Health - Adderall now includes an extra pamphlet of warnings

[GForce]

I never got one of these pamphlets with my perscription to Adderall in the past, but I do remember hearing recently that the whole Adderall/cardiovascular argument is making a comeback because of some abnormal EKGs that patients had. I have no idea if they were statistically significant, but my guess is that it was a few isolated cases like the children in Canada who died from taking Adderall XR and led to its temporary suspension from the Canadian market. Personally my psychiatrist hasn't found any changes to my cardiovascular system over the course of two years, and this is the same for family members on the medication as well as friends. Still, if your doctor isn't performing regular EKGs, or at least checking your blood pressure and such in comparison to before starting treatment, you should at least get yourself checked out. Never hurts to be too safe when it comes to normal stimulant use, especially if you're on a high dose.

Anyways, I thought I'd attach this new warning sheet I received with my prescription because I haven't seen an additional set of drug facts stapled to any of my prescriptions (for any medication) ever.

Anyone else been receiving these pamphlets?

Reputation Comments on this post:

great info/re: ekg's for adderall/signed, "beachead"

[staples]

My doctor usually gives me the prescribing information (these sheets) when starting a new medication, and my pharmacy always attaches them when filling a prescription...

Weird, though, my doctor just asked me to get an EKG when I saw her last week, I wonder if it's related...

[GForce]

Well every prescription I've ever filled has come with that large sheet of drug facts that they pull the label for the bottle off of. And if I ask for specific documentation my doctor will give me that as well. What I was surprised about was that in addition to CVS' normal blue and white informational sheet that comes with every prescription I received an additional pamphlet stapled to all the standard documents. (what I scanned) I don't know if this is a new law they have to follow, just a CVS policy, or a one-time thing they added because they just finished a distribution bottle and had it lying around or something.

[Laudaphun]

SWIM isn't trying to knock adderall, in fact her marmoset had always liked it when younger and used for different purposes than now. But, after switching prescriptions from methylphenidate to d,l-amphetamine, she has come to believe that there may be some merit to the heart problems rumored to be vaguely correlated with the 4-salt mixture. SWIM believes if this is true, it is likely due to the formulation moreso than the drugs themselves.

SWIM's marmoset has been prescribed methylphenidate up to 40mg/daily for 8 months or so. Just about 2 weeks ago the marmoset complained about the methylphenidate being too short-acting (truth be known, it was just that the marmoset had far too much work for a given time period, and was pushing the limits of her body to try and get work done.) So, the marmoset was offered 30mg/racemic amphetamine salts (the pink 30mg pills that can be broken into 4 pieces). After about 2 weeks, SWIM's marmoset decided that while the onset and decline in effects of the amphetamines were more gradual, it felt much more harsh to her body. SWIM never thought she'd hear her marmoset say that she would rather have methylphenidate than amphetamine, but the rest of the bottle of amphetamines is now on the shelf and and has returned to methylphenidate (thankfully, the marmoset uses less than prescribed and still had a factory sealed bottle of 100 10mg methylphenidate tablets left. This was after the marmoset took the amphetamines for 2 weeks, with 2 more weeks remaining until she can return to the psychiatrist to report the effects.

The funny thing is that, the marmoset discontinued the use of the amphetamine after 2 weeks, and returned to methylphenidate and that night her left middle finger began to tingle slightly for several hours, which was somewhat troubling as any SWIM's marmoset had always attributed any tingling or numbness in the left arm as a possible signal that the heart was unhappy. The marmoset has since returned to the use of methylphenidate and feels 100% better. SWIM definitely thinks that in the case of her marmoset, methylphenidate is not only more effective, but less detrimental to her body. While exact prescribing instructions are not always followed (and they are vague anyways... 10mg up to 4 times daily or a total of 40mg/day... however the marmoset finds it most helpful), the medicines are used for therapeutically, and not for recreation. SWIM's marmoset also repeatedly got a tight feeling in her chest while using the amphetamines, which never happened while using the methylphenidate. SWIM is beginning to think that the 4 salt combo is not so healthy. Perhaps d-amphetamine is safe while l-amphetamine is more responsible for heart problems? Just a thought. SWIM can't comment on that personally though as she has never taken pure d-amphetamine, only the d,l-AMP mix. SWIM may ask for a few days worth of dexedrine just for comparison. But, unless it is far different from the d,l mixture SWIM won't let her marmoset have anymore d,l-AMP.

But, SWIM always had a bad feeling that a racemic mixture of d,l amphetamine with 2 salts of each dextro and levo compound seemed like a crude formulation. SWIM would like to do some reading on the differences, as she has heard much praise of the isolated d-amphetamine (dexedrine).

