[Butter Buns]

You can do a search on your own on the Discovery Health website for drug interactions, but here is the scoop about mixing Phen and Lexapro or any Seratonin reuptake Inhibitor (SRI):

GENERALLY AVOID: Several case reports suggest that patients treated with serotonin reuptake inhibitors may exhibit an increased sensitivity to sympathomimetic agents. The mechanism of interaction is unclear. The reasction has been reported when fluoxetine was used concomitantly with phen, amphetamine or phenylpropanolamine. Additionally, some sympathomimetic agents (e.g, amphetamines) may possess serotonergic activity and should generally not be administered with SRIs because of the additive risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors. The interaction occurred in a patien treated with dexamphetamine approximately 2 weeks after the addition of venlafaxine. The medications were discontinued and the patient was given cyproheptadine for suspected serotonin syndrome, whereupon symptoms promptly resolved. A second episode occurred when dexamphetamine was subsequently resumed and citalopram added. The patient improved following cessation of citalopram on his own, and residual symptoms were successfully treated with cyproheptadine. MANAGEMENT: In general, amphetamines should not be combined with SRI's. Close monitoring for enhanced sumpathomimetic effects is recommended if these agents must be used together. Patients should also be monitored for signs and sumptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension and tachycardia.

Sorry for the bad news...I quit taking my lexapro. I'd rather be skinny and *****y than big, nice and dead!

[katyakat]

You should take a look at the phen-pro site. There is a doctor who actually reccommends taking phen with certain anti-deppressants at certain dosages to enhance the appetite supression effect of phen. I would think a person would want to be under doctor supervision if they were to try this approach, but it is interesting to read esp in light of what other sources state (as you mention above).

[jamaicabound]

Alright, I guess I am not smart enough to decipher all the medical mumbo jumbo. What does all that mean? I take Celexa and Phen and it has never hurt me. But I want to know if it's dangerous. Also, if you are like me you NEED the Lexapro. If I don't have my Celexa, I am a basket case!
Where did you get that info? I would be curious to see what else they have to say.

[phenchik831]

WHATTT???? this is crazzy, my doctor is actualy having me take lexapro and phen together. now im consernd and confused!!!!! What should we do????

[CarolinaGirl]

I think each of us should go by whatever works for us. I take phen and a SSRI and haven't had any problems. I trust my doctor's judgment.

[Butter Buns]

Hi ladies -

I got this off of a drug interaction web site. Here is the URL. You can go in and see what it says about interactions of drugs you are on. Keep in mind that doctors know what works for you, but PHARMACISTS can better tell you about drug interactions that a regular doctor can.

http://health.discovery.com/encyclop...er/checker.jsp

[SoftSucculentQueenie]

this is what i found online-


What is Phen-Pro?
"Phen-Pro" is the combination of phentermine and a low dose of one of the following: Prozac, Zoloft, Celexa, Lexapro, trazadone or Effexor. The second medicine is necessary because phentermine used alone stops working after a few weeks. The second medicine makes phentermine work longer and better. Although the second medicine is also an antidepressant, its use in the phen-pro combination has nothing to do with depression.

- Phentermine is not addictive.

- Phentermine is not "speed".

- Phentermine does not raise blood pressure.

Obesity is a serious disease, more threatening than high blood pressure or high cholesterol. One third of the US population is obese. 64% are overweight. Obesity is responsible for 300,000 deaths per year in the U.S. No physician or patient can ignore it (but most do).

Obesity is curable.

Thirty percent of my 2217 patients have reached ideal body weight so far.

The rest have lost some weight.

Four patients lost 150 lbs.

Fifteen lost 100.

In eight years, with only 5 exceptions, no one seeing me every 3 months has ever gained weight back.

Half of the successful patients were able to stop the medicines, while the rest continue to take a maintenance dose.

[SoftSucculentQueenie]

more from that same site-


Phen-Pro Method
This is the Phen-Pro method patented by Dr. Anchors.

The indication for the treatment is a body mass index BMI > 27 in a patient who has failed to reduce weight using voluntary diet & exercise alone. BMI is defined as the weight in kg/(height in m)*2.

Contraindications are mania, schizophrenia, anxiety, seizures, symptomatic enlarged prostate, severe hypertension , tachyarrhythmias, stage III or IV CHF or litigious nature of the patient. Preexisting heart valve disease is not a contraindication.

Phentermine co-treats attention deficit disorder, so Ritalin should be discontinued. Phentermine should never be coadministered with beta-blockers since they block the anorexic effect. Phentermine acts as a decongestant so patients need not take oral decongestants.

Qualified patients should be started on generic phentermine 15 mg po qAM between 8 and 10 AM with a little food and ONE of the following... Prozac 20 mg po qd, Zoloft 50 mg po qd, Celexa 20 mg po qd, Luvox 50 mg po qd, Effexor XR 75 mg po qd, generic trazadone 50 mg po QHS.

