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prescriptions online? Furthermore, stimulants can precipitate depressive symptoms. Thus, self-medicating depression with stimulants is counterproductive, as stimulants can exacerbate existing depression.9 Although methylphenidate and SSRIs have been prescribed to treat adolescents with attention deficit hyperactivity disorder (ADHD) and comorbid depression exhibiting symptoms of apathy and hypersomnia,31,32 concurrent use of stimulants with antidepressants without close medical monitoring could result in rare but serious adverse reactions for the following reasons. First, amphetamines are metabolized by the CYP2D6 enzyme in the liver. Genetic polymorphisms of CYP2D6 are common; poor metabolizers of CYP2D6 have higher blood levels of substrates metabolized by the enzyme.33 Commonly prescribed antidepressants such as SSRIs can inhibit CYP2D6, which can in turn increase serum concentrations and side effects of amphetamines.9,34 Second, amphetamines can increase serotonin release and inhibit reuptake; concurrent use of amphetamines with SSRIs can lead to dangerously high extracellular serotonin levels (serotonin syndrome).9,34 Other medications used to treat depression can also lead to serotonin syndrome when used with amphetamines. These include SNRIs, St John& x02019;s wort, bupropion (Wellbutrin), and lithium.34. Treatment for ADHD Symptoms. A large variety of amphetamines are clinically available, and individuals may respond better to one than to another. Some of the most common are dextroamphetamine (Dexedrine) and a mixture of amphetamines and dextroamphetamine (Adderall). Methylphenidate (Ritalin, Concerta, Metadate, and Methylin) is closely related to the amphetamines and has similar benefits and side effects. Rebecca Lewis, AuD, CCC-A, is a pediatric audiologist at Nationwide Children's Hospital. Rebecca currently sees patients at the Nationwide Children's Hospital Main Campus, Marysville Close To Home and Westerville Surgery Center locations. This study provides a number of novel insights regarding the differential impact of METH versus AMPH on DAT functions, all of which could be molecular
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