my appetite, what can I do?
• Will the dose of medications change over time?