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ADHD Medications

Overview of the Dangers and Side Effects of Psychotropic Medications

By | ADHD Medications, Antianxiety Medications, Antidepressants, Antipsychotics, Pharmacogenetic Testing, Precision Medicine, Psychiatric Medications | No Comments

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Psychiatric medications (often called “psychotropics”) are routinely used to treat a variety of psychiatric disorders – ranging from ADHD (attention deficit hyperactive disorder) and depression to bipolar disorder and anxiety to schizophrenia – Psychiatric medications are generally jused as an adjunct to psychotherapy.

 
It is estimated that 17 percent (some 80 million people) in the United States are taking some form of psychiatric medication (Scientific American, “1 in 6 Americans Takes a Psychiatric Drug,”  Dec 13 2016) According to the article, an earlier government report, from 2011, found that just over 10% of adults are taking prescription drugs for “problems with emotions, nerves or mental health,” published in the journal JAMA Internal Medicine.

 
While the potential benefits of psychotropic medications have been demonstrated in research and clinical practice for decades, patients are cautioned to remain vigilant of the many side effects of psychiatric medications.

 
This article presents a detailed summary of the major types of mental health medications and their associated risks for side effects as reported by the U.S. Food and Drug Administration (FDA) and the National Institute of Mental Health (NIMH) and an overview of the benefits of the Rxight® genetic test for psychiatric medications in identifying your unique genetically determined risk for developing side effects or non-response to dozens of these psychiatric medications along with hundreds of other medications across 50 pharmacological classes.

Antidepressant Side Effects

What are antidepressants?
Antidepressants are commonly used to treat depressive disorders. They also are used for other conditions, such as pain, anxiety and insomnia. Although antidepressants are not FDA-approved specifically to treat ADHD, they are sometimes used “off-label” for ADHD treatment.

The most commonly prescribed types of antidepressants today are called . Examples of SSRIs include:

Other types of antidepressants are serotonin and norepinephrine reuptake inhibitors (SNRIs) .These are chemically similar to SSRIs and include and duloxetine (Cymbalta)  and venlafaxine (Effexor).

 
Another antidepressant that is commonly used is bupropion – a third sub-class of antidepressant which acts differently than either SSRIs or SNRIs.  Bupropion is also used to treat seasonal affective disorder (SAD) and for smoking cessation treatment.

SSRIs, SNRIs, and bupropion are commonly used today because they do not cause as many side effects as the older (“first generation”) classes of antidepressants, and moreover are effective in treating a broader range of depressive and anxiety disorders.

 
Older antidepressant medications include tricyclic antidepressants, tetracyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).  These are less commonly prescribed since the development of the newer generation antidepressants.
 
What are the possible side effects of antidepressants?
Some antidepressants may cause more side effects than others. The most common side effects listed by the FDA include:

  • Sexual problems (impotence or inability to orgasm)
  • Nausea and vomiting
  • Weight gain
  • Sleepiness or fatigue
  • Diarrhea

In 2004, the FDA ordered a “black box” label – the most serious warning it issues – on all antidepressants to caution of psychiatric drugs’ increasing suicide risk in children and adolescents. In 2006, the FDA increased the age to include young adults up to age of 25. (FDA, Revision to Product Labeling, 2004)

 
Call your doctor immediately if you have any of the following symptoms, especially if they are new, worsening, or worry you (U.S. Food and Drug Administration, 2011):

  • Suicidal thoughts or actions
  • New or worsening depression
  • New or worsening anxiety
  • Feeling restless or agitated or
  • Panic attacks
  • Insomnia
  • New or worsening irritability
  • Acting aggressively, being angry, or violent
  • Acting on dangerous impulses
  • An increase in activity and talking (mania)

Additionally, drug interactions can occur.  Specifically, combining the newer SSRI or SNRI antidepressants with one of the commonly-used “triptan” medications for treating migraines can cause a life-threatening condition called “serotonin syndrome.” Serotonin syndrome is marked by agitation, hallucinations, high temperature, or unusual blood pressure changes. Serotonin syndrome is usually associated with the older antidepressants called MAOIs, but it can happen with the newer antidepressants as well.

 
Antidepressants may cause other side effects that were not included in this list, as determined by individual genetics and ability to metabolize the drug in the liver.

 
How do patients respond to antidepressants?
Some people respond better to some antidepressant medications than to others.  It is critical to know that some people may not feel better with the first medicine they try. Additionally, sometimes people taking antidepressants feel better and stop taking the medication too soon, and the depression may return.

 
These inter-individual differences are based in genetics, and the Rxight® genetic test will indicate which antidepressants may not work for you right from the start instead of having to go through trial and error with your doctor  With Rxight results, you your doctor can work together to find the best and most effective antidepressant treatment tailored to your unique genetics.

 

Antipsychotic Side Effects

What are antipsychotics?
Antipsychotic medicines are primarily used to manage psychosis, a condition that affects the mind. Psychosis is characterized by some loss of contact with reality, often including or hallucinations (hearing or seeing things that are not really there), or delusions (false, fixed beliefs). It can also be a symptom of a physical condition such as drug abuse or a mental disorder such as schizophrenia, very severe depression (also known as “psychotic depression”), or bipolar disorder.

 
Antipsychotic medications are frequently used in combination with other drugs to treat delirium, dementia, and mental health conditions, including:

The older antipsychotic medications are conventionally referred to as “typical” antipsychotics or “neuroleptics”. Some of the common typical antipsychotics include:

Second generation antipsychotic medications are also called “atypical” antipsychotics. Some of the most common atypical antipsychotics are:

According to a 2013 research review by the Agency for Healthcare Research and Quality , typical and atypical antipsychotics both work to treat of bipolar disorder (preventing mania) and symptoms of schizophrenia Additionally, some atypical antipsychotics have wider applications and are used for treating bipolar depression or general depression.

