This is the
talk page for discussing improvements to the
Lisdexamfetamine article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: 1 |
This article is rated B-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | |||||||||||||||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Lisdexamfetamine.
|
Revisions succeeding
this version of this article is substantially duplicated by a piece in an external publication. Please do not flag this article as a copyright violation of the following source:
|
I changed wording of "indicated" to "can be prescribed"..."for treatment". Although use of the word indicated is generally understood by the medical profession to mean that it has been approved for use by the FDA, I'm concerned that use in this article implies to readers that "indicated" could mean the non-medical jargon use of the word which is defined as "suggest as a desirable or necessary course of action." with synonyms to the non-medical use of "indicated", being:: "advisable, recommended, suggested, desirable, preferable, best, sensible, wise, prudent, in someone's best interests"-----which is not always the case in drug use, although again, in medical jargon, "indicated" means something else. 24.0.133.234 ( talk) 14:13, 13 June 2014 (UTC)
This entry looks very promotional and uncritical, which is a concern because many critics complain that Shire is been promoting its drugs heavily and inappropriately to the public. Here's a recent article in the New York Times:
http://www.nytimes.com/2015/02/25/business/shire-maker-of-binge-eating-drug-vyvanse-first-marketed-the-disease.html?
Shire, Maker of Binge-Eating Drug Vyvanse, First Marketed the Disease
By KATIE THOMAS
FEB. 24, 2015
(Vyvanse (Shire) is an amphetamine prodrug, $1.5 billion/year sales, recently new approval for binge eating. FDA granted priority approval, without advisory committee hearings or recommendations, because there was no other drug to treat binge eating. Shire hired retired tennis player Monica Seles to make the talk show circuit to promote awareness of binge eating. Shire similarly promoted Adderall and Vyvanse for ADHD. Lawrence H. Diller, behavioral pediatrician, Walnut Creek, CA, and critic of ADHD treatment, quoted. Shire web site on binge eating disorder offers printable symptom checklist and opening lines to start conversation with doctor, tells patients “don’t give up” if a doctor initially resists. Critics say "appeared to coach patients about how to receive a diagnosis for a relatively uncommon condition, or shop for a new doctor if they were not successful.")
This entry also seems to be quoting selectively from the Cochrane reviews. Here's one that I got with a search for lisdexafetamine:
http://www.aafp.org/afp/2012/0901/p413.html
Amphetamines for Attention-Deficit/Hyperactivity Disorder in Adults
Am Fam Physician. 2012 Sep 1;86(5):413-415.
Authors' Conclusions: Amphetamines improved short-term ADHD symptom severity. Mixed amphetamine salts also increased retention in treatment. Amphetamines were associated with higher attrition due to adverse events. The short study length and the restrictive inclusion criteria limit the external validity of these findings. Furthermore, the possibility that the results of the included studies were biased was high, which could have led to an overestimation of amphetamine efficacy.
--
Nbauman (
talk) 17:17, 25 February 2015 (UTC)
Why would anyone take a dextroamphetamine precursor when you can buy actual dextro? Verdana♥Bøld 23:10, 22 November 2015 (UTC) — Preceding unsigned comment added by Verdana Bold ( talk • contribs)
He doesn't refer to a specific point in the text. He points out that on the entire page, there is not a single reason mentioned what the benefits are for using a prodrug. It definitely is one of the most important questions that should be answered on the page. Otherwise the page isn't any different from the regular (dex)amphetamine page.
The main of advantage of prodrugs is that they are released more slowly and evenly in the system. This could lower the plasma peak in the user and potential side-effects. That the lisdexamfetamine gets released more slowly in the usersystem can be seen from the "Onset of Action" in the general information bar on the wikipages. The onset of action is for lisdexamfetamine 2 hours. For regular (dex)amphetamine the onset of action is 30 - 60 minutes.
The lisdexamfetamine has about the same tolerability and effectiveness as extended release dexamphetamine. [1] Lisdexamfetamine also has potentially lower abuse potential.
This article mentions a couple differences between lisdexamfetamine and dexamphetamine.
[2]
Rowley, H. (2012). Lisdexamfetamine and immediate release d-amfetamine–Differences in pharmacokinetic/pharmacodynamic relationships revealed by striatal microdialysis in freely-moving rats with simultaneous determination of plasma drug concentrations and locomotor activity. Neuropharmacology, 63(6), 1064-1074."
