i'm only on 10mg XR, have no other side effects except nausea...and this wierd thing where i find i am absentmindedly " chewing " when there's nothing in my mouth. i'm not shaky, or sweaty, and my BP is still about 86/54 ( normal for me ) and i'm feeling calm.

Anyone heard of this?, cause i didn't do it before the med.

So, here's what i found out:

It's called Tardive Dyskinesia, and in my case means repetative, involuntary, purposeless chewing movements, and appears only after a drug has been taken. It's a side effect and can continue even after the drug has been stopped.

The cause appears to be related to the system that uses and processes the neurotransmitter Dopamine. This side effect occurs in 15-30%, and is most commonly seen in females and those who smoke.


So, considering i'm at the lowest dose of XR, am feeling really good, and have no other side effects, i can live with it. We all know you have to weigh the side effects to the benifits, and overall i'm still happy with the XR.

Just thought i'd give others this info JIC.

I can't say I've experienced this particular side effect, mostly because I've done that chewing thing for as long as I can remember.... which is far longer than I've been on meds.

This is probably a gross TMI, but if I'm not paying attention, I tend to end up chewing on the inside of my mouth, and that eventually becomes unpleasant.... so I tend to find it helps to have something to chew on like chewing gum (or the backend of a pen... but that tends to make people around you annoyed because who wants to use a chewed on pen? ;))

Like the insides of your cheeks? Yeah, me too.

I had been on Concerta for a year and a half and the doctor added 10 mg of Prozac and I started having the chewing thing. My checks would also involuntarily suck in on the sides. It absolutely drove me crazy. I ended up getting off all medication and caffeine, because Prozac had changed something about how my body dealt with stimulents. That was about a year and a half ago and I still have problems with caffeine and absolutely can't take Concerta without looking very strange with all the mouth movements. So far I've been able to tolerate a low dose of Adderall XR -- in fact it actually reduces the mouth movements until it wears off (these days stress also triggers the chewing/sucking. I'm not sure if it's Tardive Dyskensia, mild Tourettes (that runs in my family), or just severe Bruxism.

If it really is Tardive Dyskensia you're dealing with -- be careful! That can be permanent and can get worse. It indicates that there has been some brain damage. Medication can also mask some of the symptoms while it is progressively getting worse until it breaks through. I'd encourage you to discuss it with you psychiatrist or doctor or whatever specialist you're seeing for meds.

I also do the inside of the cheeks thing -- I think some of that predated meds, but meds made it much worse.

Try chewing some sugarless gum...

I thought that TD was associated with the use of dopamine antagonists (or other drugs that might reduce dopamine activity)? Stimulants tend to be associated with exacerbation of Tics (http://en.wikipedia.org/wiki/Tic), but I've never heard of this being associated with TD.

i didn't know it either. i thought it only happened with antipsychotic meds. But the 10mg XR is the only thing i'm on.

HF- i looked at your links, and it's not a tic. i know the Tardive Dyskenisia includes things like pupousless chewing, teeth grinding ( when awake ), and sticking your tongue out. The tic is more like throat clearing, hand clapping, shoulder shrugging, and facial twinges. Thanks for the site, though, so i could compare them for sure.

1: Br Dent J. 2005 Feb 12;198(3):159-62; dicussion 147; quiz 174.
Links
Oral health sensations associated with illicit drug abuse.
McGrath C, Chan B.

Periodontology and Public Health, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong. McgrathC@hkucc.hku.hk

OBJECTIVES: To investigate oral health sensations (short term oral health effects) associated with illicit drug abuse. In addition, to identify variations in oral health sensations produced by different illicit drugs. SUBJECT: Young adults in a drug rehabilitation programme in Hong Kong, China. METHOD: Self-completed questionnaire about their previous pattern of drug abuse and oral health sensations experienced (recalled). RESULTS: All (119) subjects were poly-drug abusers (abused one or more illicit drugs in the past). Amphetamine-based drugs such as methamphetamine ('speed') and methylenedioxymethamphetine ('ecstasy') were commonly abused. A wide range of oral health sensations were reported on recall of their abuse of illicit drugs; most frequently dry mouth (95%, 113). Types of illicit drugs abused were associated with oral health sensations reported (P < 0.001). 'Ecstasy' abusers more frequently reported chewing (P < 0.001), grinding (P < 0.001), and TMJ tenderness (P < 0.001) compared to non-'ecstasy' abusers. CONCLUSION: Illicit drug abuse produces many oral health sensations. Types of drugs abused were associated with oral sensations produced. and behavioural effects that may manifest as depression, anxiety, memory loss and various neuropsychotic disorders.(8),(9) In some cases drug abuse can result in death by various means: malignant hyperthermia, internal bleeding, fatal overdosing and through allergic reactions.(10),(11) Likewise, there have been reports on the long term clinical effects of illicit drug abused on oral health.

