Cardiotoxicity of MPH vs AMP? Which is Safer?

[ryand123]

I have Adult ADD and am trying to find out which of these is more cardiotoxic before i asak my doc to put me on one. I would assume MPH would be due to its similar composition to cocaine, a notoriously cardiotoxic chemical. But as i have posted before my pharm knowledge is pretty limited so I'm looking for other peoples opinions before I go in. And how does the most cardiotoxic of these chems exert this toxicity?

 

[Epsilon Alpha]

Cocaine is mainly cardiotoxic due to its Na channel blocking action. Most studies on stimulant treatment don't find significant increases in cardiovascular complications at normal doses.

 

[THE_REAL_OBLIVION]

I've been on both. When I was around 18 or 19 I have been on ritalin for maybe 6 months, it made me shakey and have tremors and probably a lot of seizures where one doesn't lose consciousness so I put a stop to that. The doctor also had scripted me trazodone to sleep then and my research then (I still remember it) was one of the 2 increased the toxicity of the other...I put a stop to that treatment right away then.

I changed GP since then and have been on Adderall XR 25mg for 2 months then me and my doctor figured out that the government covered Dexedrine. Have used Dexedrine for almost a full year and have only stopped because I got methadone (sigh) and the 2 didn't go well together (taking my scripted dose of 30mg a day was making me puke like crazy 2x10mg spansules in the morning 2x 5mg IR at 3 or 4 pm).

And amphetamines (when pure like this) are most likely the less damaging drug I have ever used, less even than weed. Weed after using some psychedelics became very unpleasant for me for half a decade where i would get into insane panic attacks, for a couple years I continued to smoke even if I didn't like it and I guess the whole ordeal has made me stronger because I have never consulted about weed related panic attacks, i just knew they could happen and all I did was ask for very small amounts of benzos for a very short time period (20 xanax .25 non renewable) etc. I'm getting off tracks but don't take my empirical evidence as a total proof that amphetamines > MPH. But I'd rather take seroquel for sleep again than MPH (for awake tasks ofc), that should speak volumes.

To me Ritalin was unneeded as we already had dextroamphetamine and mixed amphetamine salts when it was introduced (Adderal was Obetrol was bought changed name and indication by the company making it in Ireland and there it was new add meds but they already existed). It was just because of that stigma attached to amps (possible recreational use) that Ritalin was approved for add. I think at first it was for old people who were depressive I think and i'm sure it would be more useful that way in small dosage.

By the way I was only on 5mg bid (twice a day) of Ritalin before you ask questions about the dosage.

 

[Solipsis]

Even though I agree that dexamphetamine is one of if not the cleanest feeling stimulant I have tried, any subjective experience we have with these compounds probably isn't proper guarantee of cardiotoxicity. Is it any indication though? I wonder if perceived jitteriness or palpitations or angina are any suggestion. Part of symptoms like these and tachycardia, hypertension and certainly arrythmia's can be considered cardiotoxic effects themselves but at therapeutic doses complications would indeed be rare.
Stimulant cardiotoxicity can partially be from hypercatecholamine states that increase hypoxia and oxidative stress. So can amphetamine and methylphenidate be compared regarding this? Or is this irrelevant because of limited dosage?

 

[ryand123]

Solipsis- I would say that dosage is probably irrelevant. Depending on the individual and previous health conditions and the possibility one might be hypersensitive to the cardiovascular effects of AMP or MPH, more likely MPH i would guess though. For instance, i also have panic disorder and depending on the severity of an attack my heart rate can increrase up to 200+ (230 in one case of mine). So even a moderate tachycardia from a stim could push that BPM even higher and cause me to stroke if i had panic. This is the main reason ive made this thread. Im looking for the stim with rhe least effects on the heart and blood pressure, in the short and long term.

 

[doppelgänger1]

Cocaine is mainly cardiotoxic due to its Na channel blocking action. Most studies on stimulant treatment don't find significant increases in cardiovascular complications at normal doses.

Cocaine also causes coronary vasospasms, leading to myocardial infarcts (even for young people).

http://circ.ahajournals.org/content/85/2/407.full.pdf

 

[Epsilon Alpha]

^ good find, I wasn't aware of a direct calcium effect.

 

[AlphaMethylPhenyl]

I was under the impression that Cocaine, which Methylphenidate is very similar to, was mostly harmful to the heart while Amphetamine was to the brain.

 

[bloodshed344]

Amphetamine is safer.

My opinion.

 

[ebola?]

On what basis did you develop this opinion?

ebola

 

[bloodshed344]

On what basis did you develop this opinion?

ebola

Amphetamine is prescribed to 6 year olds and methiopropamine has a lot of anecdotal evidence showing cardio problems like high blood pressure, pulse, I cant remember all those other words. Read some threads on MPH? Anecdotal experience doesn't mean a thing empirically, but it is a sure sign that something may be wrong, which is why Bluelight even exists in the first place, right? To dispel the false anecdotes and promote real empirical data?

 

[sekio]

So why does an amphetamine-type drug (methiopropamine) being "rough" make amphetamine "safer" than cocaine?

 

[endotropic]

MDMA feels pretty alright to me so it doesn't cause cardiac valvulopathies.

Ok that wasn't very helpful, here's some actual research though.

