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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Racer on March 9, 2006, at 20:04:26
My pdoc asked me to get my blood pressure checked the next time I took Ritalin. So, today, I did, and it was sky high.
Now, I had been feeling behind, was rushing, race-walked across campus looking for the student health center, was nearly late for a midterm I felt pretty much unprepared for, had a headache from the Ritalin, and when I got there I was faced with half a dozen forms to fill out before they'd check my blood pressure. Any and all of those could have contributed to the high reading. And I'm not sure it's high enough to have caused a headache, but I know little about that, since my BP is generally very low.
That's the background. The question is this: I know that the doctor is planning to change to Adderall, and I see her tomorrow. The Ritalin is helping, no question. I want to stay on a stimulant, because the difference is like night and day. I'm afraid that the elevated BP might make her decide to stop the stimulants. I really don't want that.
Does anyone know if another stimulant is less likely to increase my blood pressure? Or has anyone who has experienced elevated blood pressure from stimulants had something else prescribed to help control it?
Thanks!
Posted by alohashirt on March 10, 2006, at 0:34:18
In reply to Any stimulant less likely to raise blood pressure?, posted by Racer on March 9, 2006, at 20:04:26
Be very careful - this can kill you.
My 125/70 went to 139/110 on 30mg AdderallAdderrall worse than Dexedrine
Dexedrine worse than Ritalin
Ritalin worse than Focalin
Focalin worse than STratetra (Shame STrattera didn't work for me)When I took Dexedrine I took 100mg of Toprol XL with it
With Focalin XR I don't need to take blkood pressur emedication
Youj should definitely try it befire Adderrall - its a single isomer so 50% of dose produces same effect on symptoms with 50% of saide effects.> My pdoc asked me to get my blood pressure checked the next time I took Ritalin. So, today, I did, and it was sky high.
>
> Now, I had been feeling behind, was rushing, race-walked across campus looking for the student health center, was nearly late for a midterm I felt pretty much unprepared for, had a headache from the Ritalin, and when I got there I was faced with half a dozen forms to fill out before they'd check my blood pressure. Any and all of those could have contributed to the high reading. And I'm not sure it's high enough to have caused a headache, but I know little about that, since my BP is generally very low.
>
> That's the background. The question is this: I know that the doctor is planning to change to Adderall, and I see her tomorrow. The Ritalin is helping, no question. I want to stay on a stimulant, because the difference is like night and day. I'm afraid that the elevated BP might make her decide to stop the stimulants. I really don't want that.
>
> Does anyone know if another stimulant is less likely to increase my blood pressure? Or has anyone who has experienced elevated blood pressure from stimulants had something else prescribed to help control it?
>
> Thanks!
Posted by Racer on March 10, 2006, at 1:52:40
In reply to Re: Any stimulant less likely to raise blood pressure?, posted by alohashirt on March 10, 2006, at 0:34:18
Thanks for your response.
> Be very careful - this can kill you.
> My 125/70 went to 139/110 on 30mg AdderallMy usual BP is somewhere in the area of 90/60, so not something I generally worry about. When I'm stressed, it goes to around 95/68.
Today, though, it was 129/89.
Again, lots of variables...
>
> Adderrall worse than Dexedrine
> Dexedrine worse than Ritalin
> Ritalin worse than Focalin
> Focalin worse than STratetra (Shame STrattera didn't work for me)
>
> When I took Dexedrine I took 100mg of Toprol XL with it
> With Focalin XR I don't need to take blkood pressur emedication
>Thank you for your review. I'm actually not going to try any of the methylphenidates, and Strattera wouldn't be a good choice, either. Pretty much between Dexedrine, and Adderall, and my pdoc apparently doesn't want to prescribe dexedrine to me, although my therapist didn't remember why. (And as an aside, I really like it that my therapist admits to and jokes about her bad memory. Makes it seem much more OK to me not to be perfect.)
But you were able to take the stimulants, even though you also had to take BP medicine? That is good to know -- because this really is the best I've felt in years now, except for the headache...
Posted by Chairman_MAO on March 10, 2006, at 12:22:09
In reply to Any stimulant less likely to raise blood pressure?, posted by Racer on March 9, 2006, at 20:04:26
Pemoline has the least cardiovascular toxicity of any (marketed psychostimulant). However, I believe it has been or will be withdrawn due to concerns over hepatotoxicity.
In second place is d-methamphetamine (Desoxyn), which has a much higher therapeutic index, i.e. the dose required for a CNS effect vis a vis the dose causing untoward effects or toxicity, than d-amphetamine or methylphenidate. This is due largely due to markedly higher lipid solubility.
Posted by Chairman_MAO on March 10, 2006, at 12:35:10
In reply to Any stimulant less likely to raise blood pressure?, posted by Racer on March 9, 2006, at 20:04:26
Using small doses of clonidine seems to me to be a good way to attenuate BP increase secondary to stimulant use for ADHD, as it can help reduce impulsivity as well. The increased BP due to psychostimulant use is a result of increased NE release. Clonidine stimulates a2-adrenergic autoreceptors, which reduces sympathetic outflow. This, IMHO, is a more logical solution than using drugs which reduce blood pressure in other ways (beta blockers, etc.).
Use this with caution if you have a predisposition to [melancholic] depression.
Posted by med_empowered on March 10, 2006, at 16:56:35
In reply to clonidine » Racer, posted by Chairman_MAO on March 10, 2006, at 12:35:10
hi! Personally, I found that Ritalin affected my blood pressure more than adderall b/c Ritalin caused more anxiety; I don't quite know how to describe it, except that Ritalin made me feel "sped up" whereas smallish doses of Adderall just made me feel focused, sans any sense of panic or what have you. So..maybe some form of amphetamine (dexedrine, adderall, possibly desoxyn) will be better for you. Usually it seems that you need lower doses of the amphetamines than you do Ritalin, so maybe that will be helpful as well.
Good luck!
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