I read this awful story about a boy died from Adderall building up in his system. Is this for real?
http://www.adhd-kids.com/adderall.html

I am skeptical. He might have had allergies or maybe he had other conditions that they don’t report. That website is devoted to selling herbal alternatives to ADD medicines so I would take any article there with a grain of salt. Google the names and see if you come up with anything else.

I agree the story could be a fake. I am still trying to get up the courage to try the Adderall again - my Ritalin will be gone in a couple days! How are your meds going?

That site doesn’t really bother me that much. They are trying to sell something, something that I think is garbage, but nonetheless I don’t mind it. The ones that I can’t stand are the Scientology related ones that claim that ADD does not exist. You see a lot of these types of articles on those sites.

I am doing pretty well. I may ask to up my dose to 20mg. I have been on 10 for about 2-3 months now. I was on 20mg for about a year and it was great. Had to get off of Ritalin. It caused too many muscle twitches. I guess that will go away after awhile but it is a hassle when it happens. Plus the drop off was a killer.

No it doesn't build up in your system - it's very short acting and is gone by the next day. For a lethal overdose you need to take many times the theraputic dose - so the story is either inaccurate or fake - Care to guess which way I'm leaning on that question ;-)
It's too bad people have to use fear tactics against parents in order to sell their products.

Most of these stories posted on sites like these are scare tactics to try and sell products like becalmed. Yes, there are rare instances of people having bad reactions to AD/HD medications like many of different types of medications.

If you are taking AD/HD medication and you are nervous about side effects take your own blood pressure on a regular basis and make sure you keep up with regular check ups.

I read those stupid science bs also. That really makes me mad too.

Did you feel like you lost your sense of humor with ritalin?

Man I feel that awfull headache creaping in again as everyday with ritalin. I have to take a vicodine to get rid of the headache sometimes. I did not get a headache in the morning with the Adderall so who knows.

UPDATE: I have done some research and part of the story checks out. According to the news stories I have been able to find, Andrew Hecker, 11, collapsed on July 3, 2002 after helping to clean pontoon boats at a boy scout camp.

Here is the most recent article I could find:

(Indiana Gazette, Indiana, Pennsylvania, September 6, 2002)

Andrew Michael Hecker, 11, of Port Matilda collapsed at 1:30 p.m. July 3 after helping to clean some pontoon boats on the shore of Yellow Creek Lake at the Boy Scouts' Camp Seph Mack. He was pronounced dead about an hour later at the Indiana Regional Medical Center.

An autopsy performed at Memorial Medical Center in Johnstown was inconclusive. According to Coroner Thomas Streams, blood tests later showed a toxic level of Adderall, a drug that Hecker had been taking for some time. Streams declined to identify the medical condition for which Hecker was taking Adderall.

An investigation found no sign that Hecker had taken an incorrect dose of the medicine and a study of the remaining pills determined that he had the correct concentration of the drug, Streams reported.

Johnstown pathologist Vimal Mittal determined that Hecker's body apparently was unable to properly break down the drug and dispose of it normally, according to Streams. Over time, the Adderall accumulated to a level that was high enough to cause cardiac arrhythmia and death.

Streams ruled that Hecker's death was the result of natural causes.

http://www.zwire.com/site/news.cfm?newsid=5282717&BRD=1078&PAG=461&dept_id=151025&rfi=8

I got that story from this source http://www.zwire.com/site/news.asp?brd=1078 The site requires registration. It’s no big deal though, I registered in 2 minutes using bogus info. Once you get in to the site go to advanced search and search on the word ‘Hecker’ in the box marked ‘full article’ and select 2002 from the menu marked ‘Articles from:’ You will find several articles.

Unfortunately the information available is inconclusive. They won’t reveal why he was taking Adderall. It seems to me that something else was wrong with the kid, though I am no doctor. Something was preventing him from breaking the Adderall down so it accumulated in his body until he died from it. I have no idea what could cause that kind of problem. Did he have other medical problems? Was he taking other medications? Did he take some food or drink that could have caused a reaction, something like Red Bull, Mountain Dew, tea ,or coffee? Did he take any herbal remedies? Illegal drugs? It is also possible that he skipped a few days and then took 2-3 days worth at once, who knows?