PMID: 15706386 [PubMed - indexed for MEDLINE]

In the case of MDMA and methamphetamine chewing was more common in MDMA.

1: Acta Neurol Scand. 2003 Feb;107(2):161-3.
Links
Severe amphethamine-induced bruxism: treatment with botulinum toxin.
See SJ, Tan EK.

Department of Neurology, Singapore General Hospital, Singapore.

While chewing and grinding movements have been observed in amphetamine addicts, recognition and management of this problem have rarely been highlighted. Botulinum toxin (BTX) has previously been demonstrated to be effective for bruxism associated with movement disorders, such as cranial-cervical dystonia. However, there is little information on its use in tardive bruxism. Here we report an amphetamine addict who presented with medically intractable bruxism, and discuss its pathophysiology and successful treatment with BTX.

PMID: 12580870 [PubMed - indexed for MEDLINE]

Chewing can be a side effect of high doses of amphetamines.

MDMA has 5-HTA1 agonist action like buspar so that lead me to this.

1: Prog Neuropsychopharmacol Biol Psychiatry. 1999 Nov;23(8):1405-18.
Links
Effects of buspirone on an animal model of tardive dyskinesia.
Queiroz CM, Frussa-Filho R.

Department of Pharmacology, Universidade Federal de São Paulo Escola Paulista de Medicina, Brasil.

1. The effects of buspirone were studied on an animal model of tardive dyskinesia, i.e., the quantification of orofacial dyskinesia in rats repeatedly treated with reserpine. 2. Rats were co-treated with saline [SAL] or buspirone (3.0 mg/kg, i.p., twice daily) and vehicle [VEH] or reserpine [RES] (0.1 mg/kg, s.c., once every other day) for 19 days. On the day 20, the animals were observed for quantification of the behavioral parameters of orofacial dyskinesia: tongue protrusion and vacuous chewing movements frequencies and duration of twitching of the facial musculature. 3. Rats of the SAL + RES group exhibited a significant increase in the three behavioral parameters of orofacial dyskinesia relative to the rats of the SAL + VEH group. However, animals of the BUS + RES group showed only an increased frequency of vacuous chewing movements when compared to animals of the SAL + VEH group. In addition, the duration of the facial twitching was significantly decreased in the BUS + RES group in relation to rats of the SAL + RES group. There were no significant differences in the orofacial parameters between the BUS + VEH and the SAL + VEH groups. 4. Because it was also verified that chronic buspirone treatment was able to increase apomorphine-induced yawning behavior, the possibility is raised that buspirone [b]attenuates reserpine-induced orofacial dyskinesia through the development of dopamine autoreceptor supersensitivity.

PMID: 10631766 [PubMed - indexed for MEDLINE]



Though the last part makes me think that if anything the 5-HTa1 agonist action of MDMA would reduce chewing so we are back to just the stimulant action alone causing the chewing. MDMA is a powerful amphetamine like stimulant.

Forgetting just chewing it all may just fit under the definition of bruxism.

http://en.wikipedia.org/wiki/Bruxism

IIRC, TD tends to occur on dopamine lowering drugs. (Stimulants put UP dopamine.)

Stimulants can cause motor side effects, however. e.g. stereotyped movements and extrapyramidal tract issues.

More properly, TD is also the name for the long term irreversible condition.

Yours sounds temporary (if you stop the drug) and reversible.

Still, talk to your Doctor.

I thought that TD was associated with the use of dopamine antagonists (or other drugs that might reduce dopamine activity)? Stimulants tend to be associated with exacerbation of Tics (http://en.wikipedia.org/wiki/Tic), but I've never heard of this being associated with TD.
You're right, but stimulents are also on the list of possible TD triggers. I'll look around later and see if I can find the list of TD triggers to post. In my case, the Prozac acted as the antagonist by reducing the dopamine from my stimulent medication (as serotonin get pushed up the dopamine gets pushed down).

