Adderall XR
Brand Names: Adderall XR
Common Name: mixed salts amphetamine extended-release
What is this drug used for?
Amphetamine belongs to the family of medications known as stimulants. It is used to treat attention deficit hyperactivity disorder (ADHD). It helps to increase attention and decrease hyperactivity and impulsiveness in children over 6 years of age, adolescents, and adults who have been diagnosed with ADHD. Other measures (e.g., psychological, educational, and social therapies) are used along with mixed salts amphetamine as part of an overall treatment program for ADHD. An improvement in ADHD symptoms can be seen within one week of starting the medication.
Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Is there any reason not to take this drug?
Mixed salts amphetamine should not be taken by anyone who:
- has advanced hardening of the arteries
- is agitated
- is allergic to a group of medications known as sympathomimetics (e.g., pseudoephedrine, epinephrine, norepinephrine)
- is allergic to mixed salts amphetamine extended release or any ingredients of the medication
- has glaucoma (increased pressure in the eye)
- has heart disease
- has a history of drug abuse
- has moderate-to-severe high blood pressure
- has an overactive thyroid gland
- is taking a monoamine oxidase (MAO) inhibitor medication (e.g., phenelzine, tranylcypromine) or has taken one in the last 14 days
What about possible side effects?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- diarrhea
- dizziness
- dry mouth
- fatigue
- heartburn
- infections
- loss of appetite or weight loss
- mood changes
- nausea or vomiting
- nervousness
- stomach ache
- trouble sleeping
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- agitation
- aggressive behaviour
- convulsions (seizures)
- fast heartbeat or heart palpitations
- fever
- headache
- increased blood pressure
- symptoms of depression (losing interest in your usual activities, feeling sad, having thoughts of suicide)
- tremor (shaking)
- uncontrolled vocal outbursts or tics (uncontrolled and repeated body movements)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- chest pain
- signs of a serious allergic reaction (difficulty breathing; hives; swelling of the face, lips, eyes, mouth, or throat)
- hallucinations (hearing, seeing, or feeling things that are not actually there)
- thoughts of suicide or harming yourself
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
What if I am taking other drugs?
There may be an interaction between mixed salts amphetamine extended release and any of the following:
- acidifying agents (e.g., guanethidine, reserpine, ammonium chloride)
- adrenergic blockers (heart medication, e.g., doxazosin, prazosin)
- alcohol
- alkalinizing agents (e.g., sodium bicarbonate, acetazolamide)
- antihistamines (allergy medication)
- antihypertensives (blood pressure medication)
- chlorpromazine
- ethosuximide
- haloperidol
- lithium
- meperidine
- methenamine
- monoamine oxidase (MAO) inhibitors (e.g., phenelzine, tranylcypromine)
- other medications for ADHD
- phenobarbital
- phenytoin
- propoxyphene
- sympathomimetics (e.g., pseudoephedrine, epinephrine, norepinephrine)
- tricyclic antidepressants (e.g., amitriptyline, desipramine)
- veratrum alkaloids
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than the ones listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Other information:
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY September 21, 2006
Health Canada has issued new information concerning medications used for ADHD. To read the full Health Canada Advisory, visit Health Canada's web site at http://www.hc-sc.gc.ca.
A previous advisory on ADHD medications was issued on May 26, 2006.
To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Behaviour or mood changes: There have been reports of agitation, hallucinations, symptoms of depression, and thoughts of self-harm in people taking this medication. If you experience these types of symptoms while taking mixed salts amphetamine, contact your doctor immediately.
Blood pressure: This medication can increase blood pressure and heart rate. People with high blood pressure, heart problems, or overactive thyroid, or who have recently had a heart attack should have their blood pressure monitored at appropriate intervals by their doctor.
Drug dependence: Due to the possibility for some individuals to develop a dependence on amphetamines, people with a history of drug or alcohol dependence should be closely monitored by their doctor while using this medication.
Epilepsy: There is some evidence that mixed salts amphetamine may increase the risk of seizures, particularly for people who have had seizures in the past. People with a history of seizures should be closely monitored by their doctor while using this medication.
Exercise: People participating in strenuous exercise or activities should consult their doctor before taking mixed salts amphetamine extended release.
Heart problems: This medication can increase the risk of sudden death for people with heart problems. People with heart problems, including an irregular heartbeat, or a family history of sudden death related to heart disease should be carefully evaluated by their doctors before starting this medication, and then closely monitored if they take the medication. This medication should generally not be used by people with known structural heart abnormalities (such as abnormal size, missing or poorly functioning heart valves, or problems with blood vessels connected to the heart).
Long-term use: If you will be using this medication for a long period of time, you will need regular heart check-ups by your doctor.
Stopping the medication: Check with your doctor before stopping this medication.
Suppression of growth: It is not known whether mixed salts amphetamine extended release causes growth suppression in children (i.e., less growth in height or weight than usual). However, this has been reported for children who use stimulants such as mixed salts amphetamine over long periods of time. Children who need long-term treatment should be carefully monitored for growth. Their doctor may also recommend a "drug holiday," where the medication is not given on weekends or during school holidays.
Psychosis: This medication may increase abnormal thoughts and behaviours in people with psychotic conditions.