I called the Indiana County Coroner’s Office and unfortunately they will not release any information because the case is still open. It is open because of pending litigation. If the case goes to trial and is decided by the court rather than being settled, some of the medical information may become part of the public record. If so we will have our answer.

Until then, I am going to keep an eye out for this case. I’ll search legal databases to see if I can find anything related. I will report back when I find any information. Just don’t expect it to be soon. This will take time.

Wow - you should be a private investigator! That is so weird that his body was unable to break it down. I wonder what cased this. Let us know if you hear anything!

The story does appear to be true - I have found it on several independant news sites too. But it still doesn't make a lot of sense to me. First, the blood condintrations mentioned don't make sense - a figure of 210 nanograms is given, but it doesn't say if that's per L or ml . If we assume it's per ml then that would give a concintration of .21mg/L.
From a drug info sheet on amphetamines I got this:
"Interpretation of Blood Concentrations: Blood concentrations can generally be used to distinguish therapeutic use from abuse. Concentrations of 0.02-0.05 mg/L are typical for therapeutic use, and up to 0.2 mg/L have been documented. Concentrations greater than this represent abuse. Concentrations do not disclose phase of use. Normal concentrations in recreational use are 0.01 to 2.5 mg/L (median 0.6 mg/L). Concentrations above this range will likely be associated with severe, possibly life threatening, toxicity"
So the level of drug in his blood is in the high theraputic range(?) and shouldn't have been toxic.
Amphetamines are broken down in the liver - as are most drugs - and the enzyme responsible is known as "cytochrome P450-2D6". This enzyme is responsible for breaking down many drugs. A small percentage of people have less of this enzyme than normal. These "poor metabolizers" take longer to break down the drug, so the effects are greater and last longer.
So it's possible that the child that died was a poor metabolizer, but if this was the case, he would have had symptoms of a stimulant overdose long before he died. His very first dose would have felt to him like taking maybe 2 or 3 times as much, so you'd think someone would have noticed, or he would have complained.
It's definately an odd case - I sure would have liked to find more specifics (like how long he was taking Adderall and what other drugs he might have been prescribed), but I couldn't find any more info than in the story links already quoted. It's not something I would worry about - if you were a poor metabolizer, you would know it by now! (if you were, it would amplify the effects of ritalin too).
Regards,
Greg

I think there is something unique to this kid. There has to be something about his body chemistry that was not normal. I have looked through some legal sites and I have not yet found an Adderall related lawsuit other than some patent cases between drug companies. I don’t have access to the better legal research databases like Westlaw and Lexis anymore so my search was not as thorough as it could be but still, you would think if this was a huge problem there would be other lawsuits.

If your liver is shot then you would have poor results with any medication. Heck you can get liver damage from tylenol!

I wonder if there is some kind of test to check your metobolic rate and see is you have sufficient enzyme.

One of the articles I found mentioned that the coroner looked at his organs and didn’t find any of them to be damaged or diseased. If he did have liver disease Adderall would be the least of his problems.

You are right about Tylenol. I only take aspirin or Ibuprofen. The worst side effect of Ibuprofen is stomach bleeding. I never have problems because I have taken so much of it and I always eat first.

I wonder if he got dehydrated?

Originally posted by akiss4u

I wonder if there is some kind of test to check your metobolic rate and see is you have sufficient enzyme.

I read on a website that there is such a test that can detect if you are a poor metabolizer or not.

That is really sad about that boy. I guess when it is your time to go then there really isnt much you can do anyway but you would think there would be some kind of warning signs with this kid. Bless his heart.

http://www.prozactruth.com/pharmagenetics.htm#drug%20metabolism

Here is more on the story....

....Administration of certain drugs in the absence of genetic testing for P450 variations has produced a number of adverse drug reactions, some of them fatalities. In 2000, a nine-year-old boy diagnosed with attention-deficit-disorder, obsessive-compulsive disorder, and Tourette's disorder and treated with a number of different drugs including Eli Lilly's controversial anti-depressant Prozac, died from cardiac arrest. An autopsy revealed concentrations of medication several times higher than expected based on overdose qualifications, and the medical examiner's report indicated death caused by fluoxetine toxicity (fluoxetine is the chemical name of Prozac). Further genetic testing of autopsy tissue revealed the presence of a gene defect in regards to an enzyme in the P450 group known as CYP2D6 which causes a poor metabolism of fluoxetine. Had genetic testing been in place, the boy's death would have been prevented. Since that time, there have been two lawsuits against Eli Lilly and Company regarding their lack of information on the danger of this same genetic defect from families of victims.

