[temporaryvector]

I was under the impression that this is a pretty known effect. I used to take anti-depressants along with CNS stimulants and this definitely was something that my psychiatrist and my other doctors mentioned to me and considered when choosing an appropriate dosage.

[Vaslo]

They have spent a lot of money to research the fact that people are less productive when hungover. I guess even known things are targets for scarce research dollars.

[Mirioron]

It's also important to figure out the magnitude of the effect.

[diffeomorphism]

How much less? How does it depend on exactly how much they drank (linear, quadratic)? How much does it differ from person to person? ...?

It is obvious that it has some impact, but not at all obvious how this works in detail.

[copperx]

Can you expound on that? Can you paraphrase the doctor's suggestions?

[temporaryvector]

There isn't much to paraphrase, really. When my doctor was prescribing fluoxetine he offhandedly mentioned that he would start me off with a lower dose than he normally would for a person of my size and issues because I was already taking amphetamines, which meant that I wouldn't need as high a dose. The offhanded way he mentioned it gave me the impression that it was common knowledge and later another doctor also mentioned the same thing to me, but this one was not a psychiatrist but a cardiologist, farther cementing my suspicions.

When I later asked my psychiatrist about this he said that since SSRIs and amphetamines are though to complement each other (even if the science on the matter isn't really decided) the recommendation they get is to adjust the dose of SSRIs down. I'm sure the actual reason is more complex than that, maybe involving fears of serotonin syndrome, but my takeaway from it was that the effect is well known.

No idea about coffee in particular since I wasn't allowed to have any caffeine during that time.

[Domenic_S]

FWIW ssris aren’t dosed by weight anyway, so it was just the amphetamine interaction they were counting on

[heavyset_go]

DAT inhibitors, DA releasers and agonists are effective antidepressants in that they reduce the symptoms of depression. Drugs like Zoloft are DAT inhibitors as well as acting as SSRIs, Wellbutrin is a NET and DAT inhibitor, and MAOIs inhibit the breakdown of serotonin, DA and norepinephrine. Newer antipsychotic medications that are indicated for use as adjunct therapy for depression also have binding action at certain DA receptor sites.

The problem with dopaminergics is that they tend to be addictive, and build tolerance. Both Zoloft and Wellbutrin only inhibit a certain percentage of DAT in areas of the brain related to reward, so they aren't exactly abusable, while something like methylphenidate (which is a potent NET and DAT inhibitor) is.