Also indexed as: Adderall, Dexamphetamine
This drug contains two central nervous system stimulants: amphetamine and
dextroamphetamine. It is used to treat narcolepsy and attention deficit disorder (ADD) with
hyperactivity.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 May Be Beneficial: Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them. |
Veratrum species
|
| May Be Beneficial: Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication. |
L-tryptophan*
Vitamin B6
|
| May Be Beneficial: Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better. |
Magnesium
Tyrosine
|
Avoid: Reduced drug absorption/bioavailability—Avoid these supplements
when taking this medication since the supplement may decrease the absorption and/or activity
of the medication in the body. |
Lithium
Vitamin C
|
|
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results. |
Alcohol
Magnesium
|
Check: Other—Before taking any of these supplements or eating any of
these foods with your medication, read this article in full for details. |
Ephedra
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
Magnesium
Dextroamphetamine can increase blood levels of magnesium, which causes significant lowering of
the calcium to magnesium ratio in the blood.
The change in this ratio may in part explain the effectiveness of stimulants like
dextroamphetamine in hyperactive boys.1 Another magnesium-amphetamine interaction
involves supplements of magnesium hydroxide,
which are known to cause retention of amphetamines in the body.2 This could
theoretically result in increased blood levels of these drugs. Finally, animal studies have
suggested that magnesium supplements can increase learning and enhance the behavioral response
to stimulants.3 For these reasons, the use of magnesium along with amphetamines may
enhance the effectiveness of these drugs in the treatment of ADD, but controlled studies of this possibility are
needed.
Vitamin
C
Ingestion of some types of vitamin C results in acidification of the intestinal contents and
thus a decreased absorption of amphetamines.4 Supplements containing vitamin C
should be taken an hour before or two hours after taking amphetamines.
Tyrosine
Tyrosine is an amino acid used by the body to
produce brain chemicals stimulated by amphetamines. Reduced stimulant effects of amphetamines
were observed in individuals who had been made tyrosine deficient.5 It is possible
that a dietary deficiency of tyrosine may reduce the effectiveness of amphetamines. Tyrosine
deficiency is not common unless a protein deficiency exists. Adequate tyrosine intake from
dietary protein or supplements is necessary in individuals taking amphetamines.
Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts
to treat mood disorders such as bipolar
disorder (manic depression). Taking lithium at the same time as amphetamines may inhibit
the appetite suppressant and stimulatory effects of the amphetamines.6 Therefore,
people taking amphetamines should take lithium only under the supervision of a doctor.
Vitamin
B6
Occasionally, individuals taking amphetamines develop compulsive behavior and anxiety, even after the drug is discontinued. When
this side effect occurred in an eight-year-old boy,7 supplementation with 200 mg
vitamin B6 each day for one week followed by 100 mg daily, reduced the compulsive behavior and
anxiety within three weeks. The symptoms were eliminated after a few months of treatment.
Controlled research is needed to determine conclusively the usefulness of vitamin B6
supplementation for preventing and treating this side effect.
L-tryptophan
In an uncontrolled study of schizophrenic
patients, 200 mg per day of L-tryptophan reduced disturbances in thinking, as well as
hallucinations caused by dextroamphetamine.8 Symptoms of psychosis rarely occur in
people who take amphetamines and are not schizophrenic. Controlled research is needed to
establish the benefits of L-tryptophan and related supplements for people taking
amphetamines.
Interactions with Herbs
Ephedra
Ephedra sinica contains a compound called ephedrine. A seven-year-old boy who had 12
mg of ephedrine twice daily added to his dextroamphetamine therapy experienced improvement in
hyperactive behavior.9 He also experienced relief from symptoms, such as headaches
and spots before his eyes, that may have been caused by dextroamphetamine. However, concurrent
use of amphetamines with other stimulants such as ephedrine or Ephedra sinica could
cause excessive stimulation of the heart or nervous system. For this reason, such combinations
should be used with great caution, and only under the supervision of a doctor.
Veratrum (Veratrum sp.)
Veratrum (Hellebore) is an herb used by doctors of natural medicine to treat high blood pressure;however, amphetamines can inhibit
this effect.10 Therefore, people taking veratrum to treat hypertension should avoid
amphetamines.
Interactions with Foods and Other Compounds
Fruit juices
Fruit juices may acidify the intestinal contents, causing reduced absorption of
amphetamines.11 Therefore, juices should be consumed an hour before or two hours
after administration of amphetamines.
Alcohol
The combination of alcohol and methamphetamine makes the heart work harder and consume more
oxygen, which may produce unwanted effects.12 Alcohol consumption may also suppress
the breakdown of amphetamines, causing elevations in blood levels of the drug.13
Individuals taking amphetamines should avoid alcoholic beverages, especially if they have
known heart problems.
References:1. Schmidt ME, Kruesi MJ, Elia J, et al. Effect of dextroamphetamine and
methylphenidate on calcium and magnesium concentration in hyperactive boys. Psychiatry
Res 1994;54:199–210.
2. Hurwitz A. Antacid therapy and drug kinetics. Clin
Pharmacokinet 1977;2:269–80.
3. Reviewed in Schmidt ME, Kruesi MJ, Elia J, et al. Effect of
dextroamphetamine and methylphenidate on calcium and magnesium concentration in hyperactive
boys. Psychiatry Res 1994;54:199–210.
4. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2953–4.
5. McTavish SF, McPherson MH, Sharp T, Cowen PJ. Attenuation of some
subjective effects of amphetamine following tyrosine depletion. J Psychopharmacol
1999;13:144–7.
6. Sifton, DW, ed. Physicians Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2953–4.
7. Frye PE, Arnold LE. Persistent amphetamine-induced compulsive rituals:
response to pyridoxine (B6). Biol Psychiatry 1981;16:583–7.
8. Irwin MR, Marder SR, Fuentenebro F, Yuwiler A. L-5-hydroxytryptophan
attenuates positive psychotic symptoms induced by D-amphetamine. Psychiatry Res
1987;22:283–9.
9. Scanlon J. Treatment of hyperkinetic child with dextroamphetamine and
ephedrine. Pediatrics 1970;46:975–6.
10. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2953–4.
11. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2953–4.
12. Mendelson J, Jones RT, Upton R, Jacob P 3rd. Methamphetamine and
ethanol interactions in humans. Clin Pharmacol Ther 1995;57:559–68.
13. Shimosato K. Urinary excretion of p-hydroxylated methamphetamine
metabolites in man. II. Effect of alcohol intake on methamphetamine metabolism. Pharmacol
Biochem Behav 1988;29:733–40.