Lisdexamphetamine (Vyvanse) Metabolite Hydroxyamphetamine and Lower Dopamine Levels
Not a Pharm major by any means, but pharmaceuticals is something that interests me greatly, I am currently an 11th grader, but plan to go onto pharmacy school. I do know quite a bit though. Anyways that's all the background info that's really necessary.
I read long ago about the metabolism of lisdexamphetamine (I take 60 mgs). It gets metabolized into D-Amphetamine in the body, and then roughly 95% of the D-Amphetamine is metabolized into phenylacetone, then to benzoic acid, and then finally hippuric acid. The other 5% gets converted into p-Hydroxyamphetamine,while although a minor metabolite, may have significant physiological effects as it is an analogue of norepinephrine.
"Although p-hydroxyamphetamine is a minor metabolite (~5% of the dose), it may have significant physiological effects as a norepinephrine analogue"
From:
http://en.wikipedia.org/wiki/Dextroamphetamine
Coming across this next bit of inforation made me start to do some digging.
Hydroxyamphetamine is known to bind to the TAAR-1 receptors in humans, and as I read here : "Activation of rat TAAR1 expressed in HEK293 cells assessed as accumulation of [3H]cAMP after 1 hr by competitive binding assay "
source:
http://pubchem.ncbi.nlm.nih.gov/assay/assay.cgi?aid=635290#aDescription
Does this have the same effect in humans with increased cAMP levels? I was wondering if this could be the cause of what i will later discuss.
I have read that increased cyclic adenosine monophosphate reduce your dopamine levels. "Another side-effect of high cAMP levels, is decreased dopamine activity and increased prolactin levels. "
source:
http://voices.yahoo.com/negative-effects-high-cyclic-amp-levels-11299662.html
Although this is not the most scholarly of sources, I do believe that they wouldn't misrepresent conclusions of tests/experiments.
My step-brother is prescribed Vyvanse and Paroxetine, and I found out he was put on Paroxetine (SSRI) after being put onto Vyvanse. Paroxetine inhibits cytochrome P450 2D6 (CYP2D6), which does not allow any of the D-amphetamine to be metabolized into Hydroxyamphetamine. Could the Hydroxyamphetamine have caused (through increased cAMP levels) lower dopamine levels while there was still a buildup of cAMP before the effects of the Hydroxyamphetamine go away, and thus contributed to some depression-like symptoms? I do know that CNS stimulants/amphetamines usually cause higher dopamine levels (which are generally naturally lower in people with ADHD), but is the deficit caused by the hydroxyamphetamine enough to offset the gain in dopamine caused by Dextroamphetamine. Could this be a reason why he developed minor depression like symptoms or his already current symptoms (I don't know which was the case) worsened or did not improve after starting vyvanse? Or could this have been perscribed in response to anxiety onset by the Hydroxyamphetamine? Could Paroxetine then be considered as a booster such as Intuniv (guanfacine) to increase the duration of the drug and lower anxiety/other adverse affects? Any input would be greatly appreciated as I am very curious!