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sleepiness and amphetamine

Posted by Zeke on December 30, 1999, at 2:57:25

In reply to update: I fell asleep after taking 20mg Dexedrine, posted by Janice on December 28, 1999, at 15:18:49

Rather than answer your questions, I'll make some comments...

The first is to note the reported comorbidity of anxiety (and dysthymia) and ADD. This at least suggests some biological relation. I have been diagnosed with ADD and in the past, an anxiety disorder. And I take Dexedrine and in the past Ativan. Both were helpful but the Dexedrine much more so. Personally, I found Ativan much superior to Xanax, which tended to make me sleepy.

The fact that Dexedrine makes you sleepy is something that Dr. Paul Wender -- certainly an primary expert in ADD -- has commented on. In his book "Attention Deficit Hyperactivity Disorder in Adults" he refers to reports by Adults w/ ADD who indeed that stimulants make them feel sleepy. (Unfortunately I've loaned out my copy of the book so I can't give better reference but take a look at the book if you can.)

I did find one reference to the amphetamine/sleepiness connection where boys with ADD reported the sleepiness effect, but men w/o ADD did not. see: In particular it says, "The men reported euphoria, while the boys reported only feeling "tired# or "different# after taking the stimulant." However Wender (above) seems to feel this sleepiness effect may be a marker for ADD (and as I have said, he notes this in adults). I have experienced this effect occasionally but moreover a more general calming effect.

There are psychiatrists that report on efficacy of amphetamine in relieving OCD and mania*, but the common perception is that amphetamine cause or exasperate anxiety and thus would be contraindicated with anxiety. I think this has soem truth but is largely tied to fear of controlled substances and especially of untoward reactions in naive users as well as extreme anxiety and paranoia seen in chronic abuse and overdose with amphetamine (and other stimulants). But IMHO this is describes on the behavioral differences of amphetamine effects at mederate and high doses, just like moderate doses relieve hyperactivity but high doses will cause hyperactivity. Also, while amphetamine acts primarily on dopamine and penylethylamine, there is evidence that it will elevate synaptic serotonin levels in conjunction with substances that act on serotonin (eg, SSRIs or Xanax, which has an antidepressant effect beyond its anxiolotic effect). There is also evidence of a direct dopamine/serotonin connection: "Evidence that serotonin3 (5-hydroxytryptamine3, 5-HT3) antagonists attenuate behavioral responses to D-amphetamine and cocaine suggests that 5-HT3 receptors modulate brain dopamine." (see: note too a possible connection of euphoria and anxiety implied there -- since moderate doses used in ADD tend not to cause euphoria does this also speak to the non-anxiety response therein?)

Another study, suggests that amphetamine has effects on GABA, the transmitter system that benzodiazepines effect and one attributed to anxiety: "GABAergic drugs are potentiated by enhanced dopaminergic neurotransmission with regard to their actions on ambulatory activity and rearing." (see: )

Interestingly, phobias may be preciptated by amphetamine withdrawl: "d-amphetamine ... when discontinued by our patient, was followed by the full syndrome of agoraphobia." (see: )

*see Psychopharmacology Tips (also, , , , )




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