Bipolar disorder: This medication may trigger a mixed or manic episode in people with bipolar disorder. Tell your doctor of any history of mental problems or any new or worsening mental problems while taking this medication.
Vision Problems: Difficulties with vision such as blurring of vision have been reported with stimulant use. If this problem persists, talk to your doctor.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. Women should not breast-feed while they are taking mixed salts amphetamine.
Children: The safety and effectiveness of this medication have not been established for children less than 6 years of age. This medication should not be used by children under 6 years old.
Special Instructions:
The dose of this medication needs to be individualized according to the needs of the person taking the medication. The dose is usually started low and increased gradually. The usual starting dose is 5 mg to 10 mg once daily in the morning with or without food. Doses above 30 mg daily are not recommended.
Swallow this medication whole with water or other liquids. Do not crush or split the capsules. The capsule contains small pellets of medication specially designed to release their contents slowly inside the body. The capsule may be opened and the contents sprinkled over applesauce. The applesauce should be eaten immediately after sprinkling, not stored for later. Avoid chewing the applesauce - chewing could damage the pellets from the capsule. Eat all of the sprinkled applesauce to make sure you get the full dose.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones above, do not change the way that you are taking the medication without consulting your doctor.
It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Concerta
Brand Names: Concerta
Common Name: methylphenidate extended release
What is this drug used for?
Methylphenidate extended release belongs to the family of medications known as stimulants. It is used for the treatment of attention deficit hyperactivity disorder (ADHD). It helps to increase attention and decrease restlessness in children and adolescents from the age of 6 to 18 years who have been diagnosed with ADHD. Other measures (e.g., psychological, educational, and social therapies) are used along with methylphenidate extended release as part of an overall treatment program for ADHD.
Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Is there any reason not to take this drug?
Methylphenidate extended release should not be taken by anyone who:
- is allergic to methylphenidate or to any of the ingredients of the medication
- is taking an monoamine oxidase (MAO) inhibitor (e.g., phenelzine, tranylcypromine) or has taken one in the last 14 days
- has advanced hardening of the arteries
- has an overactive thyroid gland
- has anxiety, tension, or agitation
- has glaucoma (increased pressure in the eye)
- has heart disease
- has moderate-to-severe high blood pressure
- has motor tics, Tourette's syndrome, or a family history of Tourette's syndrome
What about possible side effects?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- agitation, nervousness, or anxiety
- diarrhea
- dizziness or drowsiness
- dry mouth
- headache
- heartburn
- joint pain
- loss of appetite
- nausea or vomiting
- skin rash or itching (mild)
- stomach pain
- trouble sleeping
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible any of the following side effects occur:
- chest pain
- confusion
- fever
- hallucinations (hearing, seeing, or feeling things that are not actually there) or abnormal thoughts or behaviour
- increased blood pressure
- muscle twitching or tics
- palpitations (feeling your heart beat quickly or irregularly)
- pinpoint-sized red spots on skin or unusual bruising
- prickling or tingling sensations in the hands, arms, feet, or legs
- sore throat and fever
- sudden high fever
- sweating
- symptoms of depression (e.g., losing interest in your usual activities, feeling sad, having thoughts of suicide - see below)
- symptoms of liver damage (e.g., yellow skin or eyes, abdominal pain, loss of appetite, pale stools, dark urine)
- tics or symptoms of Tourette's syndrome (involuntary, sudden body movements or uncontrolled vocal outbursts)
- vision changes
Stop taking the medication and seek immediate medical attention if any of the following occur:
- convulsions (seizures)
- peeling or blistering of the skin
- signs of a serious allergic reaction (difficulty breathing; hives; swelling of the face, lips, eyes, mouth, or throat)
- thoughts of suicide or hurting yourself
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
What if I am taking other drugs?
There may be an interaction between methylphenidate extended release and any of the following:
- alcohol
- amphetamines (e.g., dextroamphetamine)
- antidepressants (e.g., amitriptyline, imipramine, fluoxetine)
- appetite suppressants (e.g., phentermine)
- carbamazepine
- clonidine
- guanethidine
- monoamine oxidase (MAO) inhibitors (e.g., phenelzine, tranylcypromine)
- methyldopa
- other medications for ADHD
- phenobarbital
- phenytoin
- primidone
- sympathomimetic medications (e.g., epinephrine)
- warfarin
If you are taking any of these medications, speak with your doctor or pharmacist.
Mylan-Clonazepam
Brand Names: Mylan-Clonazepam
Common Name: clonazepam
What is this drug used for?
Clonazepam belongs to the class of medications called benzodiazepines. In general, benzodiazepines are used as a sedative or to decrease seizures or anxiety.
Clonazepam is used to treat seizure disorders. It helps by slowing the activity of the nerves in the brain (i.e., the central nervous system).
Your doctor may choose to use this medication for conditions other than the ones listed in these drug information articles. If you are unsure why you are taking this medication, contact your doctor.
Is there any reason not to take this drug?
Clonazepam should not be taken by anyone with:
- an allergy to clonazepam, any other benzodiazepine, or any ingredient of this medication
- severe breathing problems
- myasthenia gravis
- significant liver disease
- acute narrow or closed angle glaucoma
Clonazepam may be used by people with open angle glaucoma who are receiving appropriate treatment.
