From the Research
Temperature instability during withdrawal from Prozac or lisdexamfetamine can be managed by tapering medications gradually under medical supervision, with a typical taper for Prozac reducing by 10mg every 2-4 weeks and for lisdexamfetamine decreasing by 10-20mg weekly. When discontinuing Prozac, temperature fluctuations may include chills, sweating, or feeling hot and cold, typically lasting 1-2 weeks due to the body adjusting to changing serotonin levels 1. For lisdexamfetamine withdrawal, temperature dysregulation often manifests as sweating or chills as the body adapts to decreased stimulant effects, usually resolving within 7-10 days 2. Key factors to consider during withdrawal include:
- Staying hydrated
- Dressing in layers
- Maintaining stable room temperatures
- Using cooling or warming measures as needed These temperature fluctuations occur because both medications affect neurotransmitters that regulate body temperature - Prozac through serotonin pathways and lisdexamfetamine through dopamine and norepinephrine systems 3, 4. If temperature changes are severe or accompanied by high fever, confusion, or severe symptoms, seek immediate medical attention as this could indicate serotonin syndrome or other complications. It's also important to note that lisdexamfetamine has a reduced potential for abuse compared to other stimulants, as shown in a study where 50 or 100 mg doses of oral lisdexamfetamine had less likability than d-amphetamine 40 mg 1. Additionally, a recent study found that lisdexamfetamine at a dose of up to 250 mg/day was safe and well tolerated by study participants, warranting larger trials as a pharmacotherapy for methamphetamine dependence 2. However, the most recent and highest quality study on this topic is from 2022, which provides guidance on allowable room temperature excursions for refrigerated medications, including those used for withdrawal management 5. Overall, the management of temperature instability during withdrawal from Prozac or lisdexamfetamine requires careful consideration of the underlying neurochemical mechanisms and individual patient factors, as well as adherence to evidence-based tapering protocols.