 
What are the possible side effects of antipsychotics?

Antipsychotics are known to have a large number of side effects (also called adverse events) and risks, including potentially fatal complications.

 
The FDA lists the following side effects of antipsychotic medicines:

  • Constipation
  • Nausea
  • Vomiting
  • Uncontrollable movements, such as tics and tremors (the risk is higher with typical antipsychotic medicines)
  • Seizures Drowsiness
  • Blurred vision
  • Low blood pressure
  • Dizziness
  • Restlessness
  • Weight gain (the risk is higher with some atypical antipsychotic medicines)
  • Dry mouth
  • A low number of white blood cells, which fight infections

Typical antipsychotic medications can also cause additional side effects related to physical movement, such as:

  • Tremors
  • Restlessness
  • Rigidity
  • Muscle spasms

Long-term use of antipsychotic medications may lead to a condition called tardive dyskinesia (TD). Tardive dyskinesia causes uncontrolled muscle movements, commonly around the mouth. TD can range from mild to very severe, and in some people, the problem cannot be cured and becomes disfiguring.

 
Avoid the Risk of Antipsychotic Side Effects with Rxight®

The Rxight® medication panel includes 18 popular antipsychotics on the market. Because the potential side effects of both typical and atypical antipsychotics can be very serious and potentially fatal, knowing your risks ahead of time with Rxight® can be an invaluable test for you and your prescriber.

 

Mood Stabilizer Side Effects

What are mood stabilizers?
Mood stabilizers work by decreasing abnormal brain activity. They are used mainly to treat bipolar disorder and the mood swings associated with other mental conditions including:

  • Depression (usually in conjunction with an antidepressant)
  • Disorders of impulse control
  • Schizoaffective Disorder

Anticonvulsant (anti-seizure) medications are most frequently used as mood stabilizers. They were originally developed for treatment of seizures, but they were found to help control mood swings as well. One anticonvulsant commonly used as a mood stabilizer especially in patients with symptoms of both mania and depression, or those with rapid-cycling bipolar disorder, is valproic acid (sold as Depakote). Anticonvulsants used as mood stabilizers include:

Lithium is a non-anticonvulsant mood stabilizer approved for the treatment of mania and the maintenance treatment of bipolar disorder.

 
What are the potential side effects of mood stabilizers?

Mood stabilizers can cause several side effects, some of which may be serious, especially at high dosages. These side effects include:

  • Potentially fatal rash (Stevens-Johnson Syndrome)
  • Itching
  • Extreme thirst
  • Tremor
  • Nausea and vomiting
  • Fast, slow, or irregular heartbeat
  • Slurred speech
  • Blackouts
  • Changes in vision
  • Hallucinations
  • Loss of coordination
  • Swelling

Mood stabilizers may cause other side effects that are not included in this list. Your unique reaction to anticonvulsants is based in genetics, and the Rxight® genetic test will indicate which mood stabilizer not work for you may right from the start instead of having to go through trial and error with your doctor – a process which can be expensive, lengthy and dangerous.  With Rxight® results, you your doctor can work together to find the best and most effective antidepressant treatment tailored to your genotype, preferably before treatment begins.

 

Anti-Anxiety Medication Side Effects

What are anti-anxiety medications?
Anti-anxiety medications (also called “anxiolytics”) work by reducing the symptoms of anxiety, such as that seen in panic attacks, or extreme worry and fear. The most commonly prescribed anti-anxiety medications are called “benzodiazepines.” Benzodiazepines are most frequently used to treat a condition called generalized anxiety disorder, while in cases of social phobia (social anxiety disorder) or panic disorder (panic attacks). Benzodiazepines are usually second-line treatments, behind antidepressants such as SSRIS.

Benzodiazepines used to treat anxiety disorders – all of which are tested in the Rxight® panel – include:

Short-acting benzodiazepines such as Lorazepam and another class of medication known as beta-blockers are used to treat non-persistent symptoms of anxiety. Beta-blockers are used primarily to manage physical symptoms of anxiety (e.g., shaking, rapid heartrate, and sweating).

 
Buspirone  (which is chemically unrelated to the benzodiazepine family) is sometimes indicated for the long-term treatment of chronic anxiety. It is not effective to use on an “as-needed” basis like the benzodiazepines.

 
How common is addiction to benzodiazepines?
One of the serious risks of anti-anxiety medications is that you can build up a tolerance to benzodiazepines if they are taken over a long period of time and may need increasingly higher doses to get the same effect. There is a serious risk of addiction and dependence. To avoid these problems, doctors usually prescribe benzodiazepines for short periods, particularly in the elderly (NIMH, “Despite Risks, Benzodiazepine Use Highest in Older People”), and people with addiction tendencies. If people suddenly stop taking benzodiazepines, they may have withdrawal symptoms or their anxiety may return.