References
Bonnom ( talk) 15:55, 29 April 2016 (UTC)
Why is the single largest section on this page a generic amphetamine addiction cut/paste? At one point it even goes into addiction recovery and opiate addiction. Amphetamine addiction is almost entirely the result of abuse. Lisdexamfetamine MOA makes it very hard (impossible?) to abuse... information that isn't even mentioned. — Preceding unsigned comment added by Billyoffland ( talk • contribs) 15:55, 12 March 2016 (UTC)
The point is being missed. Neither Water or Properties of water make any mention of drowning potential or methods of resuscitation. This article is on Lisdexamfetamine. Not Lisdexamfetamine addiction / addiction recovery. Alcohol, Nicotine and Opiate make no / limited mention of addiction / recovery. Notoriously addictive Oxycodone and Benzodiazepine (eg Alprazolam) also make appropriately limited mention of related but not necessary relevant topics. Here is an NIH report on the reduced abuse potential of Lisdexamfetamine http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/ that can be included in this article as it's directly related to Lisdexamfetamine specifically.
More commonly, "Generic" means generally related to. I said the cut/paste was of generic (as in relating to general) "amphetamine addiction". "LDX" (as you call it) is indeed a prodrug. "hence it shares its addiction mechanisms" is not accurate. The very information in your cut/paste on addiction talks about dependence verses addiction verses addictive behaviors. Billyoffland ( talk) 15:41, 14 March 2016 (UTC)
I was recently prescribed this I came here for some more info. The page is named 'Lisdexamfetamine' but it is spelled as 'lisdexamphetamine' several times throughout. I looked up this difference and it seems to be the same thing as color/colour and armor/armour where it is just the British spelling and the U.S. spelling. I know that even a two letters difference can mean wildly different chemicals. I'm posting this here because I want to give a notice before I change what I can to make it more parsimonious. I'll be changing every 'lisdexamfetamine' to 'lisdexamphetamin' to help clear the confusion of using two different words for the same thing — Preceding unsigned comment added by Sigil47 ( talk • contribs) 02:50, 16 May 2016 (UTC)
Is there any reason to have this article and dextroamphetamine separate from amphetamine? Jytdog ( talk) 22:36, 10 July 2017 (UTC)
The article claims a duration of action of 10-12 hours which is twice as long as normal dexedrine. Considering that lisdexamphetamine is metabolised into its active ingredient dexamphetamine within one to two hours this doesn't make sense to me. I suggest someone with access to sources 2, 4 and 5 checks whether they support this claim. 12:58, 21 April 2018 (UTC) — Preceding unsigned comment added by 92.218.227.67 ( talk)
The longer duration reflects the extended release dosage forms of all current lisdexamfetamine pharmaceuticals, which are combined with inactive polymers that slow their absorption. The duration of action of a hypothetical "immediate release" lisdexamfetamine dosage form hasn't been published in academic literature, but I assume it would be roughly the same as IR dextroamphetamine formulations.I find it a bit bizarre that I actually wrote this given that I know LDX is just formulated as an inactive prodrug and its conversion to dextroamphetamine is, as Garzfoth restated, mediated by a rate-limiting enzyme in blood. I suppose I could've conflated LDX and ER amphetamine salt formulations if I were drunk and/or half-asleep or drunk, but I honestly don't remember what I was thinking when I wrote that. In any event, what I originally wrote is, indeed, completely wrong.
@ Doc James: Can you restore this statement with clarification? I don't know what this means and I imagine neither do our readers. In what context and by whom is this less preferred? E.g., by British adults for the treatment of ADHD? By American children for the same purpose?
"It is usually less preferred than methylphenidate. [1]"
Seppi333 ( Insert 2¢) 06:58, 17 April 2019 (UTC)
References
"Chemically, lisdexamfetamine belongs to the class of substituted amphetamines."
Not saying it is incorrect. But if not source makes the claim it makes one wonder how notable it is? Probably best to go in the body of the text regardless.