I would ignore anything you read on that website. That site is funded by Scientology. The founder of Scientology, L. Ron Hubbard, was declared insane three times during WWII. He made it his mission to discredit the fields of psychology and psychiatry. Hatred for shrinks is written into Scientology’s theology. That’s why Kirsty Alley never guest stared on Frasier. She’s a Scientologist and Frasier is a shrink.

What "Penultimate" said...
Plus, while poor metabolism of medication can be an added problem (about 9% of people are "PM's" to some degree or another), it's not often fatal, unless the person completely lacks the enzyme. I beleive my brother is a "PM" and he finds that most psychotropic medications give him wicked side effects - make him dizzy, excessively sleepy, etc. - but nothing life threatening.
I found a very interesting but technical web page:
http://www.anaesthetist.com/physiol/basics/metabol/cyp/cyp.htm

The following is an excerpt regarding PM's and people who extensively metabolize with 2D6:
"The explanations for the various polymorphisms are thought to be complex, but perhaps the most interesting is the high expression of CYP2D6 in many persons of Ethiopian and Saudi Arabian origin. 2D6 is not inducible, so these people have developed a different strategy to cope with the (presumed) high load of toxic alkaloids in their diet - multiple copies of the gene. These CYPs therefore chew up a variety of drugs, making them ineffective - many antidepressants and neuroleptics are an important example. Conversely, prodrugs will be extensively activated - codeine will be turned in vast amounts into morphine!

In contrast, many individuals lack functional 2D6. These subjects will be predisposed to drug toxicity caused by antidepressants or neuroleptics, but will find codeine (and indeed, tramadol) to be inefficacious due to lack of activation! Other drugs that have caused problems in those lacking 2D6 include dexfenfluramine, propafenone, mexiletine, and perhexiline. Perhexiline was in fact withdrawn from the market due to the neuropathy it caused in those 2D6 inactive patients unfortunate enough to be treated with it. Even beta-blocker removal may be impaired (for example, propranolol) in 2D6-deficient people"

I gather that some people do get tested for problems with 2D6, but I'd be very surpised if it was common. The only thing my Dr (the specialist, not my GP) asked for before prescribing ritalin was an EKG - to detect any conductivity problems (undetected heart conductivity problems are often the cause of death when athletes or otherwise very fit or young people suddenly drop dead for no appearent reason).
I would also expect that testing for 2D6 would be very expensive (?)

Hello, The story you are referring to is about my son Andrew. And yes this story is very true. I cannot say much about all of this because my lawyers have advised me not to. But I can say that the death of our boy was something that could have been avoided had the right care been given to him. He was so special and such a polite and proper gentleman. It has been 2 1/2 years since this happened to Andy and most times it seems like yesterday. Andy was a very healthy 11 yr. old boy with much energy and enthusiasm for life. He loved his family and spread his joy to whomever he met. I'm glad that his story has reached others and has brought concern. Though it saddens me that I must write about him in the past tense. He was a very special person with a lot of love to give and to share with others. I know that other people who have lost a loved on say the same and it has become stereotypical for a person to say their child was or is the best. But I say truly to you that he was a person of a very special kind. He wasn't caught up in all that worries people today, and the sadness of the world. He always looked and turned to the bright side of things. And had Great goals and achievments planned in life. He was sure to be a person of true impression to another.

I will try to answer your questions within reason of my lawyers appointments and instructions.

Thank you

I realize that this is an old thread, but I just found it...

I was proscribed Strattera by a GP, 40mg for 3 days, and then 80mg/day. (I'm 26/m BTW)

I started on the 40 and had all kinds of heart palpitations, dilated pupils, and I was mentally totally messed up (basically made my ADD symptoms a lot worse)...

To make a long story short, I ordered that metabolism test (the local hospital did the blood sample for me for free), and I am in fact a 2D6 PM. I got the whole set done ($600, but I later found it for $450, or $175 per individual test, if you search in google).

Anyway, even 10mg of strattera is too much, I'm currently trying 5mg. I have to make up my own doses, 1/8th of the powder from a 40mg, since they don't make a 5mg. I got an American Weigh milligram scale for 80 bucks and a huge bag of gelcaps for like 10 bucks.