 
What are the possible side effects of anti-anxiety medications?
Like other medications, anti-anxiety medications may cause side effects, many of which are serious. The most common side effects of benzodiazepines are sleepiness and dizziness. Other possible side effects include:

  • Headache
  • Confusion
  • Tiredness
  • Nausea
  • Blurred vision
  • Nightmares

Tell your doctor immediately if any of these symptoms are severe or do not go away:

  • Drowsiness
  • Difficulty thinking or remembering
  • Increased saliva
  • Dizziness
  • Unsteadiness
  • Problems with coordination
  • Blurred vision

If you experience any of the symptoms below, call your doctor immediately:

  • Swelling of the eyes, face, lips, tongue, or throat
  • Difficulty breathing or swallowing
  • Rash
  • Hives
  • Hoarseness
  • Seizures
  • Yellowing of the skin or eyes (jaundice)
  • Depression
  • Difficulty speaking
  • Difficulty breathing

Common side effects of beta-blockers include:

  • Fatigue
  • Dizziness
  • Weakness
  • Cold hands

 

Stimulant Side Effects

What are Stimulants?
Stimulants increase alertness, attention, and energy, as well as elevate blood pressure, heart rate, and respiration. Stimulant medications are generally prescribed to treat individuals diagnosed with ADHD (attention-deficit hyperactivity disorder). People with ADHD who take prescription stimulants describe a calming and “focusing” effect from the medication.  This is due to its effects on the brain chemical dopamine.

Stimulants used to treat ADHD – all of which are analyzed in the Rxight® DNA test – include:

In 2002, the FDA approved non-stimulant medication atomoxetine (Strattera) for use as a treatment for ADHD. Additional non-stimulant antihypertensive medications, clonidine  and guanfacine, are also approved for treatment of ADHD.

In addition to treating ADHD, stimulants are prescribed to treat other health conditions, including narcolepsy, and occasionally depression.

 
What are the possible side effects of stimulants?
Stimulants may cause side effects, most of which are relatively minor and disappear when dosage levels are lowered. The most common side effects include:

  • Loss of appetite
  • Insomnia
  • Stomach pain
  • Headache

Less common side effects include:

  • Motor tics or verbal tics
  • Personality changes

What are serious side effects of stimulant medications?
While side effects of stimulant medications tend to be minimal, patients and parents of patients are cautioned that serious adverse effects may occur, as reported by the FDA Drug Safety Communication in 2013. Also see
FDA Warns of Psychiatric Adverse Events from ADHD Medications
.

 
Heart-related problems:

  • Sudden death in patients who have heart problems or heart defects
  • Stroke
  • Myocardial infarction (heart attack)
  • Increased blood pressure and heart rate

Mental (Psychiatric) problems:

  • Behavior and thought problems
  • New or worse aggressive behavior or hostility
  • New or worse bipolar illness
  • New psychotic symptoms (or new manic symptoms)
  • Physical or psychological dependence

For additional details on the FDA warnings and manufacturer labeling for medications covered in the Rxight® panel, please refer to our list of medications covered.

 

About Rxight® Pharmacogenetic Testing

The Rxight® genetic test analyzes your risks based on your unique genetic makeup through a process called “SNP genotyping.” The report which will be shared with you in a personal consultation with a pharmacist. The report “red-flags” medications which may cause you to have issues, or conversely highlight medications which may not be effective for you.

 
Rxight® is based on pharmacogenetics — the study of how genes affect a person’s response to medicines. Our panel of over 200 clinically significant medications includes dozens of commonly prescribed psychiatric medications, including antidepressants across five sub-classes, mood stabilizers used in bipolar disorder and schizoaffective disorder, antipsychotics, ADHD medications (stimulant and non-stimulant), and anti-anxiety medications.

 
Based on how well you metabolize those particular medications, which is determined by your genes that encode liver enzymes that break down drugs, you will be at risk for developing side effects or the medication not working well or at all. With the results of the Rxight® test you and your prescriber can find the right medication for you, preferably before treatment begins.

 
Contact us today by phone 1 (888) 888-1932 or email to learn more about how Rxight® pharmacogenetic testing can help you find the right medication, right from the start.

FDA Warns of Psychiatric Adverse Events from ADHD Medications

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Medications commonly used for ADHD (attention deficit/hyperactivity disorder) may carry an increased risk of triggering some of the same psychiatric symptoms as those seen in schizophrenia and mood disorders, even in patients who did not have previous psychiatric problems. These psychiatric symptoms include psychotic episodes marked by auditory or visual hallucinations, paranoia, delusions, and mania.
 
ADHD is a condition that affects approximately 10 percent of the pediatric population in the U.S., according to estimates by the Centers for Disease Control and Prevention (CDC). The primary symptoms of ADHD are inattention, hyperactivity, and impulsivity. Individuals with ADHD may have difficulty functioning in work or school, and suffer with issues of low self-esteem or depression.

 
On February 21, 2007, the Food and Drug Administration issued a requirement that ADHD drug manufacturers inform patients about the associated adverse psychiatric symptoms (FDA Asks Attention-Deficit Hyperactivity Disorder (ADHD) Drug Manufacturers to Develop Patient Medication Guides). The FDA warned about psychotic events from the use of ADHD medications in its 2006 briefing “Adverse Events Associated with Drug Treatment of ADHD: Review of Post marketing Safety Data,” presented to the Pediatric Advisory Committee: “The most important finding of this review is that signs and symptoms of psychosis or mania, particularly hallucinations, can occur in some patients with no identifiable risk factors, at usual doses of any of the drugs currently used to treat ADHD.”

 
Stimulant medications prescribed for ADHD include Focalin (dexmethylphenidate hydrochloride), Adderall (amphetamine), Dexedrine (dextroamphetamine), Vyvanse (lisdexamfetamine) and Ritalin (methylphenidate hydrochloride). All these ADHD medications are tested as part of the Rxight® genetic testing panel, which is designed to analyze your body’s ability to metabolize these and over 200 other common prescription and over-the-counter medications.