Doc James ( talk · contribs · email) 14:40, 17 April 2019 (UTC)
Does anyone recommend its use? All the sources including the manufacturer recommend against such use. Unless someone reputable states otherwise we can just state it as fact. Doc James ( talk · contribs · email) 14:45, 17 April 2019 (UTC)
May occur not just in overdose but when this is used in combination with other medications per the source. [2] Doc James ( talk · contribs · email) 14:45, 17 April 2019 (UTC)
These are two different conditions within psychiatry and the reference deals with them separately. Ref says "Manic symptoms may occur with usual dosages in children and adolescents without prior history of mania." [3] Doc James ( talk · contribs · email) 14:48, 17 April 2019 (UTC)
Lisdexamfetamine is classified as a CNS stimulant. This is despite the fact that it is converted into dextroamphetamine first. Just because something requires metabolism in the body does not mean it is not in that class of medications. Stating that it "works after being converted by the body" is how one says in common English that it is a prodrug. Technical terminology can generally go in the body. Doc James ( talk · contribs · email) 14:53, 17 April 2019 (UTC)
Ideally, this statement in the lead - Serious side effects may include sudden cardiac death, mania, and psychosis.[3] It has a high risk of abuse.[3][dubious – discuss]
- should be rephrased to mirror these statements (N.B. the prevalence of amphetamine psychosis at therapeutic doses is about 1 in 1000):
Larger doses of amphetamine may impair cognitive function and induce rapid muscle breakdown. Drug addiction is a serious risk with large recreational doses but is unlikely to arise from typical long-term medical use at therapeutic doses. Very high doses can result in psychosis (e.g., delusions and paranoia) which rarely occurs at therapeutic doses even during long-term use. Recreational doses are generally much larger than prescribed therapeutic doses and carry a far greater risk of serious side effects.
— Amphetamine lead
USFDA-commissioned studies from 2011 indicate that in children, young adults, and adults there is no association between serious adverse cardiovascular events ([ sudden cardiac death ], heart attack, and stroke) and the medical use of amphetamine or other ADHD stimulants.); cardiovascular disease is a contraindication for that reason.
Evidence from human studies indicates that therapeutic amphetamine use does not cause developmental abnormalities in the fetus or newborns (i.e., it is not a human teratogen), but amphetamine abuse does pose risks to the fetus." [1] Alternatively, we could attribute the recommendation; I don't care either way. All other recommendations/normative statements in this article are attributed already.
Seppi333 ( Insert 2¢) 05:26, 18 April 2019 (UTC)
References
Appears we have decent sources saying there is no physical dependence or that their is physical dependence at high doses.
For example see [5] Doc James ( talk · contribs · email) 17:40, 19 April 2019 (UTC)
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
High quality sources disagree. Thus for "dependence liability: physical" we should put either "controversial" or "disputed".
We have multiple high quality sources that support physical dependence. We have the following text under the heading for "lisdexamfetamine" in this medical textbook.
Physical dependence. Chronic amphetamine use produces physical dependence. If amphetamines are abruptly withdrawn from a dependent person, an abstinence syndrome will ensue. Symptoms include exhaution, depression, prolonged sleep... Rosenthal, Laura; Burchum, Jacqueline (2017). Lehne's Pharmacotherapeutics for Advanced Practice Providers - E-Book. Elsevier Health Sciences. ISBN 9780323447799.
We also have the current source which says
cessation of cocaine use and the use of other psychostimulants in dependent individuals does not produce a physical withdrawal syndrome but may produce dysphoria, anhedonia, and an intense desire to reinitiate drug use.
Doc James ( talk · contribs · email) 04:49, 22 April 2019 (UTC)
Lots of more examples of books that mention physical dependence from stimulants
Doc James ( talk · contribs · email) 05:05, 22 April 2019 (UTC)
characterised by general weakness and low mood" - why did you leave out the part where they specify symptoms of psychological dependence? Is it because it contradicts your argument? I'd wager that's the reason for your omission.
cessation of cocaine use and the use of other psychostimulants in dependent individuals does not produce a physical withdrawal syndrome but may produce dysphoria, anhedonia, and an intense desire to reinitiate drug use.- read physical dependence and psychological dependence.