Important note. Doses of SSRI drugs much higher than the above doses cancel out the anorexic effect of phen (Padla, 1997).

After one week, the patient should increase the dose of phentermine to two 15 mg capsules taken together in the morning. Never start patients on 30 mg of phentermine!

No initial blood work or other studies is necessary, but if the patient fails to lose weight by the first follow-up visit in 4 weeks, TSH and cortisol should be checked. Expected weight loss is 2 lbs per week for the first 6 weeks, and 1-1.5 lb per week thereafter. Side-effects when they occur can usually be eliminated.

Some patients after being on phen-pro for several weeks or months report that their excess hunger returns. They still don't gain weight back, but they stop losing weight. If this occurs, the physician should inquire whether the hunger is occurring at a particular time of day.

If the hunger is occurring only at night, the patient should be encouraged to take phentermine later in the morning or even the early afternoon. Alternatively, the phentermine dose can be increased and/or split doses can be given. If the hunger is generally increased all day, then the patient should be given 5-HTP (5-hydroxytryptophan) 50 mg twice a day with a little food. 5-HTP is an over-the-counter medicine, but patients and physicians should obtain it from Pragmatic Research Many over-the-counter brands are impure. The Pragmatic Research brand is certified to be free of peak X. From 3 days to 2 weeks after ADDING 5-HTP to phen-pro, patients will feel their resurgent hunger go away again.

ALWAYS stress to the patient that ALL the physician can do is to make the patient less hungry. It is still up to the patient to EAT LESS FOOD. Nothing less will work. Nothing more is necessary.

When patients reach ideal body weight or get stuck after losing some weight, I recommend stopping phen-pro for a month to see if the patient can maintain their new low weight off the medicines.

Approximately one third of the patients can keep their weight low off the medicines. They do not need to continue taking medicine, but they should weigh themselves once or twice a month to be sure they are not regaining; they may need a "refresher course" of medicines in the future.

The remaining two thirds of patients, off the medicine, will see their weight start to go back up because their excessive hunger returns. They should be put back on phen-pro before they regain too much weight and they should be kept on phen-pro, indefinitely if necessary. It's no big deal. If they had high blood pressure, you would put the patients on life-long medicine. Ditto high cholesterol. Ditto gout. Ditto estrogen. No one should discriminate against weight loss medicines. No one should discriminate against obese people at all. Obesity is a medical disease like any other.

One little caveat. There is something called SSRI withdrawal syndrome, which occurs rarely when patients are discontinued from the shorter-acting SSRI drugs, such as Zoloft. I have seen this ONLY with Zoloft (and Paxil). The symptoms consist of nausea and flu-like feelings for several days. To avoid this possibility, patients being withdrawn from phen/Zoloft should have their Zoloft dose reduced to 25 mg for two weeks before going off Zoloft entirely. Gradual withdrawal from phentermine is NOT necessary unless the phentermine dose was pushed to 60 mg per day. In that case only, the phentermine should be decreased to 30 mg a day for two weeks before being finally discontinued.

The side-effects of phen-pro are less frequent and less serious than many medical therapies, certainly no worse than therapies for high blood pressure, etc. And the side-effects of phen-pro, if they do occur, tend to improve with time and patience. It's worth some sacrifice to cure obesity, a common, serious medical problem for which, at the moment, there is no other effective long-term treatment.

Note! Caffeine increases all the side-effects of phen-pro without making it work better. Patients should switch to decaffeinated coffee. The caffeine in soft drinks and tea is negligible. Only coffee matters.

COMMON SIDE-EFFECTS (LESS THAN 50% OF PATIENTS)

Dry mouth

The only solution is to drink more water. Phentermine reduces the production of spit, but so do Sudafed and other common decongestants. If drinking more water is not enough, patients can get Biotene mouth products over the counter or use Mouthcoat artificial saliva--these are rarely needed.

Trouble sleeping

Switch the SSRI to generic trazadone 50 mg at night.

LESS COMMON SIDE-EFFECTS (LESS THAN 10% OF PATIENTS)

Orgasmic delay

Switch SSRI to Luvox 50 mg or Effexor XR 75 mg.

Nervousness

Switch SSRI to Luvox 50 mg or add clonidine pill or patch .

Sweating

A common problem in overweight people generally. Obviously the patient can try to stay cool. If the excess sweating is in the feet or armpits, Drysol will handle the sweating well. If the sweating is more widespread, the patient can spray the sweating parts with Arrid Extradry.

Constipation

Switch SSRI to Zoloft 50 mg or add Senokot-S twice a day.

Rapid heartbeat

Start phentermine more gradually or temporarily add atenolol. Check for unrecognized hyperthyroidism or concomitant stimulant drugs.

Drowsiness

Switch SSRI to Effexor XR and consider undiagnosed ADD.