 
The Rxight® pharmacogenetic test is grounded in the analysis of a set of genes and their alleles to determine how you will metabolize different medications and assimilate them into the body based on your unique genotype. If you are a so-called “fast metabolizer” of a particular medication, you process the drug and therefore may require a higher than normal dose to achieve therapeutic benefit. Conversely, if you are a “slow metabolizer” you are prone to toxic effects from the medication and its metabolites building up in your system and causing potentially serious adverse reactions, such as a stimulant intoxication in the case of ADHD medications.

Amphetamines for ADHD: Side Effects, Dangers and Addiction

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Amphetamines are a distinct class of drugs that stimulate the central nervous system producing an increase in awareness, alertness and wakefulness. This class of stimulant drugs is sometimes used in the treatment of ADHD (attention-deficit/hyperactivity disorder) as well as obesity and narcolepsy, but they are not widely accepted for use due largely to the risks of addiction and the resulting withdrawal symptoms that ensue when amphetamines are abruptly stopped.  Some of the common amphetamines that are prescribed include Ritalin (methylphenidate) and Adderall (a mixture of amphetamine and dextroamphetamine) used for ADHD, and Ephedrine (ephedrine sulfate) for use as a bronchodilator. Other amphetamines on the market include: Dextrostat, Concerta, Levoamphetamine, Ritalin, Dexedrine, Focalin and Vyvanse.

 

Amphetamine Side Effects

 
Amphetamines have many adverse side effects on the brain, the central nervous system, and the user’s body.  The neurotransmitters norepinephrine and dopamine are released from nerve endings within the brain when amphetamines are used and the ability of the neurotransmitters to reuptake is inhibited.  This causes an influx of the neurotransmitters at the synapses or the nerve endings of the brain which can lead to various side effects.  When the nerve cells within the brain and the spinal cord are activated by the use of amphetamines, there is an increase in mental alertness and the ability for the user to stay awake. Increased focus and the ability to concentrate are also present.  That is why amphetamines are sometimes used in the treatment of ADHD, to help those with focus disorders and in the treatment of sleep disorders such as narcolepsy.

 

Addiction and Serious Adverse Reactions to Amphetamines

 
The FDA has reported that amphetamines have a high potential for abuse. Untoward effects of amphetamines include the risk of hypertension, particularly with a higher than recommended oral dose.  Insomnia is a common side effect.  Unrecognized underlying cardiovascular disease may cause serious results.  Excessive or prolonged use of amphetamines can have several negative side effects including ulcers, psychosis, and damage to the central nervous system.  Long term use of amphetamines can lead to an increased physical dependence on and tolerance to the drugs.

 
Immediate side effects of ADHD medications can be dangerous, even life-threatening. Amphetamines can also lead to heart attack, stroke or death caused by increased strain on the heart.  Blood pressure increases with increased doses of amphetamines put the user at even greater risk for heart attack or stroke. Amphetamines are highly addictive drugs and should never be used recreationally. If you want to more know more information about how the drug will react to your body before taking the drug, genetic testing will provide you with information about how it will react to your genome. Talk to your provider about any prescription for these medications, and carefully monitor the patient while taking these medications.

 

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ADHD or Depression? It Could be Both

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Attention deficit hyperactivity disorder (ADHD) is a neurobiological condition that is marked by difficulty paying attention, impulsivity, irritability and forgetfulness. More than 1 in 10 children in the U.S. and four percent of adults are diagnosed with ADHD, according to the Centers for Disease Control and Prevention (CDC).
 

Depression Disproportionately Affects ADHD Patients

 
Some children and adults with ADHD also experience depression according to the University of Chicago. Numerous studies also highlight that adolescents with ADHD are ten times more likely to experience depression than adolescents without ADHD.
 
The symptoms of ADHD and depression often overlap. Depression is a neuropsychiatric condition marked by a persistent feeling of sadness or loss of interest. Patients with depression can experience a range of behavioral and physical symptoms. These may include changes in self-esteem, sleep, appetite, energy level, and concentration.
 

Is there a Causal Link between ADHD and Depression?

 
Environmental and psychosocial factors may contribute to children with ADHD experiencing depression. Children with ADHD are often overly active, which can lead to poor performance in school, difficulties in social situations, and loss of confidence and self-esteem.
 
According to the findings in the journal Lancet Psychiatry published online on Feb 15, 2017, recent brain imaging studies show that the brain structures of children with ADHD differ in small but significant ways from the brains of children without ADHD.
 
These brain scans revealed that five brain regions were slightly smaller in people with ADHD, including three brain areas within a part of the brain called the striatum ― the caudate nucleus, the putamen and the nucleus accumbens.
 
Patients with depression experience structural changes as well. Imaging studies of the brain structure have shown smaller hippocampal volume with the chronicity of depression correlating to a reduction in volume – a finding also seen in ADHD patients as discussed in CNS Spectrums “Structural changes in the brain in depression and relationship to symptom recurrence” (Feb 2002).

 
The structures within a section of the brain known as the striatum are involved in the brain’s reward system as well as its processing of dopamine, a neurotransmitter that helps control motivation and pleasure. Dopamine signaling abnormalities and brain structure differences are also present in depression (Current Topics in Behavioral Neurosciences )
 

Find the Right Medications with Rxight® Pharmacogenetic Testing

 
Medications for patients with both ADHD and depression include stimulants and various classes of antidepressants, which affect dopaminergic and serotonergic signaling pathways in the brain. (Psychiatry, Major Depression with ADHD, Apr 2006)

 
MD Labs’ CLIA-certified Rxight® genetic testing panel is among the most comprehensive available. Its panel includes six commonly prescribed stimulant and non-stimulant ADHD medications, and 26 antidepressant medications across clinically significant antidepressant classes. Over 200 other medication are also tested, and the results are good for life since your genetics don’t change.
 

