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  • BDD Moderators: Keif’ Richards | negrogesic

Heart palpitations when therapeutic dose wears off - should I be concerned?

L

luxray

Bluelighter
Joined
Jul 4, 2014
Messages
256
Been using dex for about 2 years now.

Dosage schedule:
11.00 - 10 mg dex-amphetamine
13.30 - 5 mg dex-amphetamine


My heart is normal the entire day, no palpitations or anything. The pulse is slightly elevated (about 5-10 beats per minute).
Heart palpitations starts around 20.00 or something and pulse is about 80-85 (same as during the day when on meds, when I wake up in the morning it is around 55-65).

My blood pressure and pulse is checked regularly, at they are fine. I've taken an EKG some years ago, and that was fine as well.


I have not been worried about the palpitations at all, since they don't bother me, but my boyfriend think I should talk to my doctor about it... Or am I wrong?


Can dex be the reason for these palpitations? I would think it would happen when the meds were active, and not at the evening?


Other possible reasons (?):
- Dex rises my anxiety levels when it wears off. I'm usually not anxious when it wears off, but I get easier anxious if that makes sense.
- Sleep deprived. During the week I get 5-7 hours of sleep. (During the weekend I usually sleep 9-11 hours.)
- Slightly under weight. Not much, but I usually eat very little during the day.
- Stress related? I don't feel stressed, but I have never been good at noticing when my body is under stress.
 
Anxiety, poor sleep, and stress, stimulants, and dietary issues can all cause or worsen heart palpitations. Youre almost certainky fine, but its definitely a good idea to get checked out by your doctor. This is s medicsl issue where 99% of the time you have nothing to worry about, but that 1% could be serious.
 
Oh, I know why, it's the 10mg single dose that causes it. Split your 15mg into 3 doses, taken:

- 11:00am - 5mg
- 2:00pm - 5mg
- 5:00pm - 5mg

This will make the palpitation problem go away. The point is for you to take something at 5pm, if it's not 5mg, make it 3mg. But take something, don't just stop everything at 1pm, it's not healthy.
 
Ksa said:
Oh, I know why, it's the 10mg single dose that causes it. Split your 15mg into 3 doses, taken:

- 11:00am - 5mg
- 2:00pm - 5mg
- 5:00pm - 5mg

This will make the palpitation problem go away. The point is for you to take something at 5pm, if it's not 5mg, make it 3mg. But take something, don't just stop everything at 1pm, it's not healthy.
Click to expand...

I find it somewhat disturbing that you're stating these statements which such certainty. While the described symptoms may very well be reflecting the effects of an amphetamine comedown, and lower peak plasma concentrations due to spread out dosing might indeed alleviate these, I believe it should be noted that everyone responds differently to different amphetamine dosages. Sure, spreading out the dose might work out for the topicstarter, although falling asleep might be somewhat harder when dosing 5mg later on the day, there's no guarantee doing so will help him/her.

Also, lower dosing at a later timepoint might postpone heart palpitations, but it's still merely postponing them. While there's valuable information Ksa's reply, don't takte it for granted. It might even be more worthwhile to lower the first dosage to 5mg, instead of sticking to 15mg/day.
 
^ It's best that her doctor lowers/raises her dose. With my schedule, the last dose will crash at 8pm, normally it would be 9pm because amphetamines last for 4 hours, but in this case the crash is accelerated by the crash of the 2 previous doses. By 10:00pm she should be tired. It's also a matter of getting used to it, like, now it's 10:32pm, I've had 4mg of Dexedrine at 7:00pm and now I'm tired and feel like going to bed. I find sometimes Dexedrine helps me sleep. So it's not black and white really. It might seem like taking Dexedrine later during the day is bad but it's not, in fact, the more even your dopamine levels stay throughout the day the better.

Remember that the reason why ADHD is medicated with amphetamines is to raise dopamine/norepinephrine levels to a higher value, but the ideal is for that higher value to fluctuate naturally, just like it would in absence of medication. The fact that 5mg or 10mg instant release doses are given and a dopamine spike is obtained, is due to technological limitations. The spike was never intended, it's just that we have no other way of raising dopamine and norepinephrine to higher levels in patients. Vyvanse creates even levels a bit more successfully, but best results are obtained if you do not create waves of highs and lows.

Otherwise she can split doses earlier in the am, but always separated by at least 3 hours, at least 3 doses or more, it can be 4 or even 5 equal doses 3 hour apart. She can take 5 doses of 3mg 3 hours apart, no problem, that's even better:

6:00am - 3mg
9:00am - 3mg
12:00pm - 3mg
3:00pm - 3mg
6:00pm - 3mg

This will prevent palpitations. Another thing to consider is, if she drinks coffee she should stop doing that. Furthermore, Intuniv or Clonidine will also reduce palpitations and also help with ADHD so this is something to discuss with her doctor.
 
