ADD/ADHD Drug Guide – Part 4

This week, I am going to give you a summary of the side effects for the class of stimulants known as Dextroamphetamines (Dextrostat, Dexedrine, and Dexedrine Spansule) and Mixed Amphetamines (Adderall).  You may see that some of the side effects are the same as those for taking Methylphenidates (Ritalin, Focalin, Concerta, Metadate, and Methlyn), but some are different, so read carefully so you won’t miss anything.

Your treating physician needs to know if any of the following conditions apply to you:

  • Glaucoma
  • Hardening or blocking of the arteries or heart blood vessels
  • Heart disease or defect
  • High blood pressure
  • History of substance abuse or current use
  • Psychotic illness, depressed mood, or suicidal thoughts
  • Recent weight loss
  • Seizures
  • Have taken an MAOI like Carbex, Eldepryl, Marplan, Nardil, or Parnate in the  last 14 days
  • Thyroid disease
  • Tourette’s Syndrome
  • An unusual or allergic reaction to dextroamphetamines, other amphetamines, other medicines, foods, dyes, or preservatives
  • Pregnant or trying to become pregnant
  • Breast-feeding

The list of medications that can interact with these stimulants is pretty vast and long:

  • Alcohol
  • Certain migraine medications such as Almotriptan, Eletriptan, Frovatripan, Naratriptan, Rizatriptan, Sumatriptan, and Zolmitriptan
  • Lithium
  • MAOIs such as Carbex, Eldepryl, Marplan, Nardil, and Parnate
  • Melatonin (herbal supplement)
  • Meperdine
  • Other stimulant medications for ADD/ADHD, weight loss, or to stay awake
  • Pimozide
  • Procarbazine
  • Acetazolamide
  • Ammonium Chloride
  • Ascorbic Acid
  • Glutamic Acid
  • Medicines for blood pressure, heart disease, irregular heart beat
  • Medicines for colds, sinus, and breathing difficulties
  • Meds for depression, anxiety, or psychotic disturbances
  • Meds for seizures like Carbamazepine, Phenobarbital, and Phenytoin
  • Methanamine
  • Norepinephrine
  • Propoxyphene
  • Sodium Acid Phosphate
  • Sodium Bicarbonate

Like the other group of stimulants, the drug company recommends that you tell your physician about ANY prescription of non-prescriptions drugs that you take.  Do not assume something is safe to use with these drugs simply because it isn’t listed!

Now we are back to the side effects you might notice.  Again, you will recognize some of these already, but there are also some side effects that are different as well.

  • Allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • Intense anger, anxiety, or mania
  • Chest pain
  • Fast, irregular heartbeats
  • Fever, or hot, dry skin
  • Hallucinations
  • High blood pressure
  • Muscle twitching
  • Uncontrollable head, mouth, neck, arm, or leg movements
  • Dizziness
  • Headaches
  • Loss of appetite
  • Nausea, vomiting
  • Nervousness, restlessness
  • Stomach cramps
  • Weight loss
  • Trouble sleeping

Jill W. recounted to me her experience with taking Adderall.  She had enough problematic symptoms of ADD that she went to her physician where, predictably, he suggested medication as the first line of treatment.   Like many of us, she said that she’d trusted her doctor and his recommendations.  “After all,” she said, “he’s the doctor.”  He even gave her some samples of Adderall so she could keep her costs down (Hmmm – wonder where he got those???).  She was not told about side effects nor was she asked about any existing medical conditions.

The first thing she noticed was that she had no appetite.  However, Jill said she wasn’t about to report that because she wanted to lose some weight anyway and this seemed like a great “extra.”  She wasn’t sleeping very well, but chalked it up to stress, not the medicine.  She did find herself, in her words, “ready to kick anyone’s a*$ that crossed me,” but still didn’t find these problems to be enough to report to her doctor.

What finally scared her were the chest pains and fast heart beat she began to have for several days in a row.  Convinced she was having a heart attack, she went to the ER where she was sent home with a diagnosis of “panic attack.”  The symptoms persisted until one day, she looked on the insert that came with her Adderall.  There it was in black and white.  Her symptoms matched some of those listed as side effects.

Even though she reported this to her physician, his first recommendation was that he would adjust her dose.  But Jill wasn’t convinced.  She stopped the medication altogether.

Next week, we will explore the class of drugs known as Atomoxetine and Buproprion.