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Transient hypertension from MAOI + new Dex

Posted by cassandracomplex on June 25, 2013, at 18:09:24

Since I have idiopathic hypersomnia, I've been prescribed dextroamphetamine to take as needed. Since we all know that Barr/Teva are horrific generic substitutes, I checked beforehand and found that my pharmacy was ordering from Mallinckrodt (a company that, when I was on dextroamphetamine before, didn't make the immediate-release tablets). I'm also taking 80 mg Parnate daily. In the past, I'd combined up to 40 mg Adderall + 15 mg Dexedrine Spansules with this dose of Parnate, so I wasn't concerned about adding a mere 10 mg.

The dextroamphetamine was ... different. It was like Dexedrine had taken a Dexedrine Spansule. It took longer than I would have wanted to start working but when it did it lasted an incredibly long time and those mere 10 mg felt excessive (I became hyperfocused, euphoric, and productive for about 12 hours now; the tablet is just now wearing off.)

I began to have a headache and began to get panicky when my blood pressure machine was out of batteries so I went to the pharmacy to have my blood pressure taken. It was definitely hypertensive and (according to guidelines) probably warranted a clonidine but I'd taken 1 mg of Klonopin right before that, hoping that the Klonopin would both calm me down and lower my blood pressure/heart rate. Fortunately, it did.

I have NEVER had 10 mg of dextroamphetamine affect me in this way before. My concern is that because I'm using it as needed for days when I need to wake up, I may experience transient hypertension and even a full-on hypertensive crisis, since my body won't be able to become tolerant to the drug. This is, of course, the whole idea behind making it a PRN.

Any suggestions? It took a WHILE to start working, which is also problematic because if I take a lower dose, I risk further excessive daytime sleepiness and inability to do things I need to do ... and yet if I take a higher dose, I risk hypertension. Would dissolving 5 mg sublingually increase the speed at which it works while also reducing the length/potency? The tablets can be cut in half.

I've yet to talk to my doctor but just wanted some opinions - and I'm wondering if anyone else has tried the new generic formulation of Dexedrine IR and found it equally as strong.

 

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