Your Insurance May Cover Testing with Rxight®

 
Many insurance companies now cover Tetrabenazine (Xenazine), Nortriptyline (branded as Pamelor and Aventyl Hydrochloride) and Amitriptyline (branded as Elavil, Endep and Vanatrip), antidepressants within the Rxight® panel.
 
If you have ADHD and suffer from depression as well, ask your doctor about authorizing the Rxight® Pharmacogenetic Test. Genetic testing with Rxight® enables you and your prescribers to know – preferably ahead of time – which medications may causes potentially dangerous adverse reactions and conversely which may be ineffective.
 
To get started, we invite you to email us today or call 1-888-888-1932 to discover how you may benefit from our pharmacogenetic testing program.

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Amphetamine Side Effects

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Amphetamines are chemically related to the parent chemical compound amphetamine. They define central nervous system stimulant-type medications. Amphetamines are a distinct class of drugs that stimulate the central nervous system producing an increase in awareness, alertness and wakefulness. This class of drugs is sometimes used in the treatment of ADHD (attention-deficit/hyperactivity disorder) as well as obesity and narcolepsy, but they are not widely accepted for use due largely to the risks of addiction and the resulting withdrawal symptoms that ensue when amphetamines are abruptly stopped.  
 
Amphetamine given orally raises both systolic and diastolic blood pressure but not usually the heart rate. Some of the common amphetamines that are prescribed include Ritalin (methylphenidate) and Adderall (a mixture of amphetamine and dextroamphetamine) used for ADHD, and Ephedrine (ephedrine sulfate) for use as a bronchodilator. Other amphetamines on the market include: ProCentra, Dextrostat, Concerta, Strattera, Levoamphetamine, Dexedrine, and Vyvanse.

 

How Amphetamines Work

 
The neurotransmitters norepinephrine and dopamine are released from nerve endings within the brain when amphetamines are used and the ability of the neurotransmitters to reuptake is inhibited.  This causes an influx of the neurotransmitters at the synapses or the nerve endings of the brain which can lead to various side effects.  When the nerve cells within the brain and the spinal cord are activated by the use of amphetamines, there is an increase in mental alertness and the ability for the user to stay awake. Increased focus and the ability to concentrate are also present.  That is why amphetamines are sometimes used in the treatment of ADHD, to help those with focus disorders and in the treatment of sleep disorders such as narcolepsy.

 

High Addiction Potential

 
Amphetamines have a high potential for abuse. Untoward effects of amphetamines include the risk of hypertension, particularly with a higher than recommended oral dose.  Insomnia is a common side effect.  Unrecognized underlying cardiovascular disease may cause serious sometimes fatal results.  Excessive or prolonged use of amphetamines can have several negative side effects including ulcers, psychosis, and damage to the central nervous system.  Long term use of amphetamines can lead to an increased physical dependence on and tolerance to the drugs. 

 

Danger of Cardiac Issues from Amphetamine Use

 
Amphetamines have many adverse side effects on the brain, the central nervous system, and the user’s body. Amphetamine use can also lead to heart attack, stroke or death caused by increased strain on the heart.  Blood pressure increases with increased doses of amphetamines put the user at even greater risk for heart attack or stroke. Amphetamines are highly addictive drugs and should never be used recreationally.
 

The Utility of Genetic Testing for Amphetamines

 
If you want to more know more information about how the drug will react to your body before taking the drug, genetic testing with Rxight® will provide you with information about how it will react to your genome. Over 200 other medications are tested, including many commonly prescribed ADHD medications.
 

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Focalin Side Effects and Warnings

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Focalin is a mild central nervous system (CNS) stimulant used to treat attention deficit hyperactivity disorder (ADHD), and is usually accompanied with psychological, behavioral, educational, or other forms of treatment. Stimulants help ameliorate the symptoms of ADHD by making it easier for the user to concentrate, avoid distraction, and control behavior.

 

Warnings for Patients with Cardiac Issues

 

Children, adolescents and adults, who are candidates for treatment with stimulant medications should have family background checkup (to look for cases of ventricular arrhythmia) and a physical exam to assess for the presence of cardiac disease, and should receive further cardiac evaluation if findings suggest such disease (e.g., electrocardiogram and echocardiogram) exist.

 

Patients who have symptoms such as exertional chest pain, unexplained syncope (temporary loss of consciousness due to low blood pressure), or other symptoms suggestive of cardiac disease during stimulant treatment, should undergo a prompt cardiac evaluation.

 

Focalin Psychiatric Adverse Effects: Psychosis

 

There are a number of potential psychiatric adverse events from ADHD medications such as Focalin that should be discussed with your provider. Conditions such as pre-existing psychosis may be exacerbated with Focalin, and new psychiatric symptoms may emerge. A thorough discussion with your provider is appropriate.

 

Common Side Effects of Focalin

 

Common side effects of Focalin include: insomnia, dry mouth, sore throat, dizziness, nausea, upset stomach, headache, anxiety, loss of appetite, or weight loss. If any of these effects continue or worsen, tell your physician promptly. This medication might raise your blood pressure. Tell your physician if the results are high. Tell your doctor right away if you have any serious side effects such as: signs of blood flow problems in the fingers or toes, unusual wounds on the fingers or toes, or irregular heartbeat.

