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drugs / psychostimulants / non-psychostimulants authorized

Non-psychostimulants authorized for the treatment of ADHD

Caution​

Intuniv XR:

  • Sedation is an undesirable effect which has been frequently reported during clinical studies.

  • Syncope and decreases in heart rate and blood pressure may be dose-related.

  • Blood pressure and heart rate may be increased when treatment is discontinued.

  • The effectiveness of Intuniv XR for long-term treatment, ie more than 9 weeks, has not been rigorously evaluated in controlled trials. Therefore, physicians who choose

  • using Intuniv XR for an extended period of time should periodically re-evaluate the long-term usefulness of this medication in each individual.

 

Straterra:

  • Possible behavioral and emotional effects that may lead to self-harm.

  • In the presence of jaundice or biological signs of liver damage, stop treatment and do not resume it.

  • Effects on growth and development should be monitored.

  • There have been reports of sudden death in children and adolescents with heart defects taking Strattera at usual doses.

  • Risks of suicidal behavior and thoughts in children have been reported.

Directions​

Attention deficit disorder with or without hyperactivity (ADHD)

Contraindications​

Intuniv XR:

  • Heart problem (a very low heart rate  or a heart rhythm disorder)

  • Fainting in the past or current

  • Low blood pressure

  • Liver disease or kidney disease

  • Any other disease

 

Straterra:

  • Angle-Closure Glaucoma

  • Monoamine oxidase inhibitor  (MAOI)

  • Product allergy

  • Pheochromocytoma (tumor condition11 sometimes malignant): possibility of high blood pressure and tachyarrhythmia

  • Heart disease

  • Moderate to severe hypotension

  • Advanced arteriosclerosis

  • Uncontrolled hyperthyroidism

Drugs interactions​

Intuniv XR:

  • Ketoconazole antifungal used to treat fungal infections of the mouth (thrush), esophagus, reproductive tract (yeast infection) and other areas

  • Valproic Acid (Depakene)

  • Drugs that slow heart rate

  • Drugs that prolong the QT interval (electrical duration of heart contraction)

 

Straterra:

  • Monoamine oxidase inhibitors (MAOIs)

  • Desipramine (tricyclic antidepressant)

  • Antihypertensives and pressor agents

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Side effects​

They depend on the dosage and duration of treatment, the metabolism of the individual and the context in which he lives.

 

Frequent

 

Intuniv SR

  • Headache

  • Dizziness

  • Nausea

  • stomach pain

  • Drowsiness

  • Fatigue

  • Difficulty sleeping

  • Low blood pressure

 

strattera

 

In children over 6 years old and adolescents:

  • stomach troubles

  • Decreased appetite

  • Nausea or vomiting

  • Dizziness

  • Fatigue

  • Constipation

  • Hypotension

 

In adults:

  • Constipation

  • Dry mouth

  • Nausea

  • Decreased appetite

  • Dizziness

  • Difficulty sleeping

  • Sexual side effects

  • Difficulty urinating

  • Rapid or irregular heartbeats

  • Fatigue

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Infrequent or rare

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Intuniv SR

  • Fainting

  • Seizures

  • Allergic reaction to the product

 

strattera

  • Swelling or hives

  • Prolonged and painful erection without sexual arousal (priapism)

  • suicidal behavior

  • New psychotic or manic symptoms

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Therapeutic effects​

Helps increase attention span (including the ability to follow directions and complete a task) and reduce impulsivity and hyperactivity.

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Monitoring and medical supervision ​

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Intuniv SR

Before treatment :

> Warn the doctor in case of:

  • cardiac problem  (a very low frequency  heart or a heart rhythm disorder)

  • fainting in the past or current

  • low blood pressure

  • liver disease

  • kidney disease

  • any other disease

 

> Tell the doctor about all medications, vitamins, products used in alternative medicine and any plant-based product

that you take.

 

During treatment :

> Measure blood pressure and heart rate at the start of treatment.

> Check growth and weight regularly.

> Avoid dehydration or exposure to excessive heat.

> Measure blood pressure and heart rate at the start of treatment, after  dose adjustments at regular intervals.

 

After treatment :

Measure blood pressure and heart rate after discontinuation of treatment.

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Straterra

Before treatment :

> Warn the doctor in case of:

  • Structural heart abnormalities

  • Congenital or acquired long QT syndrome

  • Fainting in the past or current

  • mental health problem

  • Seizures (convulsions, epilepsy)

  • Brain blood vessel disorders

  • Family history of sudden death or death related to heart problems

  • Intense exercises

  • Taking other ADHD medications

  • liver disease

  • Hypertension

  • Low blood pressure

 

> Measure heart rate and blood pressure.

> Tell the doctor about all medicines, vitamins, products used in alternative medicine and any product  herbal medicine that you take.

 

During treatment :

> Measure blood pressure and heart rate at the start of treatment.

> Development and growth monitoring.

> Daily observation by families and caregivers.

> Consult the doctor immediately if the following hepatic signs are present:

  • Dark urine

  • Yellow skin and eyes

  • Pain in the right quadrant of the abdomen

  • Itching

  • Flu-like symptoms

> Consult the doctor immediately if there is aggravation or the appearance of new emotional or behavioral problems.

 

After treatment :

Measure blood pressure and heart rate after discontinuation of treatment.

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Withdrawal symptoms

Psychotropic drugs act in the brain just as they do in the rest of the body; and as we have seen, each person reacts differently. It's the same with weaning; the person's metabolism, the type of drug, the dose as well as the duration of the intake and its half-life, explain that the withdrawal effects are varied. We have listed the potential and main withdrawal symptoms of each class of psychotropic drugs. This list is incomplete, as not all withdrawal effects are listed; moreover, knowledge is rapidly evolving in this field. A person may have no withdrawal symptoms or experience one, a few, or even many. The medication reduction journey is specific to each person, just as each process is unique. For example, a person can take the same medicine twice at the same dose and the effects will be different. Gradual reduction, like removing 10  % of dose per week/month, reduces the frequency or intensity of withdrawal symptoms and the incidence of rapid relapses. It is very important to undertake this process with the collaboration of your doctor. The pharmacist also plays a key role and can provide guidance to monitor withdrawal effects for each drug. Most people who will have withdrawal symptoms will tolerate them without problems for the short duration of these symptoms.

 

Common and frequent withdrawal symptoms for all classes: anxiety, nervousness, restlessness, sleep problems, greater need to rest, sleep, irritability, fatigue.

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