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Attention Deficit Hyperactivity Disorder

Adderall XR Is Working... Blood Pressure Up!

03/04/2010

Question:

Hello and thank you for reading my question.

I`ve researched, but can`t seemed to get the exact info I`m looking for.

I was prescribed 20mg a day of Adderall XR for my ADHD about 2 months ago and I can`t tell you how much it has improved the quality of my life! So far I`ve noticed:

• Improved focus • Motivation • Able to think clearer • Added energy • Hunger suppressant • Increased pleasant mood • Much more social • More tolerant of situations • Not as forgetful... Memory has improved

Great right? Here`s the problem:

When I went for my second follow up visit with my med management doctor to see how I was doing he checked my blood pressure and it was very high... 154/105.

I was told to stop taking the Adderall and see my primary MD about the concern.

I did and when my blood pressure was taken 3 days after stopping the Adderall it had dropped, but still a tad on the high side. I was then prescribed "Hydrochlorothiazide 25mg a day for the high BP and asked to return for another reading in a week.

When I had returned, my BP had come down to just about normal (I forget the exact numbers, but it was almost perfect).

That`s where I`m at now and here is my question...

I`ve been on many drugs over the years, some hit, some miss, but Adderall has done wonders for me. I`ve had a lot of disappointments in the past with possible misdiagnoses, psychotropic meds which were incredibly difficult to get through the withdrawl stages of after finding out they were making me worse... Adderall was finally making progress with me...

and now I have to stop.

Is there ever a case where Adderall is prescribed and even though it raises the blood pressure is continued and perhaps another drug is prescribed to counteract the high blood pressure? Maybe a lower dose of Adderall along with treatment for the high BP?

What about other drugs that have the benefits of Adderall without the increased blood pressure?

I`m 38 years old, male, about 80 lbs overweight (which is why I was loving the appetite suppressant part of the Adderall!) and I recently started smoking again after having quit for 6 months.

It pains me to think that after all of this time I had finally found something that did so much for me in a positive way that I now have to walk away from it.

Any help is greatly appreciated! Thank you!

Answer:

You need to discuss these concerns with your prescriber.

There is actually an FDA-approved drug for ADHD that has the side effect of lowering BP. It's called Guanfacine, available in generic but also in an extended-release form under the trade name Intuniv. It can also be combined with Adderal XR. It has another side effect of mild sedation, but you might find a combination of guanfacine and a lower dose of Addrall XR friendly to both BP and your ability to focus. Discuss it with your doctor.

Regardless, you should change your eating habits to gradually lose a few pounds a year and make the new eating habits a way of life. That will help both energy level, BP, and prevent diabetes.

For more information:

Go to the Attention Deficit Hyperactivity Disorder health topic, where you can:

Response by:

L Eugene Arnold, MD, MEd L Eugene Arnold, MD, MEd
Professor Emeritus of Psychiatry
College of Medicine
The Ohio State University