What about possible side effects?
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your health professional. They may be able to help you to deal with some of the effects.
The following side effects may go away as your body becomes used to the medicine; check with your doctor if they continue or become bothersome.
More common
- clumsiness or unsteadiness
- dizziness or lightheadedness
- drowsiness
- slurred speech
Less common or rare
- abdominal or stomach cramps or pain
- blurred vision or other changes in vision
- changes in sexual desire or ability
- constipation
- diarrhea
- dryness of mouth or increased thirst
- false sense of well-being
- headache
- increased watering of mouth
- muscle spasm
- nausea or vomiting
- problems urinating
- trembling or shaking
- unusual tiredness or weakness
Check with your doctor as soon as possible if any of the following side effects occur:
Less common
- anxiety
- confusion
- depression
- fast, pounding, or irregular heartbeat
- lack of memory
Rare
- abnormal thinking (disorientation, delusions, or loss of sense of reality)
- agitation
- behavioural changes, including:
- aggressiveness
- bizarre conduct
- decreased inhibition
- angry outbursts
- convulsions (seizures)
- hallucinations
- hypotension (low blood pressure)
- muscle weakness
- skin rash or itching
- sore throat, fever, and chills
- trouble sleeping
- ulcers or sores in mouth or throat
- uncontrolled movements of body, including the eyes
- unusual bleeding or bruising
- unusual excitement, nervousness, or irritability
- unusual tiredness or weakness (severe)
- yellow eyes or skin
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
What if I am taking other drugs?
The following medications may affect how clonazepam works or increase the risk of side effects:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, the nicotine from cigarettes, or street drugs can affect the action of many medications; you should let your prescriber know if you use them.
Other information:
Dependence and withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as clonazepam. Severe withdrawal symptoms may occur if the dose is significantly reduced or suddenly discontinued. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms.
Medical conditions: Clonazepam is not recommended for use by people with depression or psychosis. People who have an addiction to alcohol or other drugs should not take clonazepam except in rare situations under medical supervision.
Occupational hazards: Because clonazepam causes drowsiness and sedation, do not engage in activities requiring mental alertness, judgment, and physical coordination (such as driving or operating machinery) while taking it. This is particularly true when first taking the medication and until you have established that clonazepam does not affect you this way. Alcohol can increase the drowsiness effects and should be avoided.
Pregnancy: If clonazepam is used to prevent major seizures, its use should not be discontinued. If it is taken for minor seizures, the risks posed by seizures need to be weighed against the risks posed by the medication. Women who have epilepsy should notify their doctor promptly if they become pregnant.
Breast-feeding: Clonazepam may pass into breast milk and is not recommended for use by nursing mothers. Mothers who take clonazepam should not breast-feed their infants.
Children: If long-term use of clonazepam is being considered for a child, the benefits needs to be weighed against the risks.
Seniors: Seniors may be at increased risk for the sedative and impaired coordination effects of this medication. They need to use extra caution, for example, when getting up during the night.
Special Instructions:
The recommended adult starting dose of clonazepam ranges from 0.5 mg to 2 mg daily in divided doses, with or without food. It is important that the dose be individualized to your specific needs to avoid excessive sedation or motor impairment. Your doctor may increase this dose to as high as 20 mg per day in two to four divided doses. The dose is usually started low and increased if necessary by your doctor.
Children who are more than 10 years old or who weigh more than 30 kg have their doses based on weight (0.01 mg per kg of body weight per day - 0.03 mg per kg of body weight per day) and need to be monitored carefully.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.
Clonazepam may be habit forming when taken for long periods of time. If you have been taking this medication regularly for a long period of time (i.e., more than one month), do not stop taking the medication without speaking with your doctor. To avoid withdrawal effects, a gradual reduction in dose is recommended when stopping this medication.
It is important that this medication be taken exactly as prescribed by the doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If your next dose is in less than 4 hours, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Apo-Clonidine
Brand Names: Apo-Clonidine Children: The safety and effectiveness of this medication have not been established for use by children.
Common Name: clonidine HCl
What is this drug used for?
Clonidine is used alone or in combination with thiazide diuretics (e.g., hydrochlorothiazide) to treat high blood pressure. It is usually tried when other types of blood pressure medications are ineffective or cannot be used.
Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Is there any reason not to take this drug?
This medication should not be taken by anyone who :
- is allergic to clonidine or to any of the ingredients of the medication
- has a certain type of abnormal heart rhythm associated with a low heart rate
What about possible side effects?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
More common:
- constipation
- dizziness
- drowsiness
- dryness of mouth
- unusual tiredness or weakness ?
Less common:
- decreased sexual ability
- dizziness, lightheadedness, or fainting, especially when getting up from a lying or sitting position
- dry, itching, or burning eyes
- loss of appetite
- nausea or vomiting
- nervousness
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Less common:
- depression
- swelling of feet and lower legs
Rare:
- paleness or cold feeling in fingertips and toes
- vivid dreams or nightmares
Check with your doctor immediately if any of the following side effects occur (signs of overdose):
- difficulty in breathing
- dizziness (extreme) or faintness
- feeling cold
- pinpoint pupils of eyes
- slow heartbeat
- unusual tiredness or weakness
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
What if I am taking other drugs?
