Chest pain following DXM and Adrafinil

[anon091]

First off I'd like to preface this by saying I am going to see a doctor, but in the meantime I'm just looking to see if anybody has had a similar experience or insights to share.

I stupidly took some adrafinil in the morning before work and when I got home (having forgotten about the adrafinil) took 450mg dxm. All good. A few hours later I decide to redose another 300mg. Shortly after my heart is racing, my blood pressure is super high. My skin was itching and burning. My sinuses were congested from the blood pressure. My chest hurt and I could feel my pulse through out my whole body. I tested my HR at a few points and it was around 150-160 resting. I managed to get a 1mg kpin which gave relief. I probably would have went to the ER if I didn't have the benzo.
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Felt fine the next day, but the following week I' get some random pangs in my chest. Kinda wrote it off as my heart being sore from the whole ordeal. It's been 2 weeks and I'm still getting some pains, they come and go and are mostly on my left side but they do happen on the center and right side. All of this plays into my anxiety which makes the whole situation worse.
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Does anybody have similar experiences with a stimulate/dxm overdose and chest pains the following days? I'm making an appointment with my doctor tomorrow but I'm just wondering if anybody else could provide some input on their experience and what to expect?
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I've quit nicotine and coffee in hopes to help resolve the issue​


Thanks for reading

 

[S.J.B.]

I've had chest pains similar to what you are describing for about four years now. It occured after a period of smoking stimulants and breathing in too many chemicals, but I'm not sure if that was the cause or just coincidental. I've had electrocardiogram, echocardiogram, chest x-ray, MRI, asthma and allergy tests, and they all turned up negative. Common causes of chest pain include acid reflux and costochondritis, or it could be caused by anxiety, or it could be idiosyncratic.

Make sure you get at minimum an electrocardiogram if the pain doesn't go away, but don't stress too much about it being a serious heart issue for now, as it could be one of many other less-serious things.

 

[dopamimetic]

Wow, me too. I developed a severe chest pain after combining daily methylphenidate 18mg with daily DXM 75-150mg - a heavily stimulating mixture, needless to say. Went to the doc's, they eventually made an ECG and prescribed some -prazole and gastric acid neutralizers (of course I knew it probably would not be that and of course I did not say that I was ABusing a cough suppressant cause I wanted to be treated seriously....) still I tried them but yeah, didn't work. So I had to stop both meds because it would come again with either of them. Got severly depressed soon afterwards and had heavy stress with my ex gf due to that.... did not want to go into useless drug rehab either..

Ok, even a YEAR after I would not tolerate DXM in tiny amounts without developing chest pain. MPH was fine after some time yet has it lost all its "magic" if there was something as to speak of about (oh, did I mention that the combo was great, but heavy on the body too?)

Now, I think its at least 6 years since, I do tolerate higher doses of DXM without problems again, yet did I develop a different chest pain now from it, one which responds to proton pump inhibitors... it's weird. But I am absolutely sure that it was a different kind back then, one that was not originating from the stomach, and had a much more breath-taking acute thing to it..

And I still fear of having hurt my one and only heart I have. Cause this chest pain also re-appeared briefly at some occasions with physical exhaustion, like fitness training etc.. yet never seriously enough to be able to grasp it and go to a doc again.. also had at least 5 ECG since then, but no fucking single other physical examination (cause I'm known now as a drug addict, and who believes a junkie..?)

 

[S.J.B.]

Now, I think its at least 6 years since, I do tolerate higher doses of DXM without problems again, yet did I develop a different chest pain now from it, one which responds to proton pump inhibitors... it's weird. But I am absolutely sure that it was a different kind back then, one that was not originating from the stomach, and had a much more breath-taking acute thing to it..

It's weird, I had the same type of transition. At first it was a stab-like pain that occurred a bit left of centre when I would inhale, and it would come and go. That slowly went away, and was replaced by a more central pain near my sternum, less stabbing and more like a soreness, and currently it is there all the time, but flares up most when I stretch in certain directions and is less related to my breathing. I haven't tried any medications yet but I have other signs of acid reflux (sore throat most days, sinus discomfort) and I think I will be put on a PPI at my next visit to the physician. I still have no idea whether either type of pain was/is cardiovascular, respiratory, gastrointestinal, muscoskeletal, or neuropathic. I guess I'll have a better idea after taking the PPI.

 

[dopamimetic]

Yeah, apparently the exact same weird sensation. Thank you so much, now I finally found somebody else - but then again, what the fuck might it have been in first line? Something wrong with the heart that docs can't diagnose yet or with the stomach? Something else?

Seems like DXM intensifies gastric motility, I did have diarrhea from doing plateau 1-2 years ago (always tablets, so not "inactive" sirup ingredients causing it), yet never nausea or vomiting. Might it have been gastric acid hurting the stomach?? Yeah I know no diagnosis over the net. Just that I happen to distrust docs [as most people in general, unless they prove that they are worth of my trust] , and I don't happen to know a good doc to talk with at the moment (the only friend with a Dr. med. [not yet practicing] is Romanian and well it's nuff said that sometimes she asks me about medicine topics, [and that's not the only origin of my suspiciousness] so ... I am left with the net).