Had to google MDMA, and i've never done Ecstasy.

10mg XR is not a high amphetamine dose, and i'm not an addict after two days. That, i know.

Beyond all this, it's not noticable to others, but i'll buy some gum and be prepared.

10mg XR is not a high amphetamine dose, and i'm not an addict after two days. That, i know.


A high dose study that observed an effect at a certain rate might suggest
the same effect could be observed at lower doses less frequently or less pronounced.

1: J Clin Pediatr Dent. 2004 Fall;29(1):63-7.
Links
Prevalence of bruxism in children receiving treatment for attention deficit hyperactivity disorder: a pilot study.
Malki GA, Zawawi KH, Melis M, Hughes CV.

Dental Center, King Fahad Hospital, Jeddah, Saudi Arabia.

The objective of this study was to evaluate reported bruxism among children affected by attention deficit hyperactivity disorder (ADHD). Thirty children diagnosed with ADHD and 30 healthy age and gender matched controls participated in the study. All subjects were examined for dental attrition, and the parents were asked for signs and symptoms of bruxism in their children using a questionnaire. Prevalence of oral parafunction was evaluated comparing ADHD children taking medications, ADHD children not taking medications, and controls. Subjects affected by ADHD and pharmacologically treated showed higher occurrence of bruxism compared to subjects affected by ADHD not taking medicines and controls; and within the ADHD group taking medications, CNS-stimulants have been associated with such side effect more frequently than the other drugs.

PMID: 15554406 [PubMed - indexed for MEDLINE]

Hmm children only....

http://www.medicalnewstoday.com/articles/33384.php

Young adults with ADHD - ADDERALL XR significantly improves driving performance, study

The most common side effects reported by patients taking ADDERALL XR during the trial included decreased appetite, weight loss, dry mouth, insomnia and bruxism (teeth grinding).

That covers young adults.

I just started Adderall IR 10mg 2x a day a little over a week ago and last night I had to take out my tongue ring because my mouth was annoying me so much.

Before I was on any stimulants I would always absentmindedly play with my tongue ring. I wouldn't even realize I was doing it until my boyfriend remarked that the plastic clicking noise irritated him because he could hear it from the other room in our house.

After starting on Adderall, that occasional playfulness with my tongue turned into an uncontrollable irritation at the tongue ring in my mouth. It's like I was constantly messing with it trying to get it out of my mouth. I had had it for over a year and I decided that it was getting old so I took it out.

The symptom went away but I still have this "mouth awareness". I'm just gonna chew gum until my tolerance evens the effects out.

Hey Edge. I've had that side effect and still get it from time to time. It's especially noticeable if I've taken my doses (I take IR) pretty close together. Sometimes I chew on the insides of my lips/mouth quite a bit, but there are days when I don't do it at all. If I've had a lot of caffeine I tend to do it a bit more. Also if I'm a bit nervous or agitated, I'll find myself doing it a bit more.

I don't really do anything to try to stop it though... Sometimes I don't even realize I'm doing it... but I never found it to be that much of a "problem" for me anyway, ya know? Is it really bothersome for you?

I'm always intrigued to hear about this side effect of meds, because adderall actually makes me chew the inside of my cheeks LESS. I've done this all my life, at times less than others but still, it's been a lifelong habit and I'm always amazed to hear others with ADD do it too. I always thought I was just a weirdo, lol. (I gave it up for Lent one year, that's when I knew it had gotten bad!) I'd be so curious to know if there's a link to that habit and ADD, but I highly doubt anyone will fund a study about cheek chewers ;)

Anyway, it's interesting how this side effect happens for some. I'd be interested to hear if it goes away for you eventually or if you find a way to stop it.

Ahahaha great that you made this thread...

I was at a party last weekend and this guy walks up to me and asks if I have any speed. I was like "WTF?" and then he said everybody had noticed I was on something because I was always doing strange movements with my jaw or "chewing" nothing.

I was at a party last weekend and this guy walks up to me and asks if I have any speed. I was like "WTF?" and then he said everybody had noticed I was on something because I was always doing strange movements with my jaw or "chewing" nothing.

Oh my gosh, really??? I'm just wondering if it is that noticeable when I do it. :confused: I guess now that I think about it, yeah, I would definitely notice if someone was chewing on their lips/cheeks. Hmmmm....