Not seeing it here. Not seeing it at WP:MEDMOS. I oppose this. Doc James ( talk · contribs · email) 11:14, 23 May 2019 (UTC)
This IMO does not belong in the first sentence " codrug composed of the amino acid L-lysine, attached to dextroamphetamin"
Doc James ( talk · contribs · email) 16:09, 29 November 2019 (UTC)
This article has a surprisingly bad noise/data ratio. Too much is transcluded or just pasted from [amphetamine] or similar articles, not directly specific to Lisdexamfetamine. The result is an essentially useless article that looks very detailed and authoritative, but requires too much effort to find out what is actually relevant to the subject matter. It might be relevant to have links to amphetamine data when there is none available that is specific to Lisdexamfetamine, but not pretend it should simply be pasted here. YamaPlos talk 19:19, 10 July 2020 (UTC)
I have revised the dependence liability of lisdexamfetamine to moderate to align with the growing body of evidence [1] and current expert consensus [2] that lisdexamfetamine has an appreciably lower potential for dependence compared to that of dextroamphetamine ( Dexedrine) or mixed amphetamine salts ( Adderall). RiMediaN ( talk) 01:20, 30 March 2021 (UTC)
References
{{
cite journal}}
: Cite journal requires |journal=
(
help); Missing or empty |title=
(
help)
On this edit, @ WikiLinuz: reversed my edit mentioning cognitive disengagement syndrome (CDS) as a treatable condition by lisdexamfetamine on the basis of the secondary source being an "advocacy study" thus not gaining sufficient recognition. This criticism is unfounded. CDS has reached the threshold of recognition as a distinct syndrome as established by the International Consensus Statement on CDS, which I cited as part of my edit, in addition to the primary research it reviews. It is not a promotive idea, but rather a statement of fact, as the scientific consensus makes plain. It is not an "advocacy study". To claim it has not reached the recognition threshold is to contradict the international scientific consensus.
Please note that the current status of diagnostic manuals are quite irreverent as they are not leading the research, but follows it and often a decade or two behind where the research is at the time. And the decisions made by the APA for instance are also political, not just scientifically-based so its hard to know where this will go in the subsequent DSM version. Thus the condition not being recognised in diagnostic manuals does not preclude it from being a distinct syndrome.
Therefore, this edit should not have been redacted on this article. Please discuss/refute/or attest if my understanding of the guidelines here are misled. Димитрий Улянов Иванов ( talk) 19:59, 18 February 2024 (UTC)
This is the
talk page for discussing improvements to the
Lisdexamfetamine article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: 1 |
This article is rated B-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | |||||||||||||||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Lisdexamfetamine.
|
Revisions succeeding
this version of this article is substantially duplicated by a piece in an external publication. Please do not flag this article as a copyright violation of the following source:
|
I changed wording of "indicated" to "can be prescribed"..."for treatment". Although use of the word indicated is generally understood by the medical profession to mean that it has been approved for use by the FDA, I'm concerned that use in this article implies to readers that "indicated" could mean the non-medical jargon use of the word which is defined as "suggest as a desirable or necessary course of action." with synonyms to the non-medical use of "indicated", being:: "advisable, recommended, suggested, desirable, preferable, best, sensible, wise, prudent, in someone's best interests"-----which is not always the case in drug use, although again, in medical jargon, "indicated" means something else. 24.0.133.234 ( talk) 14:13, 13 June 2014 (UTC)
This entry looks very promotional and uncritical, which is a concern because many critics complain that Shire is been promoting its drugs heavily and inappropriately to the public. Here's a recent article in the New York Times:
http://www.nytimes.com/2015/02/25/business/shire-maker-of-binge-eating-drug-vyvanse-first-marketed-the-disease.html?
Shire, Maker of Binge-Eating Drug Vyvanse, First Marketed the Disease
By KATIE THOMAS
FEB. 24, 2015
(Vyvanse (Shire) is an amphetamine prodrug, $1.5 billion/year sales, recently new approval for binge eating. FDA granted priority approval, without advisory committee hearings or recommendations, because there was no other drug to treat binge eating. Shire hired retired tennis player Monica Seles to make the talk show circuit to promote awareness of binge eating. Shire similarly promoted Adderall and Vyvanse for ADHD. Lawrence H. Diller, behavioral pediatrician, Walnut Creek, CA, and critic of ADHD treatment, quoted. Shire web site on binge eating disorder offers printable symptom checklist and opening lines to start conversation with doctor, tells patients “don’t give up” if a doctor initially resists. Critics say "appeared to coach patients about how to receive a diagnosis for a relatively uncommon condition, or shop for a new doctor if they were not successful.")