 

Know Your Risks with the Rxight® Genetic Test

 

For optimal safety in dosing and frequency, ask your provider about Rxight® pharmacogenetic testing from MD Labs, that is available from your pharmacist through a simple cheek swab. This test will tell your provider what genetic variabilities you have that may require adjustment of dose or frequency of your medication.

 

Recent advances in medicine has shown that genetic variability in genes that are responsible for making the enzymes that metabolize drugs, can alter the way a patient responds to medications. The Rxight® test will inform your provider about your ability to metabolize over 200 prescription and over-the-counter medications.

 

This area of study is called pharmacogenetics and is instrumental in bringing precision or individualized medicine to the patient. By elucidating your specific genetic variation in the genes that metabolize medicines, you may benefit from reduced side effects to Dexmethylphenidate and many other drugs. Ask your physician about Rxight® from MD labs to help bring precision medicine to your individual care.

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Adderall Side Effects

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Description

 

Amphetamine, commonly known by its trade names Adderall, Dyanavel XR and Evekeo, is a stimulant drug used in the treatment of a number of disorders including ADHD (attention deficit hyperactivity disorder), narcolepsy, depression, and obesity.

 

Adderall Mechanism of Action

 

Adderall is a strong neurostimulator. It causes the release of noradrenaline (norepinephrine) from adrenergic presynaptic neurons. Norepinephrine is a central nervous system stimulant, and this stimulant effect is thought to underlie the drugs therapeutic actions in ADHD.

 

Common Side Effect of Amphetamines

 

Adderall is usually a well tolerated drug with few side effects. However it is associated with a number of ADHD medication adverse reactions. These include (occur in more than 1% of patients):

 

  • Epistaxis (nose bleeds)
  • Allergic rhinitis (stuffy nose)
  • Upper abdominal pain

 

Less Common Side Effects of Amphetamines

A number of side effects have been reported when taking amphetamine (Adderall) but have not had their frequency reported in large scale trials. These side effects include:

 

  • Euphoria
  • Dysphoria
  • Insomnia
  • Restlessness
  • Dizziness
  • Dyskinesia (involuntary movement)
  • Tremor
  • Headaches
  • Dry mouth
  • Diarrhea
  • Constipation
  • Impotence
  • Frequent erections
  • Increase libido
  • Decreased libido
  • Weight loss
  • Anorexia

 

How Does Pharmacogenetic Testing Work?

 

As previously mentioned, Adderall is usually a well-tolerated drug that has few side effects in most patients. However, a small portion of individuals will suffer multiple severe adverse reactions. This inter-patient variation is partially accounted for by the genetic differences between individuals. Polymorphisms in genes that code for receptors and enzymes that interact with amphetamine could increase the probability of developing side effects when taking the drug.

 

For instance, amphetamine is metabolized by the cytochrome P450 superfamily of enzymes, namely isoenzyme CYP2D6. Studies have suggested that polymorphisms in CYP2D could increase the probability of developing side effects when taking Amphetamine. Other studies have suggested that variants in the mu opioid receptor OPRM1 mediated the euphoria often seen in patients taking Amphetamine.

 

Understand Your Risks with the Rxight® Genetic Test

 

Identifying these polymorphisms can therefore aid a clinician’s decision making when prescribing amphetamine and other ADHD stimulant medications. A clinician may lower the dose given a specific allele or recommend the drug not be prescribed at all. Unfortunately routine genomic screening in not performed by most health care providers. MD Labs’ genetic testing program, Rxight®, sequences 18 genes (including OPRM1 and CYP2D6) to establish how a patient is likely to respond to hundreds of clinically relevant medications (including Adderall).

 

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Focalin Side Effects

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Focalin Side Effects

 

Description

 

Focalin (generic name, dexmethylphenidate) is an oral medication used to treat attention deficit/hyperactivity disorder or ADHD. Focalin is available in an immediate-acting form and an extended release form. It is indicated for the treatment of adults and children six years of age or older. Dexmethylphenidate is a stimulant that works somewhat paradoxically to help people with ADHD focus and reduce their impulsiveness.

 

Serious Side Effects of Focalin

 

The most serious Focalin adverse effects arise in people who are allergic to the drug. These include anaphylaxis, angioedema, and hypersensitivity reactions to the drug. Anaphylaxis is a rapid and severe allergic reaction in which the heart rate increases, blood pressure decreases, and lung passageways tighten, leading to severe shortness of breath and dizziness. Angioedema is also a severe allergic reaction in which the lips, tongue, and throat swell. This swelling can block air from passing and cause choking and death, if left untreated.

 

Dexmethylphenidate may provoke or worsen symptoms in people with existing cardiovascular diseases such as structural heart problems, serious heart arrhythmias, and coronary artery disease.

 

One of the less discussed but certainly serious Focalin adverse effects is priapism, which is a painful erection lasting for several hours. Fortunately, priapism is a rare side effect of Focalin.

 

Some people report blurry vision or being unable to see things up close. These dexmethylphenidate adverse effects almost always occur in adults.

