ADHD: LISDEXAMFETAMINE (AND DEXAMFETAMINE)

Question 1

Lisdexamfetamine and dexamfetamine MOA

Answer 1

Potent CNS stimulant.
Increases dopamine and noradrenaline levels in the brain.

Question 2

CI

Answer 2

Same as methylphenidate
- psychosis - suicidal thoughts, severe depression
- CVD
- Hyperthyroidism
- Severe hypertension

Question 3

Caution

Answer 3

• Anxiety + depressoin
• History of alcohol and drug abuse
• Epilepsy (can cause lower seizure threshold)
• Tics & Tourette’s syndrome

Question 4

SEs

DAWSIP

Answer 4

• Weight and appetite decreased
• Drowsiness (warning about driving)
• Altered mood
• Seizures (Stop if there is an increase in frequency)
• Psychiatric disorders
• Insomnia

Question 5

Which side-effects of Lisdexamfetamine are more common in children than adults?

Answer 5

• Depression
• Drowsiness
• Fever
• Psychiatric disorders
• Skin reactions
• Vomiting

Question 6

Overdose

Answer 6

• Wakefulness (note insomnia is a common side-effect of Lisdexamfetamine)
• Excessive activity
• Paranoia/ Hallucinations
• Hypertension

Followed by
- Convulsions
- Hyperthermia

Question 7

Knowing the side-effects of
Lisdexamfetamine,
What are the monitoring requirements?

Answer 7

Similar to Methylphenidate:
- BP / pulse
- Psychiatric symptoms including aggressive behaviours
- Weight & height at initiation, at dose change, and every 6 months

Question 8

Interaction with MAOIs

Answer 8

• Predicted to increase the risk of a hypertensive crisis
• SS

Question 9

-perazine antipsychotics interaction

Answer 9

They are predicted to decrease the effects of dexamfetamine and dexamfetamine is predicted to decrease their effects

Question 10

Dexamfetamine and SSRIs, SNRIs (dulox, venlfax), bupropion, TCAs, ondansetron, lithium, methadone, triptams, pethidine, vortioxetine etc

Answer 10

can increase the risk of serotonin syndrome