Mixed amphetamine salts: Difference between revisions
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| interactions = Minimal in practice. Caution with other psychostimulants, including caffeine. metabolized by 2D6, so relevant caution applies. | | interactions = Minimal in practice. Caution with other psychostimulants, including caffeine. metabolized by 2D6, so relevant caution applies. | ||
| pregnancy_details = [https://www.ncbi.nlm.nih.gov/books/NBK501307/ Category C]. Crosses the placenta. Prenatal amphetamine exposure has been associated with low birth weight, premature delivery, and neonatal withdrawal (agitation, dysphoria, lassitude). Long-term neurodevelopmental outcomes from prescribed therapeutic exposure are less clear and likely modest, but illicit-dose exposure is associated with significant developmental impact. Decision should be individualized; many patients defer ADHD treatment during pregnancy. Excreted in breast milk in clinically significant amounts — breastfeeding generally discouraged. | | pregnancy_details = [https://www.ncbi.nlm.nih.gov/books/NBK501307/ Category C]. Crosses the placenta. Prenatal amphetamine exposure has been associated with low birth weight, premature delivery, and neonatal withdrawal (agitation, dysphoria, lassitude). Long-term neurodevelopmental outcomes from prescribed therapeutic exposure are less clear and likely modest, but illicit-dose exposure is associated with significant developmental impact. Decision should be individualized; many patients defer ADHD treatment during pregnancy. Excreted in breast milk in clinically significant amounts — breastfeeding generally discouraged. | ||
| monitoring = * Baseline: cardiovascular history | | monitoring = * Baseline: cardiovascular history, weight/height, mental health history (especially for psychosis/bipolar/substance use risk), (optional) blood pressure, (optional) heart rate, | ||
* At each visit: efficacy, side effects, general well-being | |||
* At each visit: | * Periodically reassess continued need; consider drug holidays to assess ongoing benefit | ||
* Periodically reassess continued need; consider drug holidays | |||
* Sleep quality (insomnia is dose-limiting) | * Sleep quality (insomnia is dose-limiting) | ||
| counseling = * Take in the morning to minimize insomnia; avoid afternoon dosing. | | counseling = * Take first thing in the morning to minimize insomnia; avoid (late) afternoon dosing. | ||
* '''Do not crush, chew, or split Adderall XR or Mydayis capsules''' — disrupts the controlled-release mechanism. (Capsules may be opened and sprinkled on applesauce if needed.) | * '''Do not crush, chew, or split Adderall XR or Mydayis capsules''' — disrupts the controlled-release mechanism. (Capsules may be opened and sprinkled on applesauce if needed.) | ||
* Take with or without food; high-acid beverages (orange juice, vitamin C) may reduce absorption. | * Take with or without food; high-acid beverages (orange juice, vitamin C) may reduce absorption. | ||
* Stay well-hydrated, especially in heat or during exercise. | * Stay well-hydrated, especially in heat or during exercise. | ||
* Eat regular meals despite appetite suppression. | * Eat regular meals despite appetite suppression. | ||
* Report any chest pain, palpitations, severe agitation, hallucinations, or signs of poor circulation in extremities. | |||
* Sudden discontinuation can cause a fatigue/depression "crash" — plan for it. | |||
* Report chest pain, palpitations, severe agitation, hallucinations, or signs of poor circulation in extremities. | * Take caution: make increase bowel motility and increase risk of expelled fecal content. | ||
* Sudden discontinuation can cause a fatigue/depression "crash" — | |||
| anecdotes = | | anecdotes = | ||
| seealso = [[Dextroamphetamine]], [[Lisdexamfetamine]], [[Methylphenidate]], [[Dexmethylphenidate]], [[Modafinil]], [[Atomoxetine]], [[Methamphetamine]] | | seealso = [[Dextroamphetamine]], [[Lisdexamfetamine]], [[Methylphenidate]], [[Dexmethylphenidate]], [[Modafinil]], [[Atomoxetine]], [[Methamphetamine]] | ||
| references = | | references = | ||
}} | }} | ||