Safety Disclaimer for Stimulant Medications
Before starting stimulant medication, you must inform your doctor if you or your family have any history of heart problems, sudden death, psychosis, bipolar disorder, substance abuse, glaucoma, seizures, or tics, as these conditions require special evaluation or may prevent safe use of these medications. 1
Absolute Contraindications - Do NOT Use If:
- You are currently taking or have taken MAO inhibitor medications within the past 14 days (risk of severe hypertension and stroke) 1
- You have active psychosis, schizophrenia, or are experiencing a manic episode with psychotic symptoms 1
- You have glaucoma (stimulants may increase eye pressure) 1
- You have a history of recent stimulant drug abuse or dependence, unless under close medical supervision in a controlled setting 1, 2
Cardiac Safety Requirements - Must Screen Before Starting:
Your doctor must obtain your personal and family history for: 1
- Sudden unexplained death in family members
- Structural heart abnormalities or cardiomyopathy
- Wolff-Parkinson-White syndrome
- Long QT syndrome
- Hypertrophic cardiomyopathy
- Serious cardiac arrhythmias or coronary artery disease
If any cardiac risk factors are present, you will need an electrocardiogram (ECG) and possibly cardiology evaluation before starting stimulants. 1, 3
Common Side Effects to Expect:
- Decreased appetite, abdominal pain, headaches, and sleep disturbance (most common) 1
- Mild increases in heart rate (1-2 beats per minute) and blood pressure (1-4 mmHg) 1
- Potential growth reduction of 1-2 cm from predicted adult height in children on higher, consistent doses 1
Note: 5-15% of patients may experience more substantial increases in heart rate and blood pressure requiring monitoring. 1
Serious Psychiatric Risks - Seek Immediate Help If:
- New hallucinations, delusions, or manic symptoms develop (occurs in approximately 0.1% of patients) 1, 3
- Worsening of pre-existing psychotic symptoms 3
- Severe mood changes, especially if you have a personal or family history of bipolar disorder or depression 1, 3
Other Important Warnings:
- Priapism (prolonged painful erections): Seek immediate medical attention if erections last more than 4 hours 3
- Seizure risk: If you have a seizure disorder, it must be controlled with anticonvulsants before starting stimulants 1
- Growth monitoring: Children require regular height and weight measurements 1
- Vital sign monitoring: Blood pressure and heart rate should be checked regularly during treatment 1
Abuse and Misuse Potential:
Stimulants have high potential for abuse, misuse, and addiction. 3
- Store medication in a locked, secure location 3
- Never share your medication with others 3
- Do not use higher doses or alternative routes (snorting, injection) as this increases overdose and death risk 3
- If household members have substance abuse history, additional safeguards are needed 1, 2
Special Populations:
- Pregnancy/Breastfeeding: Discuss risks and benefits with your doctor; limited but largely reassuring safety data exists 1
- Tics/Tourette's: Contrary to package inserts, controlled studies show stimulants generally do not worsen tics, though individual monitoring is needed 1
- Anxiety disorders: Can be safely treated with stimulants in most cases 1
When to Contact Your Doctor Immediately:
- Chest pain, shortness of breath, or fainting 1, 3
- New or worsening psychiatric symptoms 1, 3
- Prolonged painful erections 3
- Signs of allergic reaction
- Significant changes in heart rate or blood pressure 1
The benefits of treating ADHD with stimulants generally outweigh risks when medications are used appropriately under medical supervision, but careful monitoring is essential. 4, 5