Autoimmune Thyroid Disease

An Unfortunate and Lengthy Adventure in Misdiagnosis

Why Britney is manic?

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If anyone reading this blog is remotely interested in the car-crash life of Britney Spears, here’s a little insight for you:

Britney admitted to to the doctors that she was on ADD medication Adderall, aka cocaine in a pill, and was taking up to ten laxatives a day. Perez Hilton

Adderall is an ADHD medication. Technically it’s speed in a pill, not cocaine. Here’s what it does:

Amphetamines, both as dextroamphetamine and levoamphetamine (or a racemic mixture of the two enantiomers), are believed to exert its [sic] effects by binding to the monoamine transporters and increasing extracellular levels of the biogenic amines dopamine, norepinephrine and serotonin.

[…]

Amphetamine also possesses the ability to inhibit the enzymes monoamine oxidase A and B (MAO-A and MAO-B) in high doses. MAO-A is responsible for the break down of serotonin, dopamine, norepinephrine and epinephrine. MAO-B is responsible for breaking down dopamine (more potently than MAO-A) and phenylethylamine (PEA), which has actions similar to amphetamine itself and is thought to be involved in feelings of lust, confidence, obsession and sexuality. Adderall

A side effect of adderall is weight loss, probably why Britney has been taking it, as she has struggled with her weight since her first pregnancy.

Adderall increases dopamine: great if you have a DRD4 polymorphism that leaves you with low dopamine levels. Not so great if you are bipolar as a result of high dopamine levels.

What does the FDA say about amphetamines and bipolar disorder?

The FDA also warned that stimulant therapy can exacerbate symptoms of behavior disturbance and thought disorder in patients with preexisting psychotic disorders.

Amphetamines should be used with caution in attention-deficit/hyperactive disorder patients with comorbid bipolar disorder because of the potential risk for induction of a mixed/manic episode. Pretreatment screening should therefore also include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression.

Also, psychotic/manic symptoms (eg, hallucinations, delusional thinking, and mania) have been reported at normal amphetamine doses in children and adolescents without prior history of these conditions. Data from a pooled analysis of multiple short-term studies have revealed an incidence rate for these events of 0.4% in methylphenidate- or amphetamine-treated patients compared with 0% for those receiving placebo. A potential causal role for the stimulant should be considered in patients who develop symptoms of psychosis or mania; discontinuation of therapy may be indicated. Medscape Today

Whoever prescribed Britney amphetamines deserves to be struck off. I feel very sorry for her right now.

Edit: more on Britney. Risperdal and Seroquel are both prescribed to people with bipolar disorder and schizophrenia, and they have some really unpleasant side effects – like diabetes. Both currently have class action lawsuits underway against them. Risperdal is a dopamine blocker. Who the heck prescribes Risperdal and Adderall in the same patient?

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Written by alienrobotgirl

31 January, 2008 at 8:19 pm

Posted in Neurotransmitters

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