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  • Q&A with Australian Health Practitioners

    Should I keep taking Dexamphetamine?

    Related Topics
    Anxiety Attention Deficit/Hyperactivity Disorder Autism Spectrum Disorder
    I am 21 years old, I have got OCD with more obsessive thinking often of intrusive nature about certain topics. I think I have ADD for which I am currently taking Dexamphetamine twice per day. Other say I dont seem as sharp as usual when speaking which has bothered me somewhat as I am really good at talking verbally, but when it comes to applying my mind especially to write something like an essay paper I really struggle and if I eventually do it is really time consuming taking way longer than it should.
    I am suffering in my studies and have been long term unemployed, which is really disheartening for me as I consider myself to be literate in my own way, but gaining any sort of formal qualification often feels like an insurmountable task.

    After taking the medication for over a week I found that I simply didn't feel myself often feeling light-headed and spaced out. Is this normal with Dex and should I continue? I believe I may have a mild form of Autism, but that hasnt been diagnosed.
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    Dr Toni Metelerkamp

    Clinical Psychologist, Psychologist

    As a humanist, I believe everyone wants and deserves happiness, but life sometimes takes us on unexpected paths, making it challenging to be in the … View Profile

    It sounds like you’re trying hard to make some positive changes, but that you’re bumping up against a few different things at the moment.
     
    Firstly, I’d suggest that you talk to the doctor who prescribed your medication before making any changes to the way you take the medication.  Try to have an open discussion.  Ask how the medication should help and roughly when you should start noticing the changes. It takes time for certain medications to have the desired impact and often there is an adjustment period.  If you can, use a diary to monitor the changes and that way you can speak with confidence when you do talk to your doctor again. 
     
    It is important to remember that Dexamphetamines do not “cure” ADD, but can make the condition more manageable.  Even then, you will need to learn alternate ways of doing things if you want to make long-term changes. Ask your doctor about access to a psychologist to help you make behavioral changes.
     
    I realize I’m suggesting that you do a fair bit if work, but when it comes to medication for psychological issues, it is difficult for doctors to know whether medication is helping at all or how much it is helping. Unlike X-rays or blood tests, that show more clearly what is going on, the person having the difficulties is best placed to describe psychological symptoms. That means you need to keep talking to your doctor about medication dosage and things like the side effects of the medication.  If you have concerns about undiagnosed Autism explain to your doctor why you think you have Autism and ask whether a referral for an assessment is warranted. 
     
    I wish you well in your studies and in the chats with your doctor. 

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    Thanks

    Dr Peter Heffernan

    Psychiatrist

    I am a Consultant Psychiatrist and Psychoanalytic Psychotherapist who specialises in Adult ADHD, Jungian Psychotherapy, and the Psychological Medicine aspects of Chronic Pain conditions. View Profile

    ADHD and OCD uncommonly coexist, and require Specialist Psychiatrist assistance.

    The symptoms you describe are side effects of the dexamphetamine, or the combination of dexamphetamine and the medication you are taking for the OCD, and you must report these side effects to your prescribing doctor immediately.

    A lower dose of the dexamphetamine is indicated. The prescribing doctor should always start with a test dose of no more than 2.5 mg dexamphetamine and cautiously increase the dose according to tolerability and benefit.

    Your case may require a shift to the slow release version, lys-dexamphetamine, or a reduction in the dose of your OCD medication, or a shift to the alternative ADHD medications, methylphenidate, atomoxetine, or guanfacine.

    With the medications now available, an excellent response is to be expected, although not guaranteed. Your Specialist Psychiatrist will advise. 

    A referral to a Clinical Psychologist with expertise in ADHD, as part of the management team, is appropriate, but will not provide the kind of benefit that usually comes from the appropriate dose of the appropriate medications. 

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