I get this page for Adderall and Nuedexta:

http://www.drugs.com/drug-interactio...281-14874.html

I also searched Nuedexta separately by both drugs in the combo.
No interactions.

Of course drug interaction databases are not 100% reliable 100% of the time. And there are exceptions.

This one lists amphetamines with Nuedexta:
http://nervous-system.emedtv.com/nue...eractions.html
But offers no details.

Adderall is listed on Drugs.com as interacting with Nuedexta, under the category "Nuedexta." Then go to the section, "What other drugs will affect Nuedexta?" Adderall is the fifth drug listed.

Okay, I see the reference to ADHD medication....
Strattera is the first one listed, followed by the amphetamines.

I can see strattera, since it is related to SSRIs... and has QT risk.
But as far as the amphetamines go?
There are no metabolic connections (like with Strattera) but perhaps it is the stimulant properties themselves, that might complicate the action of the DM in the brain?
This quote from side effects of Nuedexta:
from http://www.drugs.com/nuedexta.html

The bolded words would be additive with any stimulant. Amphetamines do increase heart rate.

Interactions between drugs usually refer to metabolic interference, meaning raising or lowering levels in the blood, so that a drug may become inactive or toxic because of that metabolism.

Therapeutic effects are different, usually additive or synergistic physiologically meaning the drugs may affect the same systems in action.

What we have been discussing on this thread are metabolic interactions which lead to unexpected results (mostly cardiac).

The effects listed for amphetamines are similar to amphetamines + other stimulants. (caffeine for example).

Today, the drugs that are available are very complex chemically. And it is no surprise that the 4th leading cause of death in US is from prescribed medications or errors with them.

I think we are reaching a ceiling of sorts, where all medications are going to have to go thru a screening data base for patients, to avoid problems. All patients are going to have to be evaluated soon for liver enzyme potentials and genetic variances. There are people taking 10, 15, and even 20 drugs a day. I see them on boards frequently and saw them in real life every day!

I have been taking Neudexta for about a year now. I started with the prescribed dosage on once in the morning, and once in the evening. The med was making a noticeable difference in my daily life, but after a few months my neuropathy was beginning to creep back into my life. I met with my very accredited neurologist, and we have increased my dosage to two pills twice a day. To an extent my symptoms are restrained, however I still have a problem with , not so much pain but, discomfort that never subsides.
I have been through nearly every test and exam and remain undiagnosed. I have seen the warning against taking Nuedexta with Elavil, however I have been a long time user of Elavil and have not noticed any adverse side effect. In fact, most of the side effects of the combination are the symptoms that the Nuedexta is suppressing; go figure.

so currently, I am taking

Neudexta 2capsuls PO 2x daily
Elavil 100mg 1x nightly


I guess im just open to anyone's thoughts or ideas on where I could possibly go from here. By "here" i mean being undiagnosed and exhausted.

There is a significant interaction between Elavil and Neudexta:
http://www.drugs.com/interactions-ch...-74,3281-14874

This is metabolic and occurs at the liver enzyme level.
If Elavil builds up in system, it can affect the heart.

Seems to me if you needed "more" effects from Neudexta, you could just take a bit more DM... and not increase that quinidine to dangerous levels. It is the DM affording the pain relief.
You can buy DM OTC in liquid form called Delsym.

This drug is highly problematic. And in combination with Elavil VERY problematic. Should you become low in potassium and magnesium (say from a stomach virus), you could have a QT event. IMO you are in a dangerous spot, with that dosage increase.

Here is more information on QT events:
http://www.azcert.org/

It might be to your advantage to have the DNA testing for liver metabolism of drugs...
This is now affordable and would reveal errors in metabolism before you have some serious event:
https://www.23andme.com/?gclid=CJKBk...FQVoKgodHlOsDg
detail:
http://spittoon.23andme.com/2011/10/...zing-medicine/

One of our PN members did this test and discovered she did not have good metabolic enzymes for 3 families of drugs! Pretty soon everyone will be tested so that serious drug events can be avoided.

I concur with Mrs. D.

I am very concerned about a doctor who would suggest combining Elavil and Neudexta. You are playing with fire.

Since you are not yet diagnosed perhaps a second opinion is in order.

Although Neudexta had an immediate positive effect on the outrageous level of pain I was on at the time, I had equally negative side effects and had to discontinue the drug.

I urge you to considering following the manufacturers warnings to protect yourself.