Do prescription stimulants increase the risk of adverse cardiovascular events?: A systematic review.

http://www.ncbi.nlm.nih.gov/pubmed/22682429

Highlights:

A second study by Winterstein et al., compared the risk between methylphenidate and amphetamine salt medication preparations [62]. In 2,131,953 Florida Medicaid beneficiaries, 3 to 20 years old, no difference was found in risk of emergency room visits for cardiac reasons between the two medication groups.

(aside: they prescribe 3 year olds stimulants? That's heinous.)

The most recent study of adults (18 years and older), by Schelleman et al. (2012), matched methylphenidate users (n = 43,999) to nonusers (n = 175,955) and found an increased risk of sudden death or ventricular arrhythmia among users (adjusted hazard ratio 1.84, 95% CI 1.33 to 2.55) [73]. No statistically significant difference in risk was found for stroke, myocardial infarction, and a combined endpoint of stroke/myocardial infarction. In a secondary analysis, the risk of all-cause death was significantly increased for methylphenidate users compared to nonusers (adjusted hazard ratio 2.38, 95% CI 2.20 to 2.56).

This all comes from daily prescribed use. The general conclusion of the report is that neither drug presents a cardiac risk to adolescents when used as prescribed, and none of the studies found increased cardiac risk in adult users of amphetamine salts.

Less frequent, high dosage use is obviously riskier regardless of the drug, but even at prescribed dosages methylphenidate has cardiac toxicity, while amphetamine does not.

 

[endotropic]

Even though I agree that dexamphetamine is one of if not the cleanest feeling stimulant I have tried, any subjective experience we have with these compounds probably isn't proper guarantee of cardiotoxicity. Is it any indication though? I wonder if perceived jitteriness or palpitations or angina are any suggestion. Part of symptoms like these and tachycardia, hypertension and certainly arrythmia's can be considered cardiotoxic effects themselves but at therapeutic doses complications would indeed be rare.

It's almost like the authors are responding directly to your question:

Stimulants and Cardiovascular Events in Youth With Attention-Deficit/Hyperactivity Disorder
http://www.sciencedirect.com/science/article/pii/S0890856711010495

This pattern suggests that stimulants may make a small contribution to the risk of palpitations or other minor symptoms,41 but these risks do not seem to translate into more clinically significant outcomes such as angina, dysrhythmias, or transient cerebral ischemia.

 

[20max10]

Amphetamine is prescribed to 6 year olds and methiopropamine has a lot of anecdotal evidence showing cardio problems like high blood pressure, pulse, I cant remember all those other words. Read some threads on MPH? Anecdotal experience doesn't mean a thing empirically, but it is a sure sign that something may be wrong, which is why Bluelight even exists in the first place, right? To dispel the false anecdotes and promote real empirical data?

Are you getting MPH mixed up with MPA? I think OP is talking about Methylphenidate, Methiopropamine is MPA

 

[pofacedhoe]

if one drug is not less likely to cause cardiovascular issues then the one that gives you (personally) the most anxiety is the more dangerous one. anxiety is bad for your heart. look at your mood when on the drug to see how it affects you

everyone is different

releasers make a mess of my head while coke has no comedown but i know it is very cardiotoxic just from the chest pains it gives me

 

[ryand123]

Thank you guys for the replies and advice. I decided to go with the addy xr because, like all these studies show, MPH is more cardiotoxic than .AMP. Also, MPH seems to make me extremely tired along with incresing my anxiety levels. In a recent conversation with a med student, he told me that MPH makes people with ADHD tired because it releases a certain endorphin that causes this drowsiness. After about a week of lookin online for verification of this statement, I've found nothing. So does anybody know anything about this? I dont believe its true, but i dont throw anything out the window without hard facts.

 

[bloodshed344]

Are you getting MPH mixed up with MPA? I think OP is talking about Methylphenidate, Methiopropamine is MPA

Yes, sorry for the confusion! Thanks for pointing that out. I'm gonna delete my post to avoid spread of misinformation, however I still think that methylphenidate (which should be MPD, not MPH which sounds retarded) SHOULD be more cardiotoxic than methamphetamine considering it's closer relation to cocaine. It could make no difference, or even be less cardiotoxic however. Anecdotal reports on the rate of chest pains from both substances would probably shed more light on this.

 

[ebola?]

In a recent conversation with a med student, he told me that MPH makes people with ADHD tired because it releases a certain endorphin that causes this drowsiness.

This doesn't make much sense. I don't think that MPH is pharmacology 'promiscuous' enough to affect opioid peptides directly to any significant degree (and causing release of endorphins would be a pretty exotic secondary activity...would this be changing pituitary glandular functioning or what?). Maybe he was talking about some downstream effect and extrapolated to tenuously?

I still think that methylphenidate (which should be MPD, not MPH which sounds retarded) SHOULD be more cardiotoxic than methamphetamine considering it's closer relation to cocaine.

This is incorrect. MPH is structurally unrelated to cocaine and lacks coke's direct anaesthetic effect, which is the key cause of cocaine's unique cardiotoxicity.

Anecdotal reports on the rate of chest pains from both substances would probably shed more light on this.

Actually, the studies that endotropic cited pretty much effectively answer the question.

ebola

 

[immad]

^Cocaine blocks sodium channels, while MPH doesn't. So the resemblance regarding both being a reuptake inhibitor is not the toxicity mechanism.