Mine is definately noticable and my husband will let me know if it's getting bad. What bothers me most though isn't how strange I might look but the fact that it is so constant at times that my face hurts. Gum wouldn't work for me at those times either, because I keep accidentally biting my cheeks -- ouch!

yikes the more i read the more i thinki am worse off than i thought... the last post took a poll on dosage... the average was 20mg im on 60mg of Adderall...

and i have all of this and more... before meds i would constantly PICK at my fingers and toes while sitting... at my cuticles. If i had a zit... it was over...

now that im on the meds... it has gotten out of control... my fingers hurt. I dont want to stop the meds... my life has been amazing... but i think if i dont figure it out soon.. im gonna have to start wearing gloves everywhere...

If I have taken my Adderall, caffeine will make me do that, I am very sensitive to caffeine though. I usually stop doing it when I become aware of it (..at least I think I stop)


....constantly PICK at my fingers and toes while sitting... at my cuticles.

now that im on the meds... it has gotten out of control... my fingers hurt. I dont want to stop the meds... my life has been amazing... but i think if i dont figure it out soon.. im gonna have to start wearing gloves everywhere...

I do the same thing sometimes, only is a problem when I take Adderall. usually only do it when at work at my desk, eventually bought a nail file thingy and now my nails always look pretty and clean (damn... did I just admit that.) every great once in awhile I will put a teeny bit of icey-hot (back rub stuff) or Lidocaine on my cuticles, make them numb rather quickly.

All medicines have side effects. Psychostimulants may cause a decreased appetite, a stomachache or a headache. The loss of appetite can cause weight loss in some people. This side effect seems to be more common in children. Some people have insomnia (trouble sleeping). Here are some ways to avoid side effects (such as a fast heart beat, chest pain or vomiting) when taking psychostimulants:



Use the lowest possible dose that still controls the hyperactivity. Your doctor will tell you the right dose.
Take the medicine with food if it bothers your stomach.
Plan to use the weekends as drug-free days. This means that you don't take any ADHD medicines on Saturday and Sunday. Ask your doctor before you try this.
Children who lose weight while taking medicine for ADHD can have healthy snacks during the day. How should medicine for ADHD be taken?


It's important to take the medicine just the way your doctor says--not more often and not less often. Follow your doctor's advice even if you think the medicine isn't working. Be sure to talk with your doctor if you think the medicine isn't working.

It's best to take the medicine 30 to 45 minutes before a meal. Good times to take this medicine are before breakfast and before lunch. Lunch-time doses can be given at school for some children. If your child can't take this medicine at school, tell your doctor. Your doctor might suggest a long-acting form of the medicine instead. The long-acting form of this medicine should not be crushed, broken or chewed before swallowing. The long-acting forms are taken only once a day, right before breakfast.

It's also important to know that some of the medicines used to treat ADHD are called "controlled" drugs. There are special rules about the way controlled drugs can be prescribed. The prescriptions for controlled drugs, such as methylphenidate and dextroamphetamine, must be refilled at the drug store every month. At some doctors' offices, these prescriptions are only written on 1 day of the month.
http://familydoctor.org/online/famdocen/home/children/parents/behavior/103.html

Hi All,
I also have that issue. I never had the chewing problem until I take the Adderall, however, when I was younger I used to suck on gum or just suck my tongue all of the time and still do this occasionally. I have always chewed on pencils and pens!! I used to get ink in my mouth quite a bit :), very embarrassing in high school!!
The chewing thing lasts through out the medication but subsides after the medicine is mostly out of my system. Previously, when I took 30mg's of Adderall XR I never experienced the chewing before but I was licking my lips a lot, getting chapped lips. Only since I went to 15xr in the morning to 15 regular in afternoon have I noticed the chewing. I didn't take my xr this morning and did not do the chewing thing until I took my 15 reg in the afternoon. What a noticeable difference in how I act too, I started blabbing a lot and was able to concentrate better when doing work!!
I don't know much about the actual medical terms though..about dopamine.

Jackie

I am CONSTANTLY chewing! In fact, I couldn't get to sleep one night because my jaws wouldn't stop moving...I can't help it. I am sure I look like a nut! At work I keep gum in my desk...I am fine with people thinking I am a chronic gum chewer...whatever works.