There may be an interaction between clonidine and any of the following:
- ACE inhibitors (e.g., enalapril, lisinopril)
- alcohol
- appetite suppressants
- barbiturates (e.g., phenobarbital)
- beta-blockers (e.g., atenolol, metoprolol)
- calcium channel blockers (e.g., diltiazem, verapamil)
- chlorpromazine
- cyclosporine
- digoxin
- diuretics (e.g., furosemide, hydrochlorothiazide)
- fluphenazine
- levodopa
- MAO inhibitors (e.g., phenelzine)
- neuroleptics (e.g., haloperidol)
- nonsteroidal anti-inflammatory drugs (e.g., indomethacin, naproxen, diclofenac)
- prazosin
- tricyclic antidepressants (e.g., amitriptyline, imipramine)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Other information:
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Withdrawal: Don't stop taking this medication without talking to your doctor. A severe withdrawal reaction may develop within 12 to 48 hours when clonidine is stopped suddenly. This reaction includes a rapid rise in blood pressure and symptoms such as nervousness, agitation, chest pain, pounding heartbeat, increased salivation, trembling hands, stomach cramps, trouble sleeping, vomiting, and headache. When stopping clonidine therapy, the doctor will instruct you to reduce the dose gradually over 2 to 4 days to avoid this reaction. A withdrawal reaction is most likely to occur in people who have been receiving large doses of clonidine or in those who are taking another type of blood pressure medicaiton called a beta-blocker at the same time. Examples of beta-blockers are atenolol, metoprolol, and propranolol.
Depression: People with a history of depression should let their doctor know if their depression worsens or returns while on this medication.
Drowsiness/reduced alertness: Clonidine can cause drowsiness. Do not operate automobiles or other machinery until you have determined that it does not produce this effect on you.
Eyes: People treated with clonidine should receive periodic eye examinations.
Heart or blood vessel disease: Because it lowers blood pressure, people with severe heart disease or blood vessel disease, or a recent heart attack or stroke, should be closely monitored by their doctor while taking clonidine.
Kidney failure: People with chronic kidney failure should be monitored by their doctor while taking clonidine.
Raynaud's disease: People with Raynaud's disease should be cautious while taking clonidine as it may worsen this condition.
Pregnancy: There are no adequate studies of the use of this medication by pregnant women. It should be used during pregnancy only if clearly needed.
Breast-feeding: Since clonidine passes into breast milk, it should not be used by nursing women.
Children: The safety and effectiveness of this medication have not been established for use by children.
Special Instructions:
For treatment of high blood pressure, the dose of clonidine ranges from 0.1 mg to 0.6 mg daily, usually in two divided doses (morning and bedtime), depending on the needs and circumstances of the person taking the medication.
Do not stop taking this medication suddenly without checking with your doctor.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Dexedrine
Brand Names: Dexedrine
Common Name: dextroamphetamine sulfate
What is this drug used for?
This medication is used to treat attention deficit disorder (ADD) and narcolepsy (falling asleep at inappropriate times without any control). It works for treating narcolepsy by acting as a stimulant to the brain. The way that it helps people with ADD has not been established.
Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
Is there any reason not to take this drug?
Dextroamphetamine sulfate should not be taken by anyone with:
- advanced hardening of the arteries
- agitated states
- allergy to sympathomimetic amines or to any of the ingredients of the medication
- glaucoma (increased pressure in the eye)
- heart disease
- a history of drug abuse
- moderate-to-severe high blood pressure
- an overactive thyroid gland
This medication should not be used at the same time as, or within 14 days after taking, MAO inhibitors such as phenelzine or tranylcypromine.
What about possible side effects?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- dizziness
- dry mouth, unpleasant taste, diarrhea, constipation, loss of appetite, nausea, or vomiting
- erectile dysfunction (trouble getting or keeping an erection) or reduced sex drive
- euphoria
- irritability or mood swings
- restlessness or trouble sleeping
- weight loss
Check with your doctor as soon as possible if any of the following side effects occur:
- abnormal thoughts or behaviour, hallucinations, or delusions
- jerky body movements
- increased blood pressure
- palpitations (feeling your heart beat quickly or irregularly)
- symptoms of depression (e.g., losing interest in your usual activities, feeling sad, having thoughts of suicide - see below)
- symptoms of Tourette's syndrome (involuntary, sudden body movements or uncontrolled vocal outbursts)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- symptoms of a serious allergic reaction (e.g., hives, swelling of the face and throat, difficulty breathing)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
What if I am taking other drugs?
The following medications may affect how dextroamphetamine works or increase the risk of side effects:
- acetazolamide
- antihistamines
- barbiturates (e.g., phenobarbital)
- beta-blockers (e.g., propranolol)
- chlorpromazine
- ethosuximide
- guanethidine
- haloperidol
- hydrochlorothiazide
- lithium
- MAO inhibitors (e.g., phenelzine, tranylcypromine)
- medications that treat high blood pressure
- meperidine
- methenamine
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- norepinephrine
- phenytoin
- propoxyphene
- SSRI antidepressants (e.g., fluoxetine, fluvoxamine, paroxetine, sertraline)
- sympathomimetic medications (e.g., epinephrine, pseudoephedrine)
- tricyclic antidepressants (e.g., amitriptyline)
- urinary tract acidifiers (e.g., ammonium chloride) and alkalinizers (e.g., potassium citrate)
- other medications for ADHD
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If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Other information:
Be sure to inform your doctor of all your medical conditions before you begin taking a medication. Some conditions can affect how you should take this medication.