[GForce]

I'm also intending to do some research on d-amphetamine only. I find with Adderall, especially lately, I am increasingly having a difficult time going to sleep regardless of what time I take Adderall during the day. I hear that taking just d-amphetamine is very similar to Adderall, the difference being that Adderall lasts a bit longer due to its racemic mixtures. If I could get the benefits of Adderall without too much stimulation it might be worth looking into.

[Dexyfiend]

If SWIGF went from aderall to dexamph he notice that the stimulation from the d isomer is far greater... SWIM wagers that it's the d amph in the mixed salts is whats keeping you up.

SWIM's never had aderall before (he was prescribed dex but we dont get mixed salts in oz) though he gets this base all the time and he swears that it's racemic (he may be wrong) but it seems racemic offers a good/smooth high with a smooth crash while d offers a really intense buzzy/tweaky sorta high which rocks but with a really harsh crash.

[ShawnD]

Originally Posted by GForce

I'm also intending to do some research on d-amphetamine only. I find with Adderall, especially lately, I am increasingly having a difficult time going to sleep regardless of what time I take Adderall during the day. I hear that taking just d-amphetamine is very similar to Adderall, the difference being that Adderall lasts a bit longer due to its racemic mixtures. If I could get the benefits of Adderall without too much stimulation it might be worth looking into.

Are you swallowing them whole? If it takes a full day for the time-release pill to break down, then the drug never really leaves your system.
One could try taking the pill first thing in the morning, and chewing the hell out of it. It will cause a sharp up and down, sort of like coffee, but at least you can sleep at night.

That's not advice, I'm not a doctor, I'm not responsible. Good luck.

[GForce]

The "smooth" crash is what is the problem though. By smoothing out the crash, it is effectively lengthening it so that blood plasma concentration levels drop more slowly. To me, it seems that this could be lengthening the duration I feel from taking a racemic mixture of ampehtamine salts rather than just a single salt. I barely crash from Adderall anymore, I just kind of stop feeling its positive effects. I think I'd rather almost have a harsh, quick crash so that I can be done with it. I haven't really looked into it much, but that is where my logic comes from.

[ctb4444]

swims never seen an extra pamplet on adderall, but swim gets an extra sheet w/ swims 40mg-citaloprm, and 1mg-clonazepam. and also swim gets swim's precription from walmart(dont know if there's a difference) and now for the clonazepam, swim has to signature electronicly.(that where swims sign a palmpilot like thing with a stylus. swim gueses maybe people were using false ID to get other people precription.

-------Yo GForce, do u have to sign for adderall, because clonazepam and adderall are both scheduled substances.

-stay up

[staples]

Originally Posted by ctb4444

swims never seen an extra pamplet on adderall, but swim gets an extra sheet w/ swims 40mg-citaloprm, and 1mg-clonazepam. and also swim gets swim's precription from walmart(dont know if there's a difference) and now for the clonazepam, swim has to signature electronicly.(that where swims sign a palmpilot like thing with a stylus. swim gueses maybe people were using false ID to get other people precription.

-------Yo GForce, do u have to sign for adderall, because clonazepam and adderall are both scheduled substances.

-stay up

I don't think it has to do with people scamming the pharmacy.. I have to sign something (not electronically, but I have been to a pharmacy where the process was electronic) that says that I didn't have any questions about my medications, or that the pharmacist answered the ones I did have.

[Laudaphun]

One other thing swim's marmoset has found with the racemic amphetamine salt combo (adderall) is that she often finds herself nodding off, which doesn't make any sense at all. The marmoset never nods off after using the methylphenidate. Perhaps, a bit of drowsiness that lasts for an hour when the methylphenidate has worn off for the day, however the racemic amphetamine causes the marmoset to become very sleepy during the first part of the day and the actual therapeutic benefits usually decide to show themselves around halfway through the day... usually after 2nd dose of the day.... (script is for 15mg b.i.d.) The psychiatrist looked at swim's marmoset like she was nuts when she reported that the adderall had caused drowsiness during the first part of the day... Every one of the SSRI's also caused the same effect in the marmoset in that they caused extreme drowsiness but to a much worse degree, and they also caused a measure of depression or perhaps apathy is a better term. Not sure if this is related or not, but in a few weeks SWIM intends to do some research as to whether or not these effects could be related to a similar mechanism of action, which is absent in methylphenidate.

The marmoset is back on 40mg/day methylphenidate for the time being. SWIM would really like to see how d-amphetamine or even d-MPH compare the racemic AMP and MPH, but always loses the nerve to bring such things up when at the dr. office.

[Donmeka]

that just looks like the usual information/warning pamphlet.