This entry also seems to be quoting selectively from the Cochrane reviews. Here's one that I got with a search for lisdexafetamine:
http://www.aafp.org/afp/2012/0901/p413.html
Amphetamines for Attention-Deficit/Hyperactivity Disorder in Adults
Am Fam Physician. 2012 Sep 1;86(5):413-415.
Authors' Conclusions: Amphetamines improved short-term ADHD symptom severity. Mixed amphetamine salts also increased retention in treatment. Amphetamines were associated with higher attrition due to adverse events. The short study length and the restrictive inclusion criteria limit the external validity of these findings. Furthermore, the possibility that the results of the included studies were biased was high, which could have led to an overestimation of amphetamine efficacy.
--
Nbauman (
talk) 17:17, 25 February 2015 (UTC)
Why would anyone take a dextroamphetamine precursor when you can buy actual dextro? Verdana♥Bøld 23:10, 22 November 2015 (UTC) — Preceding unsigned comment added by Verdana Bold ( talk • contribs)
He doesn't refer to a specific point in the text. He points out that on the entire page, there is not a single reason mentioned what the benefits are for using a prodrug. It definitely is one of the most important questions that should be answered on the page. Otherwise the page isn't any different from the regular (dex)amphetamine page.
The main of advantage of prodrugs is that they are released more slowly and evenly in the system. This could lower the plasma peak in the user and potential side-effects. That the lisdexamfetamine gets released more slowly in the usersystem can be seen from the "Onset of Action" in the general information bar on the wikipages. The onset of action is for lisdexamfetamine 2 hours. For regular (dex)amphetamine the onset of action is 30 - 60 minutes.
The lisdexamfetamine has about the same tolerability and effectiveness as extended release dexamphetamine. [1] Lisdexamfetamine also has potentially lower abuse potential.
This article mentions a couple differences between lisdexamfetamine and dexamphetamine.
[2]
Rowley, H. (2012). Lisdexamfetamine and immediate release d-amfetamine–Differences in pharmacokinetic/pharmacodynamic relationships revealed by striatal microdialysis in freely-moving rats with simultaneous determination of plasma drug concentrations and locomotor activity. Neuropharmacology, 63(6), 1064-1074."
References
Bonnom ( talk) 15:55, 29 April 2016 (UTC)
Why is the single largest section on this page a generic amphetamine addiction cut/paste? At one point it even goes into addiction recovery and opiate addiction. Amphetamine addiction is almost entirely the result of abuse. Lisdexamfetamine MOA makes it very hard (impossible?) to abuse... information that isn't even mentioned. — Preceding unsigned comment added by Billyoffland ( talk • contribs) 15:55, 12 March 2016 (UTC)
The point is being missed. Neither Water or Properties of water make any mention of drowning potential or methods of resuscitation. This article is on Lisdexamfetamine. Not Lisdexamfetamine addiction / addiction recovery. Alcohol, Nicotine and Opiate make no / limited mention of addiction / recovery. Notoriously addictive Oxycodone and Benzodiazepine (eg Alprazolam) also make appropriately limited mention of related but not necessary relevant topics. Here is an NIH report on the reduced abuse potential of Lisdexamfetamine http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/ that can be included in this article as it's directly related to Lisdexamfetamine specifically.