HEALTH CANADA ADVISORY
May 26, 2006
Health Canada has issued new restrictions concerning the use of medications for ADHD. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Allergy: Dextroamphetamine products contain tartrazine (FD&C Yellow No. 5), which can cause allergic-type reactions (including bronchial asthma) in susceptible individuals. People allergic to salicylates are often allergic to tartrazine.
Dependence: Amphetamines such as dextroamphetamine sulfate have been subject to extensive abuse. Tolerance, extreme psychological dependence, and severe social disability can occur with abuse of this medication. Some people have been reported to have increased their dosage to many times the recommended level.
Signs of chronic intoxication with amphetamines include:
- severe rashes
- extreme insomnia
- irritability
- hyperactivity
- personality changes
Diabetes: Amphetamines such as dextroamphetamine may affect blood sugar levels and alter insulin requirements for people with diabetes.
Exercise: People participating in strenuous exercise or activities should consult their doctor before taking dextroamphetamine.
Heart problems: This medication can increase heart rate and blood pressure. It may also increase the risk of sudden death for people with heart problems. People with heart problems, including an irregular heartbeat, or a family history of sudden death related to heart disease should be carefully evaluated by their doctors before starting this medication, and then closely monitored if they take the medication. This medication should generally not be used by people with known structural heart abnormalities (such as abnormal size, missing or poorly functioning heart valves, or problems with blood vessels connected to the heart).
High blood pressure: Use this medication with caution even if you have only mild high blood pressure.
Long-term use: If you use this medication for a long period of time, you will need regular heart check-ups by your doctor.
Occupational hazards: This medication may disguise extreme fatigue, which can impair the ability to perform potentially hazardous activities such as driving or operating machinery.
Stopping the medication: Check with your doctor before stopping this medication.
Pregnancy: The safe use of this medication during pregnancy has not been established. Infants born to mothers dependent on amphetamines have an increased risk of premature delivery and low birth weight. Also, these infants may experience symptoms of withdrawal after birth. The use of amphetamines by women who are or may become pregnant, and especially those in the first trimester of pregnancy, requires that the potential benefit be weighed against the possible hazards.
Breast-feeding: Dextroamphetamine sulfate passes into breast milk. Women taking this medication should not breast-feed.
Children: The long-term effects of amphetamines on children have not been well established. Chronic use of amphetamines may be associated with stunted growth; therefore, children's growth should be monitored during treatment. This medication is not recommended for treating ADD in children under six years of age.
Special Instructions:
This medication should be started at the lowest possible dose and increased slowly. For narcolepsy, the daily dosage may range from 5 mg to 60 mg daily depending on individual response. For attention deficit disorder, the daily dosage may range from 2.5 mg to 40 mg daily for best response. Dextroamphetamine is not recommended for children under 6 years of age.
The timing of this medication is very important. Generally, a long-acting form of the medication would not be taken in the evening, as it may interfere with sleep.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important that this medication be taken exactly as prescribed by the doctor. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Focalin Side Effects
Generic Name: dexmethylphenidate
Please note - some side effects for Focalin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).
Side Effects of Focalin - for the Consumer
Focalin
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Focalin:
Dizziness; drowsiness; headache; loss of appetite; nausea; nervousness; stomach pain; trouble sleeping.
Seek medical attention right away if any of these SEVERE side effects occur when using Focalin:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; joint pain; purple or brownish red spots on the skin); behavior changes (eg, aggression, hostility); blurred vision or other vision problems; chest pain; confusion; dark urine; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; mental or mood changes (eg, agitation, anxiety, depression, irritability, persistent crying, unusual sadness); seizures; severe or persistent dizziness or headache; suicidal thoughts or attempts; uncontrolled speech or muscle movements; yellowing of the eyes or skin.
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Focalin XR Extended-Release Capsules:
Anxiety, dizziness; drowsiness; dry mouth; headache; indigestion; loss of appetite; nausea; nervousness; stomach pain; trouble sleeping.
Seek medical attention right away if any of these SEVERE side effects occur when using Focalin XR Extended-Release Capsules:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; joint pain; purple or brownish red spots on the skin); behavior changes (eg, aggression, hostility); blurred vision or other vision problems; chest pain; confusion; dark urine; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; mental or mood changes (eg, agitation, depression, irritability, persistent crying, severe or persistent anxiety, unusual sadness); seizures; severe or persistent dizziness or headache; suicidal thoughts or attempts; uncontrolled speech or muscle movements; yellowing of the eyes or skin.
Focalin Side Effects - for the Professional
Focalin
The pre-marketing development program for Focalin included exposures in a total of 696 participants in clinical trials (684 patients, 12 healthy adult subjects). These participants received Focalin 5, 10, or 20 mg/day. The 684 ADHD patients (ages 6 to 17 years) were evaluated in two controlled clinical studies, two clinical pharmacology studies, and two uncontrolled long-term safety studies. Safety data on all patients are included in the discussion that follows. Adverse reactions were assessed by collecting adverse events, and results of physical examinations, vital sign and body weight measurements, and laboratory analyses.