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I take Adderal for ADD and use it appropriately and often have rapid heart beats. I go to the cardiologist once a year and he says I'm fine. That's my best advice, see your doctor regularly, heart palpitations can be harmless.
 
Thanks for the feedback. If the issue doesn't go away I'll talk to my doc about it. It seems like I left out some information in the opening post btw.

I have only had this palpitations the last two or three weeks.

Also, I take 7.5 mg in the morning, not 10 like I wrote. Sometimes I take a third dose of 2.5 mg 2 hours after the second dose.

The reason why I taper of my doses is because I feel like the effect throughout the day is more at the same level that way.

If I take 5+5+5 I feel like the effect later in the day is a lot stronger than in the morning, which is when I most need my meds (during lectures and such). Taking only 5 in the morning also some times give me slight anxiety, so 7.5 is the lowest dose that I feel give me the effects I want.

When it comes to sleeping, I can also sleep while on medication. But it's more difficult to sleep when they wear off. So that's why I've not taken them later, but I guess I could give it a try if I time it correctly... At night, I actually fall asleep easier the days I'm medicated, so it's just the period right when the meds are wearing off I find it hard to sleep.
 
I completely relate to how you say you need a bigger dose in the morning to be awake. Especially if you wake up at 6am, I have noticed myself that even I require larger doses. Here's the thing, there's several reasons why you shouldn't shock yourself into wakefulness with amphetamines in the morning:

- Naturally, the stimulation of the GABA neurons in the hypothalamus, glutamate and orexin to increase adrenaline is what contributes you you waking up in the morning. Nowhere does the brain produce methamphetamine to wake up.
- Norepinephrine naturally increases, and if you take a big dose of amphetamines to wake up suddently, it may build up to above anxiety levels, as there is nothing to stop it from increasing to high values.

My ADHD capsules are self made and look somewhat like this:

- 3.5mg Dextroamphetamine (50% contribution to waking up)
- 2mg Nicotine (50% contribution to waking up)
- 80mg Caffeine (30% contribution to waking up)
- 25ug Clonidine (-30% contribution to waking up)

That's viewed only from the angle of what helps me wake up. If you have anxiety, noradrenaline is not something you should have in large amounts. You need some of it or else your heart can stop, but you cannot have the levels you currently do, that result from the accumulation of natural adrenaline plus adrenaline coming from 7.5mg of amphetamines. Are you aware that amphetamines increase adrenaline much more than anything else like dopamine?
 
I have not said that I need a bigger dose in the morning to be awake. What I said was that I need a bigger dose to get the desired effects (to be able to concentrate during lectures). If you take 5+5+5, you will have a larger concentration of amp in your blood after the third dosage, than what you had after the first dosage. That's why a lot of people, including me, feel like they get a more even effect if the initial dose is bigger than the following doses.

Anyway, I have dosed my medicine like this for two years, so I find it weird that this should be the cause of the sudden heart palpitations?
 
^ Ok, so if I understood well, 7.5mg, in the morning gives you the desired effects to concentrate in class, and later on, even 5mg or less will do. You were fine with this schedule until 3 weeks ago when you noticed palpitations at 8pm.

Sister, what you have to come to realize is that by 8pm you're withdrawing from dopamine. How you feel, how awake you are or how well you're able to concentrate has nothing to do with how your heart interprets nervous system signals coming from your brain. Your ability to concentrate might benefit from the increase in adrenaline alone! I don't know. But meanwhile you're giving your heart 7.5 Dopamine in the morning, then YOU are fine at 5pm, what about your heart? Your heart goes like, hey, YOU are fine, sure, but what about me? Where's my dopamine? I thought you were giving me 7.5 Dopamine...I thought we were friends :(

Would you be fine, falling in love with a handsome man in the morning, so now you can concentrate for your classes, then, by 4pm you see that man kiss another woman, you argue with him, he rejects you and leaves you heart-broken and anxious, then your doctor argues, that's ok, as long as that got you to focus during class it's ok. Good daily treatment. No it's not!

What I do personally when I notice cardiac effects following an amphetamine binge is I:

- Take 3x Omega 3 Pills, I usually crush them in my mouth and swallow the liquid, for young women I do not advise crushing because they might like the taste too much and...acquire an affinity for ill-repute extra-curriculum activities... :)
- Coenzyme Q10, 1x pill.
- Redose amphetamines.

Try the first 2 options. The reason why you have palpitations is because you are withdrawing from amphetamines and your heart is asking for more amphetamines. Period. Take less in the morning, so you aren't withdrawing in the evening.

Hope I answered your question.
 
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