7 replies to this topic

[Beendazedandconfused]

I have been diagnosed with Adhd (at age 42) for the last month I have been taking 20mg of dex a day in two doses. I have read conflicting opinions on here about the long term safety of this drug. Some of the info is quite dated. Can anyone advise on long term risks?? Also possible ways of mitigating risks if they exist (eg magnesium) I like dex it seems to help me work , it doesn't make me high and nor do I want it too, the only downside I have noticed is increased irritability at night as it wears off and err trouble getting an erection.

Any advice would be appreciated , not to be rude but some posters obviously have a scientific background I don't , please assume I know nothing!!

[Tom_]

Yes, there are risks. Yes it isn't great for you. Should you stop it? No. The benefits of controlled ADHD far outweigh the risks of Dex. Methylphenidate (ritalin) is better but if you are stable of Dex I wouldn't swap until you have been on it for a few months.

Edited by Tom_, 10 December 2013 - 02:04 PM.

[Max Headroom Incident]

Amphetamines are some of the oldest drugs in psychiatry/medicine. The benefits and risks are well-known, unlike many newer drugs that we're all basically acting as guinea pigs for.

Downsides include increased heart rate and blood pressure, which is mainly bad if you're old or have a heart condition. Amphetamines are somewhat toxic to dopamine receptors. However, this is more of a problem if you're abusing it in large amounts, not sleeping/eating, etc. Normal medicinal doses aren't particularly dangerous in that regard. Plus, you always have the option to take "med vacations" (a few days off) if you feel side effects cropping up.

Used as directed, amphetamines are some of the least harmful drugs around. Doesn't mean they'll work for everyone or don't cause side effects in some.

[Construct]

Unfortunately the neurotoxicity of d-amphetamine in humans at standard doses is still an unknown. Given the long track record of amphetamine treatment in humans, we can at least infer that the neurotoxicity in humans, if it exists, is somewhat minimal. There are studies showing a correlation between amphetamine use and an increased risk of developing Parkinson's disease later in life, but again that's just a correlation at this point.

We do know that amphetamine damages dopaminergic neurons in rodents in many treatment scenarios. However, mice and rats are different than humans in several important aspects. For example, hyperthermia plays a large role in neurotoxicity in rodents, but it's not a factor in humans at clinical doses. Numerous other factors influence amphetamine toxicity in rodents, including modulation of their sleep/wake cycle, which also doesn't translate well into humans.

Studies in non-human primates have been mixed so far. The most damning study in primates unfortunately comes from Ricaurte, a researcher with a known anti-amphetamine agenda who was forced to retract an MDMA neurotoxicity paper when it was found that he had used methamphetamine instead of MDMA as he claimed.

Given what we know and what we don't know, it would be prudent to find the lowest effective dose that works for you and to stick with it. I personally don't feel the risks are well-proven enough to abandon treatment if you find it truly helpful in your life. You could consider giving Methylphenidate a trial, as it doesn't appear to have neurotoxicity to the same degree as amphetamine in animal models. Don't be tempted to dose as-needed, because acute amphetamine is more neurotoxic than chronic amphetamine in animal trials, perhaps due to downregulation of nAChRs associated with neurotoxicity, or perhaps due to other mechanisms we don't yet understand.

Preventative measures are likewise poorly understand, but there is evidence that Melatonin diminishes neurotoxicity, but obviously that wouldn't be helpful to dose concomitantly. CoQ10 is another reasonable supplement to include. As always, physical exercise every day is likely to be very helpful here and for your underlying condition as well.

[Sciencyst]

It can increase chances of Alzheimers greatly due to its neurotoxicity. It also dysregulates dopamine receptors and can cause long term anhedonia (inability to feel pleasure), and it desensitizes glucocorticoid receptors, and may precipitate psychosis. If you must take it, it would be very wise to co-supplement with an antioxidant, to try not to up the dosage, and to take days off when you don't need it. Further, try to take a month off maybe in the summer or when its unneeded.

I took Adderall 30mg XR for about 2 years, and I regret it. Tolerance builds extremely rapidly, and eventually you need it to just get out of bed (dependence). At this point it no longer motivates you but just makes you feel anxious, sweaty, anorexic and paranoid, also very zombie-like. In the short term, Adderall can exacerbate ADHD symptoms, but when tolerance builds, it has a strange effect where it blunts emotion and creativity, and all you can do or feel like doing is meaningless repetitive tasks. It can suck the personality right out of you.

Of course I must note that everybody reacts differently, and some people have very few problems with it.

Edited by katuskoti, 16 December 2013 - 09:49 AM.

[Beendazedandconfused]

Thank you for all the replies, very informative. I do take melatonin daily but not at the same time, is that good enough ?

[stponky]

Just another data point I came across randomly:

http://www.a-health-...sease-risk.html

"Exposure to amphetamines was determined by two questions: one on the use of drugs for weight loss and a second question on whether people often used Benzedrine or Dexedrine. Amphetamines were among the drugs commonly used for weight loss when this information was collected.
According to the study, those people who reported using Benzedrine or Dexedrine were nearly 60 percent more likely to develop Parkinson’s than those people who didn’t take the drugs. There was no increased risk found for those people who used drugs for weight loss."

[abolitionist]

Besides the body having to break down a refined chemical (which it is not designed to do)...

the increased dopaminergic activity will lead to more oxidative stress - as Dex blocks the reuptake of dopamine - the extra deaminated dopamine may not damage the dopamine neurons just cause more work for the anti-oxidant and other supportive systems

possibly damage other receptor systems

no data but I would think N-acetylcysteine would be helpful to replenish glutathione and normalize the glutamate activity effected by the stimulants ;

http://www.jneurosci...7/51/13968.full

http://www.drugabuse...seeking-in-rats

http://www.ncbi.nlm....les/PMC3044191/


as anyone who takes stimulants repetitively and consistently can tell you - they eventually lead to a flattened, overdriven, and monotonous inner tension as the euphoria wears off

can be helpful for doing boring tasks though and getting you moving and preventing sleep, but they won't make you feel euphoric for long

As David Pearce can attest to : selectively amplifying neurotransmitters is too crude an approach to achieve lasting happiness, brain circuitry is darwinian designed to adapt to euphoria and maintain the hedonic set point

deep brain stimulation of the pleasure centers and other areas concurrently can reliably produce happiness as long as the current is applied and the activity is supported biologically by the brain/body

ADD and ADHD are societal myths designed by a fascist darwinian social system

maybe it's helpful for you to use Dex given your situation and forced reality - maybe you can change your surroundings instead

we aren't designed to sit at desks and listen to boring speeches or stare at computer screens for long hours

people who have ADD and ADHD aren't deficient in dopamine, they have high sensitivity to competing stimuli, partly because their DNA is not being activated the way it was designed to be activated

for me, I take Dex occasionally to stay awake at night when forced to - but it's not something that makes me happy or healthy

society wants to make us into drones that feed the darwinian system - anything you get from a mainstream doctor is designed to keep you within operating parameters as determined by those with the most related power in society

as society is not designed to maximize longevity or happiness - I would be weary of conforming to its expectations.

Edited by abolitionist, 01 April 2014 - 02:29 AM.