Adverse events during exposure were primarily obtained by general inquiry and recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of events into a smaller number of standardized event categories. In the tables and tabulations that follow, standard COSTART dictionary terminology has been used to classify reported adverse events.
The stated frequencies of adverse events represent the proportion of individuals who experienced, at least once, a treatment-emergent adverse event of the type listed. An event was considered treatment emergent if it occurred for the first time or worsened while receiving therapy following baseline evaluation.
Adverse Findings in Clinical Trials with Focalin
Adverse Events Associated with Discontinuation of Treatment
No Focalin-treated patients discontinued due to adverse events in two placebo-controlled trials. Overall, 50 of 684 children treated with Focalin (7.3%) experienced an adverse event that resulted in discontinuation. The most common reasons for discontinuation were twitching (described as motor or vocal tics), anorexia, insomnia, and tachycardia (approximately 1% each).
Adverse Events Occurring at an Incidence of 5% or More Among Focalin-Treated Patients
Table 1 enumerates treatment-emergent adverse events for two, placebo-controlled, parallel group trials in children with ADHD at Focalin doses of 5, 10, and 20 mg/day. The table includes only those events that occurred in 5% or more of patients treated with Focalin where the incidence in patients treated with Focalin was at least twice the incidence in placebo-treated patients. The prescriber should be aware that these figures cannot be used to predict the incidence of adverse events in the course of usual medical practice where patient characteristics and other factors differ from those which prevailed in the clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigations involving different treatments, uses, and investigators. The cited figures, however, do provide the prescribing physician with some basis for estimating the relative contribution of drug and non-drug factors to the adverse event incidence rate in the population studied.
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Table 1 Treatment-Emergent Adverse Events1 Occurring During Double-BlindTreatment in Clinical Trials of Focalin®
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Body System
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Preferred Term
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Focalin
(n=79)
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Placebo
(n=82)
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Body as a Whole
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Abdominal Pain
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15%
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6%
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Fever
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5%
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1%
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Digestive System
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Anorexia
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6%
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1%
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Nausea
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9%
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1%
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1 Events, regardless of causality, for which the incidence for patients treated with Focalin was at least 5% and twice the incidence among placebo-treated patients. Incidence has been rounded to the nearest whole number.
Adverse Events with Other Methylphenidate HCl Products
Nervousness and insomnia are the most common adverse reactions reported with other methylphenidate products. In children, loss of appetite, abdominal pain, weight loss during prolonged therapy, insomnia, and tachycardia may occur more frequently; however, any of the other adverse reactions listed below may also occur.
Other reactions include:
Cardiac: angina, arrhythmia, palpitations, pulse increased or decreased, tachycardia
Gastrointestinal: nausea
Immune: hypersensitivity reactions including skin rash, urticaria, fever, arthralgia, exfoliative dermatitis, erythema multiforme with histopathological findings of necrotizing vasculitis, and thrombocytopenic purpura
Nervous System: dizziness, drowsiness, dyskinesia, headache, rare reports of Tourette’s syndrome, toxic psychosis
Vascular: blood pressure increased or decreased, cerebral arteritis and/or occlusion
Although a definite causal relationship has not been established, the following have been reported in patients taking methylphenidate:
Blood/lymphatic: leukopenia and/or anemia
Hepatobiliary: abnormal liver function, ranging from transaminase elevation to hepatic coma
Psychiatric: transient depressed mood, aggressive behavior
Skin/subcutaneous: scalp hair loss
Very rare reports of neuroleptic malignant syndrome (NMS) have been received, and, in most of these, patients were concurrently receiving therapies associated with NMS. In a single report, a ten year old boy who had been taking methylphenidate for approximately 18 months experienced an NMS-like event within 45 minutes of ingesting his first dose of venlafaxine. It is uncertain whether this case represented a drug-drug interaction, a response to either drug alone, or some other cause.
In children, loss of appetite, abdominal pain, weight loss during prolonged therapy, insomnia, and tachycardia may occur more frequently; however, any of the other adverse reactions listed above may also occur
Side Effects by Body System
Cardiovascular
Cardiovascular side effects associated with racemic forms of methylphenidate have frequently included tachycardia. Angina, arrhythmia, palpitations, cerebral arteritis and/or occlusion, and changes in heart rate have also been associated with racemic forms of methylphenidate. Hypertension and hypotension have been reported rarely.
Gastrointestinal
Gastrointestinal side effects associated with the use of extended-release capsules in pediatric patients have frequently included dyspepsia and decreased appetite.
Gastrointestinal side effects associated with the use of extended-release capsules in adult patients have frequently included dry mouth and dyspepsia.
Gastrointestinal side effects associated with dexmethylphenidate immediate-release in relation to placebo therapy have included abdominal pain (15% vs. 6%), anorexia (6% vs. 1%), and nausea (9% vs. 1%).
Gastrointestinal side effects associated with racemic methylphenidate have frequently included loss of appetite.
