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Attention Deficit Hyperactivity Disorder

Paradoxical Side Affects with Adderall XR

09/19/2011

Question:

 I am 72 years old – 6’2”, 200lbs (been gaining weight again since not taking Adderall, blood pressure has increased, word loss has returned, concentration is diminished, edema is returning, sleep has returned to poor (very little delta level) tired in the morning, my IQ is 155. My major was research Chemistry and math; I was very thorough in my testing. I also have an extremely non-addictive physiology.

ADDERALL XR is a once daily extended-release, single-entity amphetamine product. In young adults and children the following and additional negative side effects can be exhibited • fast, pounding, or uneven heartbeats; • feeling light-headed, fainting; • Increased blood pressure (severe headache, blurred vision, trouble concentrating,... However, I have discovered that in my case and perhaps many other older adults the above side effects may seldom be displayed and additionally the opposite may be found to be the case. • Blood pressure that under medication could only be brought down to 135/85 to leveled off at 110/70 with a reduction of my pressure medication. • Lower leg edema reduced by 70-90% • Libido was increased and erection firmness increased • Normal and extra normal loss of words during speech was virtually eliminated and the “last in first out” rule is reduced by over 70% • Concentration and retention of reading materials and class studies greatly increased. • Difficulty sleeping through the night without waking up multiple times; I found that I went to sleep easier, slept through the night and would wake up rested and refreshed. • I also exhibit narcoleptic sleep symptoms in that I may drop off for a few seconds and not realize it until I wake up. I found that this no longer happened. Note: this may not completely disappear in patients that exhibit additional Narcoleptic symptoms such as strange dreams and the like. However, I do not have those symptoms. • Tinnitus noise also was reduced by about 40% after approx one month on the medication. • I was very careful about my dosage (40mg/day) so that it was not excessive. (No excessive talking, no feeling as if I had to clean and wash all the walls in the house, etc). With that dosage level I experienced a gradual weight loss that leveled off very close to my normal body weight. (195lbs) I was taking the Generic manufactured Barr which is extended release and after two years didn’t have any (ANY) negative side effects. With Barr’s Generic a small percentage of adults aren’t able to minimize lower leg edema to the same extent that Adderall XR does.. If the patient is experiencing lower leg edema after taking the Barr Generic you may wish to switch them to Shire’s original Adderall XR and monitor the results. It is not clear to the medical community why Adderall produces all the above paradoxical positive effects in me (and probably in many elderly adults), when similar dosages of 100% Dextroamphetamine Sulfate will not and in fact, in most cases produces higher blood pressure. Many patients also exhibit mild to severe gastritis, which in my experience seems to be non-existent with Adderall. I do have a working theory as to why this medication works so extremely well. As the brain begins to wake up (again) and exhibits a euphoric feeling of being “functional” (that Adderall supplies), that state actually causes the brain to become aware of bodily and endocrinal imbalances that it ignored while in its “sleepy” state. It is that awareness and the higher level of functionality (of the brain) that helps to correct the above mentioned problems. I believe that we will find in years to come that jump starting the brain (so to speak) in our older generation will allow the brain and its not yet understood control of the body to correct many of the ailments we now try to correct using other drugs. I become a completely functional human being with Adderall and without it I am sleepy, lose words in conversations, constantly forget things, difficult in concentrating, etc

Have studies been done to see if other elderly adults have the same benefical reactions. Please, Please contact me very important.

Answer:

The simple answer to this long question is that I do not know of studies focused on those issues in seniors. Some drug companies have shown more interest in the adult ADHD market in recent years, and some of the studies have samples of the full adult age range, but I don't know of studies focused on these particular issues.

Many of the phenomena noted are not unexpected. Appetite reduction, improved alertness, improved working memory, and improved coordination are known effects of stimulants at any age. Also, increased sexual function has been reported by stimulant users. As an inotropic agent, amphetamine might as well reduce dependent edema of congestive heart failure, but at some risk.
 
The reduction of blood pressure is harder to explain, but individual cardiovascular responses are variable. It would be reasonable to discuss these things with your cardiologist.

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Response by:

L Eugene Arnold, MD, MEd L Eugene Arnold, MD, MEd
Professor Emeritus of Psychiatry
College of Medicine
The Ohio State University