 

Common Side Effects of Focalin

 

The most common Focalin side effects, that is, the side effects that occur in more than 10% of people taking the drug include:

 

  • Headache
  • Anxiety
  • Insomnia (children)
  • Restlessness (adults)
  • Decreased appetite (children)
  • Dry mouth (adults)
  • Abdominal pain (children)

 

Less Common Side Effects of Focalin

Other Focalin side effects are less common, occurring in 1 to 10% of people taking the medication include:

 

  • Dizziness (adults)
  • Fever (children)
  • Irritability (children)
  • Depression (children)
  • Mood swings (children)

 

  • Itchiness (children)
  • Nasal congestion (children)
  • Nausea (children)
  • Vomiting (children)
  • Decreased food intake to the point of weight loss (children)
  • Throat pain (adults)
  • Upset stomach or heartburn (children or adults)

 

Potential for Abuse of Focalin

 

While dependence and addiction are not technically dexmethylphenidate side effects, the drug is a stimulant, and therefore can be abused. Physicians may be reluctant to prescribe Focalin to people who have a history of drug dependence or alcoholism. People who chronically use Focalin may become dependent on the medication, need higher doses of the medicine to achieve the desired effect, and experience withdrawal symptoms is the medication is stopped. When used inappropriately, dexmethylphenidate can cause euphoria, so it is considered a potential drug of abuse. On the other hand, people who improperly use dexmethylphenidate are more likely to experience serious and perhaps life-threatening events such as psychosis (i.e. hallucinations, delusions, paranoia) and severe cardiac conditions.

 

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ADHD Medication Side Effects and Inefficacy as Applied to PGx Testing

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Pharmacogenetic testing, provided by MD Labs, can reduce side effects associated with ADHD medication. Our PGx Testing allows clinicians to reduce inefficacy in ADHD medication. Many individuals being treated for experience side effects from ADHD medication or are non responders to treatment.

 

The World Health Organisation estimates that ADHD affects almost 39 million people worldwide. The disorder is characterised by a difficulty to control behavior and usually presents in children between the ages of 6 and 12. The neurodevelopmental disorder includes symptoms such as

 

  • Have difficulty focusing on one task
  • Become bored with a an activity after a few minutes
  • Are in attentive when taking instructions
  • Individual Does not follow instructions

 

For a diagnosis to be made, symptoms must be present for 6 months and negatively   affect two areas of the child’s life (e.g., school and home).

 

ADHD is a common disorder and has a number of treatments. Commonly behavioral therapy is initially recommended but and increasing number of doctors are turning to medication. Methylphenidate, trade name Ritalin, is the first line drug but is associated with a number of side effects. These include

 

  • Irritability
  • Dyskinesia (tics)
  • Lethargy (drowsiness or fatigue)
  • Appetite loss
  • Anxiety
  • Depression
  • Hyperhydrosis (increased sweating)
  • Blurred vision
  • Dry eyes

 

As such, pharmacotherapy for ADHD can be cumbersome. Dosage is highly variable between patients and it can take months to find the right medication at the right dose. Almost 20% of individuals are non-responders to Ritalin, and alternative medication needs to be found.

 

The side effects of ADHD medication have been associated with polymorphisms in a number of genes. These include COMT DAT1, DRD2,DRD4, SNAP25, NET1, ADRA2A, and 5HTT. Individuals with polymorphisms in these genes may be at an increased risk of developing the common side effects of methylphenidate or being non-responders to the drug.

 

Pharmacogenetics is able to provide improved efficacy in ADHD pharmacotherapy. Genetic sequencing can identify individuals with known polymorphisms and clinicians and pharmacists can alter medication and dosage accordingly. This improves the speed with which the right medication is found at the right dose. MD labs provides Rxight®, a genetic testing service that sequences over 18 genes for more than 60 known alleles. This allows clinicians to identify how patients will react to more than 200 common medications, including Ritalin. We currently offer genetic sequencing of ADRA2 and COMT, two genes associated with ADHD medication side effects.

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Psychiatric Medication Side Effects

By | ADHD Medications, Adverse Drug Reactions, Antipsychotics, Drug Metabolism, Psychiatric Medications | No Comments

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Almost 79 million Americans use some form of psychotropic drug. Psychiatric medications include antidepressants, antipsychotics, anti-anxiety drugs, mood stabilizers and stimulants used to treat mental health conditions such as anxiety, depression, attention deficit disorder and schizophrenia. Some are used for non-psychological ailments including pain and neuropathy.

 

Common Side Effects of Psychiatric Medications

Most psychiatric drugs have side effects, although not every patient experiences adverse effects. Common side effects include blurred vision, headaches, nausea and drowsiness. A small percentage of patients experience severe or life-threatening adverse reactions such as fever, seizures or difficulty breathing. These drugs must be used under the supervision of a clinician. Patients must strictly adhere to prescription protocols to avoid side effects, drug interactions or withdrawal symptoms.

 

Adverse reactions to psychiatric drugs occur for a number of reasons including diet, type and severity of disease and use of other medications. Some reactions occur because of a person’s unique genetic makeup. Studies demonstrate that particular genes affect the metabolism of specific medicines. Pharmacogenetics looks at the way an individual metabolizes and responds to drugs. Knowing a patient’s genetic characteristics allows clinicians to select medications that have the greatest therapeutic value and minimize adverse drug events.

 

Antidepressants Side Effects

 

Antidepressants are used to treat several conditions including depression, anxiety, pain, smoking cessation, neuropathic pain and sleep disorders. These drugs correct chemical imbalances in the brain. Neurotransmitters, chemicals produced by nerve cells in the brain that communicate with one another, include dopamine, gamma-aminobutyric acid, norepinephrine and serotonin. Antidepressants inhibit chemical imbalances and enhance communication between cells.

 

Older antidepressants include monoamine oxidase inhibitors such as selegiline, tetracyclics such as mirtazapine and tricyclics such as amitriptyline. MAOIs may produce side effects such as muscle cramps, low blood pressure and weight gain. MAOIs also interact with certain foods, so dietary restrictions are necessary. Common side effects of tricyclics and tetracyclics include constipation, dizziness and dry mouth. More serious side effects include thoughts of suicide, vomiting and hives.

