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Re: Help with Methylphenidate induced tachycardia, » Babak

Posted by SLS on July 28, 2015, at 7:16:55

In reply to Re: Help with Methylphenidate induced tachycardia, » Babak, posted by Babak on July 28, 2015, at 3:01:25

> I just like to mention that non-stimulant ADHD approved medication such as Clonidine and Intuniv (except atomoxetine which is really just a weaker stimulant)

Atomoxetine is more like an antidepressant than it is a stimulant. It just hits the brain in the right place (PFC) and helps to reduce dopamine clearance there. This should increase PFC activity and output, thus reducing ADD symptomatology.

If my resting heart rate were to become uncomfortably high, I might ask my doctor about taking atenolol. It is a beta-blocker that does not cross the blood-brain barrier. It should slow down the heart.

Clonodine can produce symptoms of depression, even in otherwise healthy individuals. I would be hesitant to take it. Guanfacine might be a better choice here. It does not stimulate all of the NE alpha-2 receptor subtypes as does clonidine. Guanfacine is selective for the alpa-2a subtype and is more stimulant-like than depressant-like. It thus strengthens PFC activity via postsynaptic receptor stimulation rather than more globally inhibiting NE release via presynaptic receptor stimulation.

When I first combined Parnate + desipramine, my resting heart rate was often over 100 bpm. I had no history of heart disease, though. My worry over increased HR was mitigated by my doctor telling me that this was often the case, and that it did not represent a threat. The "100" bpm value is arbitrary, anyway. I know of no studies demonstrating the safety of 100 and the danger of 105. I think real trouble starts at 120 bpm, but my perceptions are biased for having had to take trycyclics for 33 years.

If your doctor specializes in the use of methylphenidate, I would take his advice regarding accelerated heart rate. I would be curious to know his opinion of the use of atenolol to reduce HR.

Good luck.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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