Adderall
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied Health
• Large doses of caffeine should be limited or avoided with this medication.1
• Magnesium Dextroamphetamine can increase blood levels of magnesium, which causes significant lowering of the calcium to magnesium ratio in the blood. The change in this ratio may in part explain the effectiveness of stimulants like dextroamphetamine in hyperactive boys.1 Another magnesium-amphetamine interaction involves supplements of magnesium hydroxide, which are known to cause retention of amphetamines in the body.2 This could theoretically result in increased blood levels of these drugs. Finally, animal studies have suggested that magnesium supplements can increase learning and enhance the behavioral response to stimulants.3 For these reasons, the use of magnesium along with amphetamines may enhance the effectiveness of these drugs in the treatment of ADD, but controlled studies of this possibility are needed.2
• Vitamin C Ingestion of some types of vitamin C results in acidification of the intestinal contents and thus a decreased absorption of amphetamines.4 Supplements containing vitamin C should be taken an hour before or two hours after taking amphetamines.3
• Tyrosine is an amino acid used by the body to produce brain chemicals stimulated by amphetamines. Reduced stimulant effects of amphetamines were observed in individuals who had been made tyrosine deficient.5 It is possible that a dietary deficiency of tyrosine may reduce the effectiveness of amphetamines. Tyrosine deficiency is not common unless a protein deficiency exists. Adequate tyrosine intake from dietary protein or supplements is necessary in individuals taking amphetamines.4
• Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as bipolar disorder (manic depression). Taking lithium at the same time as amphetamines may inhibit the appetite suppressant and stimulatory effects of the amphetamines.6 Therefore, people taking amphetamines should take lithium only under the supervision of a doctor.5
• Vitamin B6 Occasionally, individuals taking amphetamines develop compulsive behavior and anxiety, even after the drug is discontinued. When this side effect occurred in an eight-year-old boy,7 supplementation with 200 mg vitamin B6 each day for one week followed by 100 mg daily, reduced the compulsive behavior and anxiety within three weeks. The symptoms were eliminated after a few months of treatment. Controlled research is needed to determine conclusively the usefulness of vitamin B6 supplementation for preventing and treating this side effect.6
• L-tryptophan In an uncontrolled study of schizophrenic patients, 200 mg per day of L-tryptophan reduced disturbances in thinking, as well as hallucinations caused by dextroamphetamine.8 Symptoms of psychosis rarely occur in people who take amphetamines and are not schizophrenic. Controlled research is needed to establish the benefits of L-tryptophan and related supplements for people taking amphetamines.7
• Fruit juices may acidify the intestinal contents, causing reduced absorption of amphetamines.11 Therefore, juices should be consumed an hour before or two hours after administration of amphetamines.8
• The combination of alcohol and methamphetamine makes the heart work harder and consume more oxygen, which may produce unwanted effects.12 Alcohol consumption may also suppress the breakdown of amphetamines, causing elevations in blood levels of the drug.13 Individuals taking amphetamines should avoid alcoholic beverages, especially if they have known heart problems.9
• The following herbs may have cardioactive or sedative properties that could interact dangerously with Adderall: Astragalus, Catnip, Dong quai, Feverfew, Fo-ti, Guarana, Kava, Kelp plant, Ladys slipper, Lavender, Linden tree, Lobelia, Marigold, Passion flower, Chamomile, Slippery elm, St. Johns wort, and Yohimbe.10
• Eucalyptus may decrease the effectiveness of drugs like Adderall by increasing its clearance from the body.11
• It may be advisable to avoid ginseng with Adderall due to its stimulant properties.12
• Ephedra sinica contains a compound called ephedrine. A seven-year-old boy who had 12 mg of ephedrine twice daily added to his dextroamphetamine therapy experienced improvement in hyperactive behavior.9 He also experienced relief from symptoms, such as headaches and spots before his eyes, that may have been caused by dextroamphetamine. However, concurrent use of amphetamines with other stimulants such as ephedrine or Ephedra sinica could cause excessive stimulation of the heart or nervous system. For this reason, such combinations should be used with great caution, and only under the supervision of a doctor.13
• Veratrum (Hellebore) is an herb used by doctors of natural medicine to treat high blood pressure;however, amphetamines can inhibit this effect.10 Therefore, people taking veratrum to treat hypertension should avoid amphetamines.14
References1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 1. Schmidt ME, Kruesi MJ, Elia J, et al. Effect of dextroamphetamine and methylphenidate on calcium and magnesium concentration in hyperactive boys. Psychiatry Res 1994;54:199210.
2 2. Hurwitz A. Antacid therapy and drug kinetics. Clin Pharmacokinet 1977;2:26980
2 3. Reviewed in Schmidt ME, Kruesi MJ, Elia J, et al. Effect of dextroamphetamine and methylphenidate on calcium and magnesium concentration in hyperactive boys. Psychiatry Res 1994;54:199210.
3 4. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 29534.
4 5. McTavish SF, McPherson MH, Sharp T, Cowen PJ. Attenuation of some subjective effects of amphetamine following tyrosine depletion. J Psychopharmacol 1999;13:1447.
5 6. Sifton, DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 29534.
6 7. Frye PE, Arnold LE. Persistent amphetamine-induced compulsive rituals: response to pyridoxine (B6). Biol Psychiatry 1981;16:5837.
7 8. Irwin MR, Marder SR, Fuentenebro F, Yuwiler A. L-5-hydroxytryptophan attenuates positive psychotic symptoms induced by D-amphetamine. Psychiatry Res 1987;22:2839.
8 11. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 29534.
9 12. Mendelson J, Jones RT, Upton R, Jacob P 3rd. Methamphetamine and ethanol interactions in humans. Clin Pharmacol Ther 1995;57:55968.
9 13. Shimosato K. Urinary excretion of p-hydroxylated methamphetamine metabolites in man. II. Effect of alcohol intake on methamphetamine metabolism. Pharmacol Biochem Behav 1988;29:73340.
10 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
10 Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
10 Facts and Comparisons, The Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000
11 Jori A, Bianchetti A, Prestini PE, Garattini S: Effects of eucalyptol on the metabolism of other drugs in rats and in man, Eur. J. pharmacol, 9:362-6, 1970
11 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
12 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
13 9. Scanlon J. Treatment of hyperkinetic child with dextroamphetamine and ephedrine. Pediatrics 1970;46:9756.
14 10. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 29534.
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Disclaimers
The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.
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