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ADHD Medications (cont.)

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What are the warnings and precautions when using ADHD medications in children?

There are several warnings and precautions related to the use of ADHD medications in children.

Contraindications for ADHD medications

Administration of stimulants can lead to physical and psychological drug dependence. Therefore methamphetamine is contraindicated in patients with a history of alcoholism.

Dexmethylphenidate and methylphenidate are contraindicated in patients with anxiety since it can worsen this condition.

Dextroamphetamine/amphetamine, dextroamphetamine and methamphetamine are contraindicated for use in patients with arteriosclerosis due to the risk of sudden death.

Methamphetamine and methylphenidate are contraindicated for use in patients with cardiac disease. These stimulants can cause increases in blood pressure and heart rate and can lead to myocardial infarction and sudden unexplained death (SUD). Methamphetamine also has a Black Box Warning for this reason.

Dextroamphetamine/amphetamine, dextroamphetamine, dexmethylphenidate, methamphetamine and methylphenidate are contraindicated in people with glaucoma due to the risk of visual disturbances and blurred vision. This is because stimulants can block the outflow of aqueous humor (eye fluid) and increase intraocular pressure.

Atomoxetine is contraindicated in closed-angle glaucoma due to the risk of mydriasis (pupil dilation).

Methylphenidate (Metadate CD) contains sucrose and is contraindicated in patients with hereditary fructose intolerance, glucose-galactose malabsorption, and sucrase-isomaltase deficiency.

Stimulation of the sympathetic nervous system by dextroamphetamine/amphetamine, dextroamphetamine, methamphetamine and methylphenidate can cause cardiac arrhythmias. Therefore they are contraindicated for use in patients with hyperthyroidism.

Atomoxetine, dextroamphetamine/amphetamine, dextroamphetamine, dexmethylphenidate, lisdexamfetamine and methamphetamine should not be combined with monoamine oxidase inhibitors (MAOI) or used within 14 days of stopping an MAOI. Such combinations can cause a hypertensive crisis.

Atomoxetine is contraindicated in patients with pheochromocytoma or a history of pheochromocytoma. Atomoxetine can cause serious reactions, including increased blood pressure and tachyarrhythmia in this patient population.

Dextroamphetamine/amphetamine, dextroamphetamine and methamphetamine are contraindicated in patients with a history of substance abuse since stimulants can cause physical and psychological drug dependence. Dextroamphetamine/amphetamine and dextroamphetamine also have a Black Box Warning for this reason.

Dexmethylphenidate and methylphenidate are contraindicated in patients with tics or Tourette's syndrome (including a family history of Tourette's syndrome) since they may worsen these conditions.

Medically Reviewed by a Doctor on 8/19/2014


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