More commonly, "Generic" means generally related to. I said the cut/paste was of generic (as in relating to general) "amphetamine addiction". "LDX" (as you call it) is indeed a prodrug. "hence it shares its addiction mechanisms" is not accurate. The very information in your cut/paste on addiction talks about dependence verses addiction verses addictive behaviors. Billyoffland ( talk) 15:41, 14 March 2016 (UTC)
I was recently prescribed this I came here for some more info. The page is named 'Lisdexamfetamine' but it is spelled as 'lisdexamphetamine' several times throughout. I looked up this difference and it seems to be the same thing as color/colour and armor/armour where it is just the British spelling and the U.S. spelling. I know that even a two letters difference can mean wildly different chemicals. I'm posting this here because I want to give a notice before I change what I can to make it more parsimonious. I'll be changing every 'lisdexamfetamine' to 'lisdexamphetamin' to help clear the confusion of using two different words for the same thing — Preceding unsigned comment added by Sigil47 ( talk • contribs) 02:50, 16 May 2016 (UTC)
Is there any reason to have this article and dextroamphetamine separate from amphetamine? Jytdog ( talk) 22:36, 10 July 2017 (UTC)
The article claims a duration of action of 10-12 hours which is twice as long as normal dexedrine. Considering that lisdexamphetamine is metabolised into its active ingredient dexamphetamine within one to two hours this doesn't make sense to me. I suggest someone with access to sources 2, 4 and 5 checks whether they support this claim. 12:58, 21 April 2018 (UTC) — Preceding unsigned comment added by 92.218.227.67 ( talk)
The longer duration reflects the extended release dosage forms of all current lisdexamfetamine pharmaceuticals, which are combined with inactive polymers that slow their absorption. The duration of action of a hypothetical "immediate release" lisdexamfetamine dosage form hasn't been published in academic literature, but I assume it would be roughly the same as IR dextroamphetamine formulations.I find it a bit bizarre that I actually wrote this given that I know LDX is just formulated as an inactive prodrug and its conversion to dextroamphetamine is, as Garzfoth restated, mediated by a rate-limiting enzyme in blood. I suppose I could've conflated LDX and ER amphetamine salt formulations if I were drunk and/or half-asleep or drunk, but I honestly don't remember what I was thinking when I wrote that. In any event, what I originally wrote is, indeed, completely wrong.
@ Doc James: Can you restore this statement with clarification? I don't know what this means and I imagine neither do our readers. In what context and by whom is this less preferred? E.g., by British adults for the treatment of ADHD? By American children for the same purpose?
"It is usually less preferred than methylphenidate. [1]"
Seppi333 ( Insert 2¢) 06:58, 17 April 2019 (UTC)
References
"Chemically, lisdexamfetamine belongs to the class of substituted amphetamines."
Not saying it is incorrect. But if not source makes the claim it makes one wonder how notable it is? Probably best to go in the body of the text regardless.
Doc James ( talk · contribs · email) 14:40, 17 April 2019 (UTC)
Does anyone recommend its use? All the sources including the manufacturer recommend against such use. Unless someone reputable states otherwise we can just state it as fact. Doc James ( talk · contribs · email) 14:45, 17 April 2019 (UTC)
May occur not just in overdose but when this is used in combination with other medications per the source. [2] Doc James ( talk · contribs · email) 14:45, 17 April 2019 (UTC)
These are two different conditions within psychiatry and the reference deals with them separately. Ref says "Manic symptoms may occur with usual dosages in children and adolescents without prior history of mania." [3] Doc James ( talk · contribs · email) 14:48, 17 April 2019 (UTC)
Lisdexamfetamine is classified as a CNS stimulant. This is despite the fact that it is converted into dextroamphetamine first. Just because something requires metabolism in the body does not mean it is not in that class of medications. Stating that it "works after being converted by the body" is how one says in common English that it is a prodrug. Technical terminology can generally go in the body. Doc James ( talk · contribs · email) 14:53, 17 April 2019 (UTC)
Ideally, this statement in the lead - Serious side effects may include sudden cardiac death, mania, and psychosis.[3] It has a high risk of abuse.[3][dubious – discuss]
- should be rephrased to mirror these statements (N.B. the prevalence of amphetamine psychosis at therapeutic doses is about 1 in 1000):
Larger doses of amphetamine may impair cognitive function and induce rapid muscle breakdown. Drug addiction is a serious risk with large recreational doses but is unlikely to arise from typical long-term medical use at therapeutic doses. Very high doses can result in psychosis (e.g., delusions and paranoia) which rarely occurs at therapeutic doses even during long-term use. Recreational doses are generally much larger than prescribed therapeutic doses and carry a far greater risk of serious side effects.
— Amphetamine lead
USFDA-commissioned studies from 2011 indicate that in children, young adults, and adults there is no association between serious adverse cardiovascular events ([ sudden cardiac death ], heart attack, and stroke) and the medical use of amphetamine or other ADHD stimulants.); cardiovascular disease is a contraindication for that reason.
Evidence from human studies indicates that therapeutic amphetamine use does not cause developmental abnormalities in the fetus or newborns (i.e., it is not a human teratogen), but amphetamine abuse does pose risks to the fetus." [1] Alternatively, we could attribute the recommendation; I don't care either way. All other recommendations/normative statements in this article are attributed already.
