Getting jitters on Adderall and Zoloft?

Dear Ask The Doctor: I just started Adderall 20mg for adult ADD. I have been on it for 2 days. Is it normal to have the jitters?

Dear Tina: Adderall is one of the frequent drugs prescribed for ADD. It is a psycho-stimulant containing many different ingredients that increase the dopamine and norepinephrine levels in the brain. Adderall has a high potential for abuse and addiction and may cause seizures, heart attacks, high blood pressure, stroke.

You have also mentioned that you are taking Zoloft (an SSRI). The use of Zoloft and Adderall together is contraindicated. There is a risk of serotonin syndrome, a relatively rare but serious complication. The symptoms are acute in onset and consists of :

i) In mild cases there is increased heart rate, shiverring, sweating, twitching and dilated pupils.

ii) Moderate toxicity can cause loose stools, high blood pressure and fever. You may also feel agitated and confused.

iii) In severe cases there may be seizures, renal problems, bleeding.

Depending on how bad your symptoms are, you may need to go to the emergency or see you physician. In the meanwhile, stop taking the drugs till the condition is managed.