Remember that taking a PPI takes some days for the effect to set in, I had to take an acid neutralizer on the first 2 days of that recent heartburn induced by DXM. Continued to take it for now.

(Pantoprazol 20mg is OTC here and it can't hurt cause I am also reducing on morphine - want to switch back to a low dose of methadone, morphine feels to me like it has a metabolite that must be kinda toxic. Taking DXM on top of morphine makes me sick and hearing voices, while taking it in place of the morphine does NOT. Also while methadone can make you truly tired, the morphine was weird in that it interfered with sleep but offered too little intoxication at the lower dosages.

Additionally, D-metha is a NMDA antagonist. A weak one but yeah I just love them) ...

Edit: I am right now on, something like umm 150mg DXM + 10mg Lisdexamphetamine, the latter cause I couldn't fall asleep but felt tired. I took some trazodone first - the only sleep aid I have here atm but it didn't work so I decided to get up and take a cup of coffee and half a cap of Elvanse.. Slept a good part of the past day and my circadian rhythm is kinda distorted anyways. [the length of posting is more attributed to the DXM which makes me more talkative and able to express myself, psychostims alone don't in low dosages and above they cause logorrhea and akathisia. I am a person too shy and introverted for my like.]

In this lowerish dosage I don't get physical discomfort anymore, but when going higher I'd get tachycardia and restlessness, some anxiety and yeah the sore throat kind of heartburn (when not taking a PPI), and when going even higher that stabbing kind of heart pain comes back sporadically and briefly. MPH night be worse than dex-amph but I thought it'd be norepinephrine specific, yet DA doesn't really affect the heart (does it??) and modafinil doesn't touch NA directly (does it?).

I'd love to try modafinil soon for exactly this kind of feeling tired yet restless, might be a low dopamine condition afaik but independently of the origin I want to get rid of it and not as in sleep whole days through like with psychiatry's big love, the neuroleptics.. but being able to utilize the days and sleep at night. But if it's really a masked heart condition then would I have to be wary of it or of combining it with DXM? Shouldn't be worse than what I am on right now, should it?

 

[anon091]

Something I might add: I've been in a shoulder immobilizer for the past month which could also be contributing the the chest pain. Having trouble seeing my doctor and urgent care won't take an appointment for chest pain. Might have to eat the bill and go to the ER to get peace of mind that my heart isn't failing.

 

[anon091]

Figure I'd give an update. Went to the ER today and had an EKG, chest xray and bloodwork done. Every test came back looking good. So it's most likely not my heart. Hopefully my anxiety will be at ease and the pain will go away eventually.

 

[S.J.B.]

Figure I'd give an update. Went to the ER today and had an EKG, chest xray and bloodwork done. Every test came back looking good. So it's most likely not my heart. Hopefully my anxiety will be at ease and the pain will go away eventually.

Glad to hear that. Hopefully the pain will go away soon.

 

[anon091]

Glad to hear that. Hopefully the pain will go away soon.

I do think it is/was at least partially psychosomatic. My resting heart rate was below 80 for the first time in almost 2 weeks (due to near constant anxiety about my heart/chest pains) this morning and I have had almost no pains since waking up. I'm hopeful that they will go away entirely. If things get worse and it turns out I do have heart damage, I'll be sure to update everyone haha.

 

[dopamimetic]

My current hunch is that it's actually something to do with the digestive system and the tachycardia just adds a psychosomatic nocebo effect to the whole thingy. Cause, as I've said, DXM -does- cause an increase in motility and gastric acid secretion, so much that I do now take a PPI alongside it and now I'm fine. Even with methylphenidate & DXM it's gone now (I've switched back to MPH cause I get heavy side effects from [lisdex]amphetamine that aren't present with 18mg MPH, probably due to its less pronounced NE activity).

Maybe it was even something like biliary jam, if that is possible? I know of gallstones, so maybe?

Nevertheless do not under-estimate how strong of a NE reuptake inhibitor DXM is, much more so than a SSRI and according risk for serotonin syndrome, IMHO. It does not really substitute for venlafaxine. Maybe I should try the quinidine combo.. if it just wasn't so hard to get Rx'es for all the stuff, even if there's no way to abuse something.. so unnerving. Yeah I know probably why it's how it is, but my life'd be a bit easier otherwise.

 

[awesome31311]

I used to use DXM with caffeine pills. Nothing but a disaster. Especially the day after when I got hot flashes.

 

[anon091]

Interesting. DXM is probably a no-go from now on for me to be on the safe side.

I'm still experiencing pains and my primary is having me get an ECG done. Hopefully I just strained my heart or something from the High HR and BP and things will get back to normal soon. I've been doing some light cardio and I can't tell if it's helping. Doesn't seem to be hurting but it's hard to say.