Swim's attack + ambulance!

[new_student]

40mg of adderall xr gave swim an attack of some kind. i will explaine in more detail, but first let me say that swim has taken more than this before and been fine.
to be honest, a week previously swim took ritalin and adderall in the same night (probably with ephedrine still in the system). He did not take any more for a week becuase he was paranoid he kept feeling his heart flutter, and an ache in his left arm.
Anyway, yesturday at 4am swim took 40mg of adderall XR. at 6am everything went wrong. a sudden pain/ feeling of heat over the heart, tight chest, hard to breath, fast pulse, hot/tingly left arm, major anxiety and irrational fear of death. All of ths lasted about 10-15 minutes only (though it seemed far longer). Anyway an ambulance was called and by the time paramedic arrived, swim was fine....just speeding.
Blood pressure was fine, blood sugar was fine, heart readings were fine, etc.
but this was a fucking bad expierience, and there is heart disease in swims family. does this mean swim shouldnt really take adderall again? becuase swim just found it and does not want to give up! it makes everything clear and easy. I have terrible ADHD, though its hard to get diagnosed in the UK.

has anyone else had an expierience like this?
thanks...

[hh339]

Sounds like a serious panic attack. May be related to the amphetamine, but to my knowledge this is quite uncommon in low amounts...

I have a hard time believing that amphetamine alone in that dose would result in a true physical disorder, when there's no previous history of bad reactions. SWiM had a similar response to methylphenidate a while back. Probably the same thing, probably.

[new_student]

well thats what i am hoping happened. swim's never expierienced a real panic attack before now so wouldn't know. I guess it is likly as swim was genuinly afraid of imminent death! and the paramedic told swim that everything was absolutly fine.

yes i think its ok for swim to stick with adderall for now. still swim cannot help but feel that his heart is under strain.

[fnord]

the best thing to do would be to have your heart checked for problems by your doctor.admit you use stimulants and you want to do so in the safest possible manner so have him check for irregular rythems murmurs etc etc

[eltimmy]

Yes, it sounds like a panic attack, though it could certainly be indicative of a more directly dangerous problem. Cardiovascular symptoms can often lead to panic attacks; which leads to increased cardiovascular symptoms, etc. I'd recommend taking lower doses in the future and getting some tests done if the worry stays with SWIY. I will say if SWIY is young and not constantly taking stimulants, and lack other risk factors, serious heart problems are quite rare.

EDIT: Oh, I just noticed that SWIY has a risk factor, a family history of heart disease. Therefore I must advise that recreational doses of stimulants are avoided entirely, and for therapeutic use the tests and scans Fnord mentions should be undergone.

[littlemago]

Originally Posted by eltimmy

Yes, it sounds like a panic attack, though it could certainly be indicative of a more directly dangerous problem. Cardiovascular symptoms can often lead to panic attacks; which leads to increased cardiovascular symptoms, etc. I'd recommend taking lower doses in the future and getting some tests done if the worry stays with SWIY. I will say if SWIY is young and not constantly taking stimulants, and lack other risk factors, serious heart problems are quite rare.

EDIT: Oh, I just noticed that SWIY has a risk factor, a family history of heart disease. Therefore I must advise that recreational doses of stimulants are avoided entirely, and for therapeutic use the tests and scans Fnord mentions should be undergone.

so what exactly is a recreational dose? what i mean is i've heard of people being prescribed more than 40mg XR doses...and thats all the OP took.

[eltimmy]

>
so what exactly is a recreational dose? what i mean is i've heard of people being prescribed more than 40mg XR doses...and thats all the OP took.

Individual tolerances to stimulants vary widely even prior to use. The distinction I make between recreational and therapeutic use in my posts is important because different effects of amphetamine develop tolerance at different rates. Typically sought-after "recreational" effects such as euphoria are related to dopamine release in the nucleus accumbens; to which you develop a tolerance extremely quickly. Chasing these feelings by increasing doses will eventually have the user shouldering more of the cardiovascular side effects, and also will build tolerance to "therapeutic" effects: attention, focus, motivation, cognition, etc.

On the other hand, there's a great deal of evidence that at lower doses these therapeutic effects undergo reverse tolerance: ie eventually you can take less of the drug to produce the same effect. Or, rather, side effects like cardiovascular issues will go down while the desired therapeutic effects remain. A great many people stay on the same dose of stimulants for many years, and this is thought to be the mechanism. As in all things, individual response will vary.

More to the point, since individual tolerance varies so widely, and in some people toxic reactions to amphetamine have been reported to as low as 5 milligrams orally, 40mg XR can easily be recreational or even toxic to some users; but for other users it is a daily therapeutic dose with mild side effects that works for them excellently. If a friend of the OP is experiencing noticeable cardiovascular side effects and anxiety from a certain dose, it's a good sign that that dose should be lower in the future.

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Do you smoke and/or heavily?

[soma]

SWIM developed similar attacks after a "bad trip" off of a drug called cannabis. Yes. Cannabis. He has tried many hallucinagens, uppers, downers, side-ways-ers, alcohol, nicotine, etc. Yet it was mild Cannabis that gives him panic attacks. It can happen from anything that alters one's state of consiousness.

[misterboh]

SWIM experienced the same thing with cannabis. Went from being an everyday user for 15+ years to having a serious panic attack every time he smoked it. Weird, huh?