Seppi333 ( Insert 2¢) 05:26, 18 April 2019 (UTC)
References
Appears we have decent sources saying there is no physical dependence or that their is physical dependence at high doses.
For example see [5] Doc James ( talk · contribs · email) 17:40, 19 April 2019 (UTC)
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
High quality sources disagree. Thus for "dependence liability: physical" we should put either "controversial" or "disputed".
We have multiple high quality sources that support physical dependence. We have the following text under the heading for "lisdexamfetamine" in this medical textbook.
Physical dependence. Chronic amphetamine use produces physical dependence. If amphetamines are abruptly withdrawn from a dependent person, an abstinence syndrome will ensue. Symptoms include exhaution, depression, prolonged sleep... Rosenthal, Laura; Burchum, Jacqueline (2017). Lehne's Pharmacotherapeutics for Advanced Practice Providers - E-Book. Elsevier Health Sciences. ISBN 9780323447799.
We also have the current source which says
cessation of cocaine use and the use of other psychostimulants in dependent individuals does not produce a physical withdrawal syndrome but may produce dysphoria, anhedonia, and an intense desire to reinitiate drug use.
Doc James ( talk · contribs · email) 04:49, 22 April 2019 (UTC)
Lots of more examples of books that mention physical dependence from stimulants
Doc James ( talk · contribs · email) 05:05, 22 April 2019 (UTC)
characterised by general weakness and low mood" - why did you leave out the part where they specify symptoms of psychological dependence? Is it because it contradicts your argument? I'd wager that's the reason for your omission.
cessation of cocaine use and the use of other psychostimulants in dependent individuals does not produce a physical withdrawal syndrome but may produce dysphoria, anhedonia, and an intense desire to reinitiate drug use.- read physical dependence and psychological dependence.
Not seeing it here. Not seeing it at WP:MEDMOS. I oppose this. Doc James ( talk · contribs · email) 11:14, 23 May 2019 (UTC)
This IMO does not belong in the first sentence " codrug composed of the amino acid L-lysine, attached to dextroamphetamin"
Doc James ( talk · contribs · email) 16:09, 29 November 2019 (UTC)
This article has a surprisingly bad noise/data ratio. Too much is transcluded or just pasted from [amphetamine] or similar articles, not directly specific to Lisdexamfetamine. The result is an essentially useless article that looks very detailed and authoritative, but requires too much effort to find out what is actually relevant to the subject matter. It might be relevant to have links to amphetamine data when there is none available that is specific to Lisdexamfetamine, but not pretend it should simply be pasted here. YamaPlos talk 19:19, 10 July 2020 (UTC)
I have revised the dependence liability of lisdexamfetamine to moderate to align with the growing body of evidence [1] and current expert consensus [2] that lisdexamfetamine has an appreciably lower potential for dependence compared to that of dextroamphetamine ( Dexedrine) or mixed amphetamine salts ( Adderall). RiMediaN ( talk) 01:20, 30 March 2021 (UTC)
References
{{
cite journal}}
: Cite journal requires |journal=
(
help); Missing or empty |title=
(
help)
On this edit, @ WikiLinuz: reversed my edit mentioning cognitive disengagement syndrome (CDS) as a treatable condition by lisdexamfetamine on the basis of the secondary source being an "advocacy study" thus not gaining sufficient recognition. This criticism is unfounded. CDS has reached the threshold of recognition as a distinct syndrome as established by the International Consensus Statement on CDS, which I cited as part of my edit, in addition to the primary research it reviews. It is not a promotive idea, but rather a statement of fact, as the scientific consensus makes plain. It is not an "advocacy study". To claim it has not reached the recognition threshold is to contradict the international scientific consensus.
Please note that the current status of diagnostic manuals are quite irreverent as they are not leading the research, but follows it and often a decade or two behind where the research is at the time. And the decisions made by the APA for instance are also political, not just scientifically-based so its hard to know where this will go in the subsequent DSM version. Thus the condition not being recognised in diagnostic manuals does not preclude it from being a distinct syndrome.
Therefore, this edit should not have been redacted on this article. Please discuss/refute/or attest if my understanding of the guidelines here are misled. Димитрий Улянов Иванов ( talk) 19:59, 18 February 2024 (UTC)