Adderall (dextroamphetamine and amphetamine) is one of the preferred treatment options for adults with attention-deficit hyperactivity disorder (ADHD). The medication works by increasing an individual’s ability to pay attention and control impulsive behaviors. In people without ADHD, abuse of Adderall generates a euphoric sensation, included elevated feelings of confidence and power. When taken as prescribed, Adderall carries a risk of several unpleasant side effects. These include difficulty sleeping, nervousness, restlessness, and headache. Chest pain, rapid heartbeat, and shortness of breath are all signs of a potentially serious condition, warranting immediate medical attention.

Although the risk is small, there have been several documented cases of young people experiencing sudden heart attacks after taking Adderall without a prescription. The dosages were not especially high in many of these cases. In one such example, a young male suffered an acute heart attack after ingesting 30 mg of Adderall and drinking an unspecified amount of alcohol. He had no history of heart abnormalities. Still more troubling, cardiac events are possible even in the absence of abuse. A 15-year-old boy in otherwise good health experienced a heart attack in response to his usual dose of Adderall. He fully recovered, and terminating the prescription removed any signs of heart irregularities. Doctors are not certain what causes these effects in people. Currently, there’s no test to determine who will or will not develop cardiac side effects when taking Adderall. The best practice right now is to monitor an individual’s symptoms closely and intervene at the first sign of trouble. In addition, a history of heart issues may argue for a treatment plan that does not include a powerful stimulant like Adderall.

The extended-release formulation of Adderall was removed from the Canadian market for several years out of concerns about heart attacks and rampant abuse of the medication. It was eventually reintroduced with stricter guidelines for attending physicians. As always, those who abuse prescription medications like Adderall face far greater risks of dangerous, even lethal, side effects. Heart rhythm problems and heart attacks are the most troubling potential consequences of Adderall abuse. Even those who take the medication according to a doctor’s prescription face the small but real threat of cardiac problems. As research into ADHD and stimulant medications continues, safer drugs and drugs less prone to abuse will most likely be introduced.

References:

  1. Centers for Disease Control and Prevention. (n.d.) Facts about ADHD. Retrieved from http://www.cdc.gov/ncbddd/adhd/facts.html
  2. PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Dextroamphetamine. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000310/
  3. Jiao, X., Velez, S., Ringstad, J., Eyma, V., Miller, D., Bleiberg, M. (2009). Myocardial infarction associated with Adderall XR and alcohol use in a young man. Journal of the American Board of Family Medicine, 22(2), 197-201.
  4. Sylvester, A.L., Agarwala, B. (2012). Acute myocardial infarction in a teenager due to Adderall XR. Pediatric Cardiology, 33(1), 155-157.

Amphetamine abuse and addiction is a serious and growing public health issue throughout the United States. Addiction inevitably leads to rising health costs, lost productivity, broken families, and progressively declining quality of life for drug users. Medical science has yet to formulate a satisfactory answer to this problem. Rehabilitating users is clearly one of the primary objectives, but there are numerous stumbling blocks along the way. Typical users deny the seriousness of their addiction unless and until dire consequences arise. Withdrawal effects from amphetamine are profound, and recovering addicts experience relapse at alarmingly high rates. The current best practices for addiction treatment include supportive individual therapy, group therapy, and profound lifestyle changes. In severe cases of withdrawal, anti-anxiety medications are often prescribed to ease feelings of fear and discomfort.

Ironically, amphetamines serve a therapeutic purpose in the treatment of both attention deficit hyperactivity disorder (ADHD) and narcolepsy. Dexedrine (dextroamphetamine), Adderall (dextroamphetamine and amphetamine), and Ritalin (methylphenidate) are the three primary stimulant drugs prescribed for these purposes. Recently, a nonstimulant medication, Strattera (atomoxetine) has received attention both as an alternative treatment for ADHD and as a possible therapy for recovering amphetamine addicts. Researchers in Connecticut discovered that Strattera, when taken over the course of several days, actually suppresses the effects of Dexedrine. Participants in a study group pretreated with Strattera reported fewer positive drug feelings when given a single dose of Dexedrine. Similarly, blood plasma levels showed fewer chemical markers of the heightened mood state typically associated with Dexedrine and other amphetamines.

The mechanics of amphetamine addiction are still something of a mystery. Researchers know that several chemicals in the brain are important to building and maintaining a state of dependence. Dopamine is one of these chemicals, and it plays a major role in the so-called “reward system.” Norepinephrine is thought to be responsible for the feelings of energy and euphoria experienced by users. Effective pharmaceutical interventions will need to disrupt some of the patterns that amphetamines establish within the brain. The most recent experiments have shown that norepinephrine is at least as important as dopamine in generating the stimulating physical and psychological effects of amphetamines. By altering the levels of norepinephrine with Strattera, the positive drug feelings of Dexedrine are greatly reduced.

References

  1. PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Atomoxetine. Retrieved April 18, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000222/
  2. PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Dextroamphetamine. Retrieved April 18, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000310/
  3. Sofuoglu, M., Hill, K., Kosten, T., Poling, J. (2009). Atomoxetine attenuates dextroamphetamine effects in humans. American Journal of Drug and Alcohol Abuse, 35(6), 412-416.
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