Headaches and ADHD Medication (Vyvanse)

[Trohr]

Over the last few years, I have noticed my post-dive headaches have been getting worse. On one occasion, after my third dive of the day, it was so bad that it made me vomit within 10 minutes of being on the surface. On that particular day, my first dive was at 140 ft, the second at 125, and my third was at 100 ft. I breath NO2, and I was within my decompression limits (my computer was not flashing at me.)

Most recently I was out, and I did my first dive at 100 ft, and called the dive off short out of boredom. My second dive was nearly three hours later, and was at 65 ft. On the first dive I used a 32% mix, and on the second a 34%. After surfacing from my second dive, I was hit with a headache that forced me to cover my eyes from the sun, and lay down - while having my brother hose me off with the freshwater wash down. The headache subsided after about a half hour, but not totally. I could feel it throughout the next few hours.

This is a slightly new condition that I have been experiencing, and it is incredibly agitating. I have noticed that since being prescribed to Vyvanse for ADHD 4 years ago, the headaches have made their presence more well know. Is there any correlation between the effects of the medication/pressure/headaches?

Any explanation or other things to consider would be greatly appreciated. Thank you.

 

[DocVikingo]

Hi Trohr.

I do not know if there any correlation between the effects of the medication/pressure/headaches, but per the manufacturer's data in Table 3 below(*), headache is not a significant complaint among the general population to which the drug is prescribed. This of course does not does mean that some patients don't get headaches & does not specifically address divers who are taking the medication.

You mention that, "Over the last few years, I have noticed my post-dive headaches have been getting worse." As such, it might be useful for us to know the longitiudinal history of your headaches in some detail.

I might note that significant headache can be a symptom of both dehydration & CO2 build up. Do you stay very well hydrated while diving? Do you skip-breathe or not fully inhale or exhale? Is you reg in proper tune? Do you have any history of temporomandibular disorder?

Regards,

DocVikingo

*Table 3 Adverse Reactions Reported by 2% or More of Adult Patients Taking
Vyvanse and at least Twice the Incidence in Patients Taking Placebo in a 4-Week
Clinical Trial

Vyvanse (n=358)/Placebo (n=62)

Decreased Appetite 27%/2%
Insomnia 27%/8%
Dry Mouth 26%/3%
Diarrhea 7%/0%
Nausea 7%/0%
Anxiety 6%/0%
Anorexia 5%/0%
Feeling Jittery 4%/0%
Agitation 3%/0%
Blood Pressure Increased 3%/0%
Hyperhidrosis 3%/0%
Restlessness 3%/0%
Weight Decreased 3%/0%
Dyspnea 2%/0%
Heart Rate Increased 2%/0%
Tremor 2%/0%

 

[Dr Deco]

Dear Trohr:
As Dr Vikingo mentions, CO2 buildup is the usual culprit in dive headaches. That was my first guess, and thus watching your breathing patterns would be the first line of attack.

 

[Duke Dive Medicine]

Trohr,

Do these headaches occur only after diving? If so, and watching your breathing pattern doesn't help, you may want to consider having your hypercapnic ventilatory response measured. Diving can lead to increased CO2 levels in the body. Most people's bodies will autoregulate in response to this by increasing the respiratory rate, but a small segment of the population doesn't compensate appropriately, which can lead to hypercapnia and really nasty post-dive headaches.

@DocV, do you know offhand the mechanism behind the dyspnea response in Vyvanse users?

Best regards,
DDM

 

[DocVikingo]

@DocV, do you know offhand the mechanism behind the dyspnea response in Vyvanse users?Best regards,
DDM

Morning DDM,

I'm guessing something along the lines of stimulant-induced pulmonary hypertension.

Cheers,

DocV

 

[Duke Dive Medicine]

Morning DDM,

I'm guessing something along the lines of stimulant-induced pulmonary hypertension.

Cheers,

DocV

Interesting. Strictly speculation and maybe looking for zebras, but I wonder if the OP could be experiencing this on a subclinical level on the surface and it manifests itself as CO2 retention with immersion.

 

[DocVikingo]

Dewd, you're got those pyramidal neurons in high gear.

Cheers,

Doc

 

[kelemvor]

My son takes VyVanse. It causes a significant reduction in his appetite. He often gets headaches if he doesn't eat/drink enough on a given day. Are you being careful to make sure you eat and drink enough? His headaches aren't nearly as severe as what you're describing, but he also doesn't dive. Maybe dehydration is playing a role? Just a thought, I've got no medical background - so I'm probably way off base.

 

[tracydr]

What about blood pressure? Could your blood pressure be getting too high as a combination of the medication and exertion?
Can you take a blood pressure machine with you next time and do some readings, before and after? Also, what are your everyday blood pressures running?

 

[DocVikingo]

Maybe dehydration is playing a role? Just a thought, I've got no medical background - so I'm probably way off base.

No, not off base. It was mentioned as an hypothesis in post #2 above.

Cheers,

DocVikingo