The 5mg seems to be actually starting to work, and this isn't surprising since, as far as I know, Strattera has a bell-shaped response curve. It still takes 2 weeks to figure out if it works though.

I'm highly miffed that Lilly doesn't require this test before proscribing Strattera. 1/16th of the normal dose, for crying out loud! That's more than an order of magnitude! I'd probly be dead if I took 80mg! If you read the strattera PI sheet, the AUC is 10X higher (AUC = Area Under Curve, in other words, total overall exposure to the medication).

I have an appointment with a psychiatrist in about a week, and I'm going to show him the result of the test. If he doesn't adapt the dose accordingly, I'll find a different shrink, I think.

Interesting. I started on 10 mg of Strattera, went up to 18 mg, couldn't handle the side effects, went back down to 10 mg and still had weird side effects on 10 mg (swelling, rash, stuffed nose and sweats among others). I was surprised to have such serious side effects on such a low dose. Although the drug did help me with focus issues, I finally gave up on it after 2 or 3 weeks because of the side effects.

I'm now on a low dose of Adderall. Started on 5 mg. a day and now at 10 mg. When I started on 5 mg, I got a lot of dizziness and some heart palpitations. The dizziness and heart palpitations seem to have subsided, except when I miss a meal, which induces dizziness. I try to eat very regularly, but today I got tied up in a meeting from 11:00 a.m. until 2:30 p.m. and I thought I was going to pass out. The missed meal - dizziness connection has got to be because of the Adderall because that never happened to me pre-Adderall (yeah, I'd get hungry if I missed a meal, but not dizzy).

Anyway, what is this test that you are talking about? Since I am on such a low dose of Adderall, I was thinking of trying to increase it slightly, but now I'm thinking I should have this test before I do so.

Do a google search for "drug reaction testing".

This is the site I found that has it for $175:
http://www.wdxcyberstore.com/dnadrrepr.html

I used the one from that ProzacTruth site, and it went very well, except it took some phone work to find a place that would do the blood sample for me. I'm sure a doctor could arrange for that quite easily. They charge $250 for just the 2D6 test.

The test itself is genetic, it checks for the genes that encode for the liver enzymes that break down various medications. The 2D6 one effects about half of all proscription medications, and it's the one that I don't have.

I've been taking the 5mg dose for a few days, and it's actually starting to work (the 10mg just made me worse). It still feels like it might be too much, after I take the 16 doses I made up, I might go to 4mg.

They (Lilly) only sell down to 10mg ones, unless you want to make them yourself, or find a compounding pharmacy. As I said, American Weigh makes a gem scale that has a milligram setting, and you can buy empty gelcaps very easily. A 40mg capsule has 232 mg of white powder in it, so to make 1/8 dose, I put 29mg of the stuff into an empty gelcap. It takes a bit of practice, but I'm good at it now, and I accept 28-30mg of the stuff (that's <5% error, which shouldn't make a differance). A 4mg dose would be 23mg of the stuff...

I'd trust my own scale over a compounding pharmacy, I've read that they screw up a lot, but then again I'm very mechanically inclined and I'm good at this type of thing.

Of course it's WAY cheaper, too. :) I could get a whole year's worth of 40mg strattera for less than 100 bucks.

can Adderall/Adderall XR if taken improperly meaning
if you took as prescribed and then opened up a capsule, sprinkled
a bit on your hand, did that for three days and you've been on Adderall
for 6 1/2 years could that cause damage to your brain, or effect memory??
or could it possibly kill brain cells???

Dude, you don't even make sense. On your hand? You mean snorting it?

yeah I sprinkled some on my hand,
and put it on my tongue and then swallowed.

Did we all ever come to a consensus about whether Adderal can build up if your a slow metabilizer and if so what would be the symptoms to notice? Of course, I would assume that if you are loseing a fair amount of weight since starting on it you would be a normal metabolizer but then again I still dont understand how, in theory, Adderal speeds up your metabolism but kills your appetite, I would think you would be starving all the time since your body burns through everything so fast. *shrug*I would still love to know what it is about amphetamine that kills your appetite and I can go 2 days without eating and still not be hungry but feel that I need to eat something.