Nervous system
Nervous system side effects associated with the use of extended-release capsules in pediatric patients have frequently included headache (25%) and anxiety (6%).
Nervous system side effects associated with the use of extended-release capsules in adult patients have frequently included headache (26%), feeling jittery (12%), dizziness (6%), and anxiety (5%).
Nervous system side effects associated with racemic methylphenidate have frequently included insomnia. Dizziness, drowsiness, dyskinesia, headache, and toxic psychosis have also been reported with racemic methylphenidate. Tourette's syndrome has been reported rarely.
Hypersensitivity
Hypersensitivity side effects associated with racemic methylphenidate have included skin rash, urticaria, fever, arthralgia, exfoliative dermatitis, erythema multiforme with histopathological findings of necrotizing vasculitis, and thrombocytopenic purpura.
Hematologic
Hematologic side effects associated with racemic methylphenidate have included leukopenia and/or anemia. However, causality has not been definitely established.
Hepatic
Hepatic side effects associated with racemic methylphenidate have included abnormal liver function, ranging from elevated transaminase levels to hepatic coma. However, causality has not been definitely established.
Dermatologic
Dermatologic side effects associated with racemic form of methylphenidate have included scalp hair loss. However, causality has not been definitely established.
Psychiatric
Psychiatric side effects associated with racemic methylphenidate have included transient depressed mood. However, causality has not been definitely established.
Other
Other side effects associated with the use of dexmethylphenidate immediate-release, in relation to placebo therapy, have included fever (5% vs. 1%).
Other side effects associated with methylphenidate have rarely included neuroleptic malignant syndrome (NMS).
The manufacturer reports a 10-year-old male, after receiving oral methylphenidate for a duration of approximately 18-months, experienced a NMS-like event within 45 minutes of receiving a single oral venlafaxine. Causality was not determined.
Metabolic
Metabolic side effects associated with the use of extended-release capsules in pediatric patients have frequently included decreased appetite (30%).
Metabolic side effects associated with racemic methylphenidate have included weight loss especially during prolonged therapy.
Respiratory
Respiratory side effects associated with the use of extended-release capsules in adult patients have frequently included pharyngolaryngeal pain (4%).
Vyvanse Side Effects and Warnings
Updated October 21, 2008
Dextroamphetamine Composite
- Brand Names: VYVANSE
- Generic Name: LISDEXAMFETAMINE (dextroamphetamine with lysine)
- Category: CEREBRAL STIMULANTS
FDA “Black Box” Warning Label
The Food and Drug Administration (FDA) requires the following “black box” warning on all amphetamines, including Vyvanse, which means that medical studies indicate Vyvanse carries a significant risk of serious, or even life-threatening, adverse effects.
WARNING
AMPHETAMINES HAVE A HIGH POTENTIAL FOR ABUSE. ADMINISTRATION OF AMPHETAMINES FOR PROLONGED PERIODS OF TIME MAY LEAD TO DRUG DEPENDENCE AND MUST BE AVOIDED. PARTICULAR ATTENTION SHOULD BE PAID TO THE POSSIBILITY OF SUBJECTS OBTAINING AMPHETAMINES FOR NONTHERAPEUTIC USE OR DISTRIBUTION TO OTHERS, AND THE DRUGS SHOULD BE PRESCRIBED OR DISPENSED SPARINGLY.
MISUSE OF AMPHETAMINE MAY CAUSE SUDDEN DEATH AND SERIOUS CARDIOVASCULAR ADVERSE EVENTS.
ABOVE: FDA black box warning label means that medical studies indicate the drug carries a significant risk of serious or even life-threatening adverse effects.
“Amphetamine, as with cocaine, can induce symptoms similar to those seen in obsessive disorder, panic disorder, and phobic disorders.”
ABOVE: Kaplan and Sadock's Synopsis of Psychiatry (2007) citing American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.
“High doses and long-term use of amphetamines are associated with erectile disorder and other sexual dysfunctions.”
ABOVE: Kaplan and Sadock's Synopsis of Psychiatry (2007) citing American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.
Description
Although Vyvanse is referred to as “pro-drug” of dextroamphetamine, it is still an amphetamine, meaning that it is easily abused and can cause insomnia, agitation, anxiety and sometimes psychotic symptoms like seeing things or becoming paranoid. The difference between Vyvanse and Adderall is that Vyvanse will work only if it is swallowed so that drug abusers will not be able to snort it or inject it. It is hoped this will limit abuse of Vyvanse.
A 30 mg Vyvanse capsule is molecularly equivalent to 8.88 mg dextroamphetamine.
Used For
· Attention deficit disorder
How Amphetamines Work
When we are stressed or under threat, the central nervous system prepares us for physical action by creating particular physiological changes. Amphetamines prompt the brain to initiate this ‘fight or flight’ response. These changes include:
· The release of adrenalin and other stress hormones
· Increased heart rate and blood pressure
· Redirected blood flow into the muscles and away from the gut
In small doses amphetamines can banish tiredness and make the user feel alert and refreshed. However, the burst of energy comes at a price. A "speed crash" always follows the high and may leave the person feeling nauseous, irritable, depressed and extremely exhausted.
