Brief Answer:
I would explain as follows:

Detailed Answer:
Hello XXXXXXX

Welcome on HCM!

I understand your concern and would like to explain that several reasons besides Adderall may be responsible for your high blood pressure values when in the doctor office.

Most frequent reason is what is called "white coat hypertension" a phenomenon expressed with exaggerated increased BP values when at doctor's office.Anxiety plays an important role in this issue.

It has been shown that "white coat hypertension" is present in 9%-16% of the general population and 25%-46% in hypertensive subjects.

So, these high blood pressure measured at the doctor's office may suggest you may be hypertensive.

For this reason, i recommend you to closely monitor your BP values for a couple of days (up to a week) several times daily and review these values with your attending doctor.

If high average blood pressure values are confirmed, then some additional tests should be done:

- complete blood count,
- BUN and creatinine,
- blood electrolytes levels,
- thyroid hormone levels (FT3,FT4, TSH)
- fasting blood glucose,
- liver function tests,
- blood lipid profile, etc.

and discuss for a possible anti-hypertensive therapy.

Now, returning to Adderall, i agree that it may be helpful in your work (increase concentration, motivation, etc.) but more that hypertension issue (which in fact Adderall may aggravate), there are other adverse effects that are concerning.

Adderall may lead to cardiomyopathy when on chronic amphetamine use, myocardial infarction, cardiac arrhythmia;

- also many psychotic episodes, blurred vision, constipation, serious skin rashes (including Stevens-Johnson syndrome and toxic epidermal necrolysis), impotence, changes in libido, frequent/prolonged erections, rhabdomyolysis, etc.

It is for the above reasons why I discourage you form continuing to use Adderall (not only just hypertension).

Many other strategies may help you to substitute Adderall, like participating in recreational activities, outdoor sport activities, etc.

You need to discuss with your attending physician on the above mentioned issues.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again!

Kind regards,

Dr. Iliri

---

Brief Answer:
Opinion as follows:

Detailed Answer:
Hi again, XXXXXXX

I agree with you on the fact, Adderall is shown helpful according to your work commitments.

I respect this alternative, but only would suggest taking care of your overall physical status before considering Adderall use.

First of all, be sure it will not adversely affect your blood pressure values.

Also, consider the above mentioned lab tests just to be sure that no any underlying health disorders is implicated in possible health issues, and especially in hypertension triggering.

If you think that Adderall would be a possible option in the future, I recommend you to periodically check your clinical status by your attending doctor (physical exam, resting ECG and additional tests).

Wishing all the best!

Regards,

Dr. Iliri

---