How can adderall be prescribed

Her cardiac enzymes were elevated, but the electrocardiogram was unremarkable. Her symptoms resolved in 24 h. Drug-induced-Takotsubo cardiomyopathy has been previously reported and is mainly attributed to sympathetic overstimulation Amariles In this case, the patient overdosed on Adderall, which is a sympathomimetic drug.

The mechanisms for AMP-induced cardiac injury are postulated to be similar to those seen with cocaine, which include coronary spasm, prothrombotic state, accelerated atherosclerosis due to endothelial injury, and direct myocardial Chen Inappropriate dosing or taking with alcohol increases the risk of serious cardiovascular side effects like myocardial infarction, even without underlying cardiovascular risk factors.

Unfortunately, there are few long-term studies i. A recent study Vitiello et al. The MTA study found that stimulant medication does not appear to increase the risk for abnormal elevations in blood pressure or heart rate over a year period; however, the effect of stimulants on heart rate can be detected even after years of use Vitiello et al.

The effect on heart rate may be clinically significant for individuals who have underlying heart conditions. A cohort study sought to determine whether use of MPH in adults is associated with elevated rates of serious cardiovascular events compared with rates in nonusers Schelleman et al. All new MPH users with at least days of prior enrollment were identified.

Initiation of MPH was associated with a 1. A recent study by Habel and colleagues Habel et al. Although the student enrolled adults, the same group also has reported a similar lack of significant association between serious cardiovascular events and use of ADHD medications in children and younger adults Cooper et al.

These findings support the final decision of the US Food and Drug Administration committee to not to place a black box warning for all children and adults, but to pursue further research. However, the study by Habel et al. The databases were not used to examine other cardiovascular adverse effects, such as palpitations and dyspnea, which, although less severe, are nonetheless alarming to patients.

Additional potential ADRs associated with stimulant use are important to note including abdominal pain, anorexia, constipation, dizziness, dry mouth, headache, insomnia, jitteriness, irritability, nausea, and palpitations Greydanus and Strasburger College students with ADHD who misuse prescribed stimulants also reported hyperactivity symptoms as a common adverse event.

Of particular significance to athletes, many stimulants utilized in treating ADHD may increase core temperature Piper et al. Thus, in situations of increased exogenous heat stress, stimulants should be used with caution. Although prescription stimulants have been shown to be relatively safe and effective in managing the symptoms of ADHD, there exists a significant potential for misuse.

The data are clear that individuals with and without ADHD, including athletes misuse stimulants to enhance performance. Although stimulants may improve an individual's performance when given a rote-learning task, they do not offer as much help to people with greater intellectual abilities. Stimulants do not increase IQ Advokat et al. In fact, very little is known about the effects of nonprescription stimulants on cognitive enhancement outside of the student population, although it is frequently reported in newspaper articles.

This requires education on the proper use of stimulants and on the signs and symptoms of misuse and the health risks associated with misuse. It is important that students with prescription stimulants understand that they are the main source of diversion to other students, and should receive education in the prevention of stimulant diversion.

Health centers should aim to recognize students who are misusing stimulants because they may present with a variety of signs including insisting on a larger dose, and demanding more drug during times within the academic year, such as during finals.

Students with past or active drug abuse patterns should not be prescribed stimulants, as they are more likely to divert their prescription stimulants.

As a result, education on the proper use of stimulants and on the signs and symptoms of misuse is an imperative. Authors contributions : All authors participated in the preparation of the manuscript, and read and approved the final manuscript. National Center for Biotechnology Information , U. Journal List Brain Behav v. Brain Behav. Published online Jul Shaheen E Lakhan and Annette Kirchgessner. Author information Article notes Copyright and License information Disclaimer.

Shaheen E. Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2. This article has been cited by other articles in PMC. Abstract Prescription stimulants are often used to treat attention deficit hyperactivity disorder ADHD. Keywords: Amphetamine, athletes, attention deficit hyperactivity disorder, cognition, methylphenidate, misuse, performance, students. Prevalence of prescription stimulant misuse The misuse of a stimulant medication — taking a stimulant not prescribed by a physician or in a manner not in accordance with physician guidance — has been growing over the past two decades.

Why are prescription stimulants misused? Effects of prescription stimulants on cognition in ADHD Neuropsychological studies of ADHD children and adults indicate impairments in many cognitive areas including selective attention, memory, reaction time, information processing speed, and executive control function such as set-shifting, and working memory.

Effects of stimulants on cognition in individuals without ADHD Recognition that ADHD persists into adulthood has substantially increased the prescription stimulant treatment of adults with the disorder see above.

Table 1 Overview of effects of prescription stimulants on cognitive performance in adults without ADHD. Open in a separate window. Prescription stimulant misuse in athletes ADHD is a controversial problem in sport as participants with this disorder often require banned stimulants while competing. Potential adverse affects of chronic stimulant use ADHD is now recognized as a chronic disorder that continues into adulthood; therefore, some individuals take stimulants such as MPH and d-AMP for years.

Conclusion Although prescription stimulants have been shown to be relatively safe and effective in managing the symptoms of ADHD, there exists a significant potential for misuse.

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The greatest risks and side effects occur when the medication is not used as intended or the user takes more than the prescribed dose, Dr. Stimulants can raise your heart rate and increase anxiety, so a person with high blood pressure, seizures, heart disease, glaucoma, liver or kidney disease, or an anxiety disorder should tell their doctor about them before taking any stimulant.

Non-stimulants like Strattera can take 4 to 8 weeks to reach maximum effectiveness at the proper dose. Chatigny is board-certified in child, adolescent and adult psychiatry, a fellow of the American Psychiatric Association, and is the medical director of behavioral health with Lee Physician Group. Her treatment interests include emergency psychiatry, treatment resistant depression, complex psychopharmacology, and substance use disorders.

Editor's Note: This blog was updated Feb. What is Adderall? A Doctor Can Help Adderall is not available without a prescription. Your doctor will most likely start you off with a low dose to make sure you can tolerate it. Then, the dose can be slowly increased. Before taking Adderall, tell your doctor about any preexisting physical or mental health problems you have and list all other prescription and over-the-counter medications you take.

Adderall is a federally controlled substance that should never be taken without medical supervision. You may be more awake during the day, as well as become more focused and calm. In adults, Adderall may cause changes relating to your sex drive or sexual performance. Serious side effects include fever and weakness , or numbness of the limbs.

An allergic reaction to Adderall may cause swelling of the tongue , throat, or face. This is a medical emergency and should be treated immediately. Abusing or overusing Adderall and then stopping suddenly can cause symptoms of withdrawal, such as:.

Instead, you may have to wait out the symptoms, which can last anywhere from a few days to a few weeks. Maintaining a regular routine can help with the withdrawal. Stimulants can make your blood vessels constrict, raise your blood pressure, and make your heart beat faster. In some cases, Adderall can cause further interference with your blood circulation. Your toes and fingers may become numb, or start to hurt. They may even turn blue or red.

Serious side effects of Adderall include heart attack and stroke. Contact your doctor immediately if you experience chest pain , shortness of breath , difficulty breathing, or fainting.

Adderall can lead to sudden death in people with preexisting heart conditions. Taking Adderall alongside alcohol increases your chances of having heart problems.