Do Not Use If
You have not tried other psychotherapy, have high blood pressure or any form of heart disease, are very nervous or have severe insomnia, have a history of addiction to drugs or alcohol, or have Tourette syndrome. Do not combine with monoamine oxidase inhibitors.
Common Side Effects
· Dry Mouth
· Loss of appetite
· Headache
· Difficulty falling asleep (insomnia)
· Nervousness including agitation, anxiety and irritability
· Addiction
Less Common Side Effects
· High blood pressure
· Rapid pulse rate
· Tolerance (constant need to raise the dose)
· Feelings of suspicion and paranoia
· Visual hallucinations (seeing things that are not there)
· Depression
· Cocaine craving
· Dermatoses (infected or diseased skin)
· Urinary tract infection
· Infection or viral infection
· Elevated ALT enzyme levels in the blood (signaling liver damage)
Overdose Side Effects
Amphetamines have been extensively abused. Extreme psychological dependence and severe social disability have resulted. Abuse of amphetamines may cause a sudden heart attack even in those with no signs of heart disease. Symptoms of overdose that require immediate medical assistance include:
· Restlessness
· Tremor
· Aggression
· Hallucinations
· Panic states
· Hyperreflexia (overactive reflexes, which can include twitching or spasms)
· Personality changes
· Symptoms of depression
· Seizures or abnormal EEGs
· High blood pressure
· Rapid heart beat
· Swelling of hands/feet/ankles (for example, numbing of the fingertips)
· Delusions
· Sweating
· Vomiting
· Dehydration
· Unexplained muscle pain
· Lower abdominal pain
· Rhabdomyolysis and kidney damage
· Chronic abuse can manifest itself as psychosis, often indistinguishable from schizophrenia
Amphetamine-Induced Anxiety Disorder
The onset of amphetamine-induced anxiety disorder can occur during amphetamine use or withdrawal, according to best-selling psychiatry text, Kaplan and Sadock's Synopsis of Psychiatry citing American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.
"Amphetamine, as with cocaine, can induce symptoms similar to those seen in obsessive disorder, panic disorder, and phobic disorders," states Synopsis of Psychiatry.
Amphetamine-Induced Psychosis
Induction of schizophrenic-like states in children on prescribed doses of stimulant medications, including amphetamine prescription drugs, have been observed, according to The Journal of the American Board of Family Medicine in an article entitled, "Adderall-Induced Psychosis in an Adolescent."
Amphetamine-Induced Sexual Dysfunction
Referring again to American Psychiatric Association's Manual of Mental Disorders, Synopsis of Psychiatry states: "High doses and long-term use of amphetamines are associated with erectile disorder and other sexual dysfunctions."
Vyvanse is a Schedule II Substance, which means Vyvanse has a "high potential for abuse" that "may lead to severe psychological or physical dependence," and the federal government sets limits on the amount of these amphetamine drugs that may be manufactured each year.
ABOVE: 21 USC Sec. 812 01/22/02. Drug Enforcement Administration, US Department of Justice. www.dea.gov/pubs/csa/812.htm.
Dependence, Tolerance and Withdrawal
It is possible to build up a tolerance to amphetamines, which means the person using the drug needs to take larger doses to achieve the same effect. Over time, the body might come to depend on amphetamines just to function normally. The person craves the drug and their psychological dependence makes them panic if access is denied, even temporarily.
Withdrawal symptoms can include tiredness, panic attacks, crankiness, extreme hunger, depression and nightmares. Some people experience a pattern of "binge crash" characterized by using continuously for several days without sleep, followed by a period of heavy sleeping.
If It Doesn't Work
The drug should be stopped gradually. Withdrawal symptoms are psychological and stopping suddenly can cause extreme fatigue and severe, even suicidal, depression in adult patients.
Abrupt cessation of amphetamines such as Vyvanse can cause extreme fatigue and severe, even suicidal, depression in adult patients.
SOURCE: The Essential Guide to Psychiatric Drugs—Rev. and updated (2007).
If It Does Work
"In the treatment of ADHD for children and young adults, Adderall XR is now prescribed frequently, often as a first-line drug. This is, in my opinion, a very serious mistake," states Jack M. Gorman, M.D., professor of psychiatry at Columbia University and deputy director of the New York State Psychiatric Institute. "Adderall is now abused throughout college campuses, where it is bought, sold, stolen, borrowed, snorted and injected. It is a very powerful drug that undoubtedly works for ADHD, but there are alternatives with less abuse potential that should be tried first."
If you have taken a newly released medication, you, too, are part of the great ongoing clinical trial. When a new drug is approved less than half of its serious reactions are known. The FDA relies upon you, the consumer, to determine the other half.
SOURCE: Cohen, J.S. Over Dose: The Case Against the Drug Companies: Prescription Drugs, Side Effects, and Your Health. New York: Penguin Putnam Inc., 2001.
New Medications: Are You a Drug Guinea Pig?
Drug companies have realized the enormous demand for psychiatric medications and are actively working on many new ones. When a manufacturer brings out a new drug, they advertise it aggressively. However, pre-marketing trials, performed to satisfy the FDA requirements for new drugs, test at most a few thousand people in a very structured environment.
The FDA considers the first years in the marketplace as Phase IV of a clinical trial because that's when the drug is really put to the test, treating a diverse cross-section of the population.
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