amorphousOne
Greenlighter
- Joined
- Mar 22, 2018
- Messages
- 5
Background: After 4 months of very productive stim usage (consistent 4x10mg adderall/day), I experienced sudden serious chest pain and had to go to the ER. They detected nothing (EKG, bloods, stress echo). These symptoms have persisted, and I am unable to use stimulants at the same effective dosage. Anything over the 2.5mg d-amph or equivalent and I get variant (prinzmetal's) angina. I realize this is a unique reaction specific to my body, but I can't be the only one. Hoping to find someone who's been down the same path and found a solution.
Stimulants/stimulant-analogs tried:
Racemic amph, adderall, dexedrine, methylphenidate, focalin, phenylpriacetam, ephedrine - all very effective. All caused angina.
strattera, reboxetine - made me more robotic and concrete, but caused some lethargy. Both caused angina.
Modafinil, amfonelic acid, caffeine - no help. Produced wakefulness and creativity, but without the focus that comes from NE.
guanfacine/clonidine - no help. Lethargy, reduced motivation.
The popular "nootropics" like piracetam, herbal stuff, etc - incomparable to proper stimulants
Drugs to alleviate symptoms tried:
Calcium channel blockers, nicorandil, alpha blockers, various benzos, alcohol - prevent angina to various degrees, but their effects counter the motivational aspects of stimulants that I find useful, both in studies and in my experience (ex: though prazosin improves spatial working memory, it blocks stimulant-induced release of DA in the striatum by interfering with the a1b adrenoreceptor).
Nitrates, Beta-blockers, Levosalbutamol, L-citrulline, guanadrel, ARB's, HCTZ, and a few other BP meds - Ineffective, but I found they also don't interfere mental effects of stimulants (except for the lipid-solube beta blockers). I bet the nitrates would work at a high enough dose, but at just 10mg of isosorbide dinitrate I get a headache.
Exercise or vigorous movement is the only thing that alleviates stim symptoms without interfering with mental effects. In the early days of experimentation I had to go to the ER a few more times when I felt the chest pain coming on. Now I can just start shadow boxing or stationary biking and the pain subsides. Even opening and closing my hand quickly and forcefully slowly attenuates my chest pain during an episode, but if I stop it returns. Now I'm asking myself, by what mechanism that I'm unaware of does physical exertion attenuate coronary alpha-1 vasoconstriction?
The smoking gun: phenylephrine - Recently I tried some sudafed PE after my mom recommended it for my cold. After 40 mins it caused the exact same chest pain that I resolved with prompt exercise as well as temazepam and l-citrulline. Given phenylephrine's pharmacology, clearly the problem lies with local(peripheral) alpha-1 adrenergic stimulation in the coronary artery.
Unfortunately, I've found that even those drugs that specifically counter the effects of alpha-1 receptors and possess little blood brain barrier permeability (alfuzosin, amlodipine) still cancel out the central effects of stimulants at doses necessary to prevent angina.
TLDR: Does anyone know how to prevent stimulant-induced alpha-1 coronary vasoconstriction? The only real clue I've found is everything that blocks this also blocks the mental effects of stimulants except vigorous exercise.
An enormous thanks to anyone who can help me crack this.
Stimulants/stimulant-analogs tried:
Racemic amph, adderall, dexedrine, methylphenidate, focalin, phenylpriacetam, ephedrine - all very effective. All caused angina.
strattera, reboxetine - made me more robotic and concrete, but caused some lethargy. Both caused angina.
Modafinil, amfonelic acid, caffeine - no help. Produced wakefulness and creativity, but without the focus that comes from NE.
guanfacine/clonidine - no help. Lethargy, reduced motivation.
The popular "nootropics" like piracetam, herbal stuff, etc - incomparable to proper stimulants
Drugs to alleviate symptoms tried:
Calcium channel blockers, nicorandil, alpha blockers, various benzos, alcohol - prevent angina to various degrees, but their effects counter the motivational aspects of stimulants that I find useful, both in studies and in my experience (ex: though prazosin improves spatial working memory, it blocks stimulant-induced release of DA in the striatum by interfering with the a1b adrenoreceptor).
Nitrates, Beta-blockers, Levosalbutamol, L-citrulline, guanadrel, ARB's, HCTZ, and a few other BP meds - Ineffective, but I found they also don't interfere mental effects of stimulants (except for the lipid-solube beta blockers). I bet the nitrates would work at a high enough dose, but at just 10mg of isosorbide dinitrate I get a headache.
Exercise or vigorous movement is the only thing that alleviates stim symptoms without interfering with mental effects. In the early days of experimentation I had to go to the ER a few more times when I felt the chest pain coming on. Now I can just start shadow boxing or stationary biking and the pain subsides. Even opening and closing my hand quickly and forcefully slowly attenuates my chest pain during an episode, but if I stop it returns. Now I'm asking myself, by what mechanism that I'm unaware of does physical exertion attenuate coronary alpha-1 vasoconstriction?
The smoking gun: phenylephrine - Recently I tried some sudafed PE after my mom recommended it for my cold. After 40 mins it caused the exact same chest pain that I resolved with prompt exercise as well as temazepam and l-citrulline. Given phenylephrine's pharmacology, clearly the problem lies with local(peripheral) alpha-1 adrenergic stimulation in the coronary artery.
Unfortunately, I've found that even those drugs that specifically counter the effects of alpha-1 receptors and possess little blood brain barrier permeability (alfuzosin, amlodipine) still cancel out the central effects of stimulants at doses necessary to prevent angina.
TLDR: Does anyone know how to prevent stimulant-induced alpha-1 coronary vasoconstriction? The only real clue I've found is everything that blocks this also blocks the mental effects of stimulants except vigorous exercise.
An enormous thanks to anyone who can help me crack this.
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