Dexedrine Dexedrine Side Effects DEXEDRINE® [dex'eh-dreen] (brand of dextroamphetamine sulfate) WARNING
Clinical experience suggests that in psychotic children, administration of amphetamines may exacerbate symptoms of behavior disturbance and thought disorder. Amphetamines have been reported to exacerbate motor and phonic tics and Tourette's Syndrome. Therefore, clinical evalutaion for tics and Tourette's syndrome in children and their families should precede use of stimulant medications. Data are inadequate to determine whether chronic administration of amphetamines may be associated with growth inhibition; therefore, growth should be monitored during treatment. Drug treatment is not indicated in all cases of Attention Deficit Disorder with Hyperactivity and should be considered only in light of the complete history and evaluation of the child. The decision to prescribe amphetamines should depend on the physician's assessment of the chronicity and severity of the child's symptoms and their appropriateness for his/her age. Prescription should not depend solely on the presence of one or more of the behavioral characteristics. When these symptoms are associated with acute stress reactions, treatment with amphetamines is usually not indicated. ADVERSE REACTIONS Cardiovascular: Palpitations, tachycardia, elevation of blood pressure. Central Nervous System: Psychotic episodes at recommended doses (rare), overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia, dysphoria, tremor, headache, exacerbation of motor and phonic tics and Tourette's syndrome. Gastrointestinal: Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances. Anorexia or weight loss may occur as undesirable effects when amphetamines are used for other than the anorectic effect. Allergic: Urticaria. Endocrine: Impotence, changes in libido. DRUG ABUSE AND DEPENDENCE Dextroamphetamine sulfate (DEXEDRINE) is a Schedule II controlled substance. Amphetamines have been extensively abused. Tolerance, extreme psychological dependence, and severe social disability have occurred." |
an excerpt from The Essential Guide to Psychiatric Drugs STIMULANT ANTIDEPRESSANT DRUGS The reason for these restrictions is that the stimulant drugs are addictive. They include amphetamines, sometimes called "speed" or "uppers," methylphenidate (Ritalin), and pemoline (Cylert). The drugs produce a short-term mood elevation even in people who are not depressed. College students take them to stay awake ail night and finish term papers. In most people the effects of these stimulant drugs are short-lived and there is often a letdown or "crash" after they wear off. During this "crash" the patient can feel very depressed, sleepy, and sluggish. Furthermore, and very much unlike the other drugs discussed so far in this chapter, stimulant drugs have the potential to induce "tolerance." People who abuse amphetamines and other stimulants--usually in attempts to lose weight or stay awake for prolonged periods--often find that a dose that had worked for a while is suddenly ineffective and they need a higher dose. They then become "tolerant" to the higher dose and have to increase the dose again. Soon, the person is addicted to the drug. Stopping it suddenly leads to a severe withdrawal reaction characterized by bad depression and extreme fatigue. Suicides have been reported in people who suddenly stop taking amphetamines. Given all these problems, why even mention the stimulant
drugs? Simply because they are the only drugs that work for some depressed
patients. A very small group of usually chronically depressed patients
seems to be resistant to every other treatment for depression. These people
usually function at a fairly low level relative to their ability and they
feel sad and blue all of the time. They complain of fatigue, low interest
in life, and inability to concentrate. Many say they have been depressed
since childhood. For these two groups of patients stimulant drugs may be the only answer, even though the patient will probably become addicted. This is not to be taken lightly. The decision to place a patient on a stimulant drug for depression is serious and must be done only after all other efforts are declared either unsafe or ineffective. The patient must understand that he will probably become addicted to the medication and that he should never stop taking it abruptly. AMPHETAMINES Used for: Officially, for three conditions: (1) narcolepsy, a condition in which the patient falls asleep suddenly during the day; (2) obesity, and (3) hyperactivity in children. Unofficially, it is sometimes used for chronic depression that fails to respond to all other treatments and for very ill medical patients with depression. Do Not Use if: You haven't tried other antidepressants and psychotherapy, you have high blood pressure, you are very nervous or have severe insomnia, you have a history of addiction to drugs or alcohol, or you have Tourette's syndrome. Tests to Take First: You should probably have an electrocardiogram to be sure nothing is wrong with your heart and your blood pressure should be recorded. Tests to Take While You Are on It: Blood pressure and pulse should be taken every day for the first week, then once a week for a month, and then at least every month. Usual Dose: Usually starts with 5 or 10 mg per day and can be raised, sometimes to 50 mg or higher. The higher the dose the worse will be the addiction. Amphetamines should not be taken at bedtime. How Long Until It Works: Usually almost immediately, sometimes an hour after the first dose. The effect also wears off quickly, lasting only a few hours. Therefore the drug is usually taken in divided doses two or three times daily. After it has worked for a while the effect may wear off and the patient may require a higher dose. This is called tolerance. At this point a decision must be made either to keep raising the dose or to stop the drug because it is not working adequately. Common Side Effects: (1) Nervousness. (2) Insomnia.
(3) Loss of appetite. (4) Addiction. What to Do About Side Effects: The last dose of the drug every day should be taken several hours before bedtime to prevent insomnia. Nervousness usually goes away and appetite returns so that weight loss is rarely dangerous. Nothing can be done about the addiction except to remember not to stop taking amphetamines abruptly. If high blood pressure, rapid pulse, paranoia, or tolerance becomes a problem, the drug is usually stopped. If It Doesn't Work: The drug should be slowly tapered. Fortunately, the withdrawal symptoms are psychological and not medical. If It Does Work: Some people decide to stay on the drug indefinitely. A very sick medical patient may legitimately stay on it for the rest of her life. Cost: Brand, 15 cents/5-mg pill. Generic, 3 cents/5-mg pill. Special Comments: Amphetamines are given only in special situations by very experienced psychiatrists. They are medically safe but usually produce addiction. There is also a good chance they will provide only temporary help. |
an excerpt from The People's Pharmacy Some health professionals fear that these medications may end up being over prescribed. Dr. Carl Kline, an expert in the field of learning disabilities from the University of British Columbia, has this to say,
Do these drugs make a difference in the long-term outcome of the minimal brain dysfunction?
Parents might want to consider another approach. |
|
|
Until
recently, the most important question concerning Ritalin or Amphetamine
administration has not been asked. Do these drugs make a difference in
the long-term outcome of the minimal brain dysfunction? A comprehensive
examination of this subject carried out at the Montreal Children's Hospital
discovered a startling fact. At the end of five years, hyperkinetic children
who received drugs (either Ritalin or Chloropromazine) did not differ
significantly from children who had not received. Although it appeared
that hyperactive kids treated with Ritalin were initially more manageable,
the degree of improvement and emotional adjustment was essentially identical
at the end of five years to that seen in a group of kids who had received
no medication at all.