 

Newer antidepressants include serotonin reuptake inhibitors such as fluoxetine and sertraline, and serotonin and norepinephrine reuptake inhibitors such as duloxetine and bupropion. These drugs are more commonly prescribed because they produce fewer adverse reactions. Side effects of SSRIs and SNRIs include agitation, sweating and abnormal thinking. These drugs should not be combined with other medicines or herbs that increase serotonin levels in the brain such as older antidepressants, St. John’s Wort or amphetamines. Drug interactions may cause a life-threatening condition called serotonin syndrome or gastric bleeding.

 

Clinicians typically prescribe antidepressants by trial and error to determine whether a patient will suffer adverse reactions and find a dosage that controls symptoms while minimizing side effects. When patients suffer side effects or do not get relief, the doctor may change medicines. Antidepressants should be stopped only under the guidance of a healthcare professional to avoid relapse or serious side effects.

 

Anti-Anxiety Drugs Side Effects

Anti-anxiety medicines are used to treat anxiety disorders such as panic attacks, phobias and excessive worry. Most medicines in this category are benzodiazepines such as clonazepam, chlordiazepoxide and diazepam. Beta-blockers such as propranolol and antihistamines such as hydroxyzine are also used to treat anxiety. Like depression, anxiety disorders often occur because of chemical imbalances in the brain. Although these medicines cannot cure the disorders, they can provide relief from symptoms. Benzodiazepines target GABA transmitters, while antihistamines provide a sedative effect. Beta-blockers ease anxiety such as stage fright or post-traumatic stress. Anticonvulsants such as gabapentin and topiramate are often used to augment therapy.

 

Each of these medications may produce minor side effects such as dizziness, fatigue or drowsiness. Benzodiazepines are usually used on a short-term basis because they can be habit-forming. They should not be stopped abruptly because of the risk of side effects and seizures or be combined with alcohol or other central nervous system depressants. Beta-blockers should not be used by people with asthma or diabetes. Some anticonvulsants like topiramate are associated with visual changes and decreased sweating. Anticonvulsants should be stopped gradually to avoid the risk of seizure. Combining anti-anxiety drugs with other medications should be done only under the guidance of a physician to avoid serious side effects from drug interactions.

 

Side Effects of Antipsychotics

 

Antipsychotics are used to manage mental disorders including psychosis, schizophrenia, delirium and dementia. Antipsychotics block dopamine receptors. Older medicines, called “typical” antipsychotics or neuroleptics, include chloropromazine and haloperidol. Newer drugs, called “atypical” antipsychotics, act on both dopamine and serotonin receptors. Atypical antipsychotics include risperidone and lurasidone. Common side effects of atypical
antipsychotics include tremors, seizures, constipation and restlessness. Typical antipsychotics may also impair movement or cause rigidity or muscle spasms. Long-term use may cause tardive dyskinesia, or uncontrollable movements around the mouth. Antipsychotics should not be stopped abruptly to avoid withdrawal symptoms.

 

Stimulants Side Effects

 

Stimulants increase heart rate, attention and blood pressure. They are used to treat attention deficit hyperactivity disorder, depression and other health conditions. Medicines used to treat ADHD include dextroamphetamine and methylphenidate. Common side effects include sleeplessness and loss of appetite.

 

Mood Stabilizer Side Effects

 

Mood stabilizers are used to treat mood swings and bipolar disorder. They may also be used with other psychiatric drugs to treat other mental health problems. Lithium is commonly used for these disorders. Anticonvulsants such as carbamazepine and valproic acid are also used. Side effects include itching, blackouts, seizures or loss of coordination.

 

Pharmacogenetic Testing and Adverse Drug Reactions

 

Pharmacogenetic testing examines a patient’s DNA to identify gene variants that can affect the metabolism of drugs. The cytochrome P450 family of genes metabolizes most psychiatric drugs. Genetic variations can affect the rate of metabolism. Slow metabolism may result in adverse side effects. Rapid metabolism may eliminate a drug too quickly and reduce the therapeutic value.

 

Some genes affect the metabolism of antipsychotic medicines that bind with dopamine. Other genes affect how SSRIs are assimilated. Some variants are common to particular ethnic groups; others are individual. Studies show that particular genotypes had a 50 percent higher risk of developing tardive dyskinesia. Another genetic variant is associated with a reduced risk of TD, suggesting the gene may protect from developing TD. Drugs such as clozapine that bind with serotonin receptors are associated with lower incidences of TD.

 

Gene CYP2D6  metabolizes several antidepressants and approximately 40 percent of antipsychotics including risperidone and haloperidol. Poor metabolizers of CYP2D6 are more likely to suffer side effects from several commonly prescribed antipsychotics. Genotyping for CYP2D6 can help predict metabolic responses for several antidepressants and neuroleptics. The Food and Drug Administration has issued drug label warnings and dosing recommendations for specific genetic variants for several psychiatric drugs including clozapine, risperidone and amitriptyline.

 

Clinicians and pharmacists trained in pharmacogenetics can help patients understand the potential for adverse effects of psychiatric drugs that may be due to genetic variants. When testing results are included in a patient’s medical records, pharmacists can verify that medications are appropriately dosed and communicate information about how to use the drug to patients. Reducing side effects makes patients more confident about the medications prescribed by their doctors, which can increase patient adherence to drug therapy regimens.

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