Does the use of stimulants (dextroamphetimine or methylphenidate) predispose one to oxygen toxicity when using enriched air? On a separate note, does the use of vitamin E protect somewhat against oxygen toxicity when using enriched air?
Attention Deficit Disorder medications and nitrox oxygen toxicity question
- Thread starter Robert P. Leavitt
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Stay within the established limits of oxygen partial pressures.
But there are other issues if you are simply determined to worry yourself: [Oxidative tissue damage]. - PubMed - NCBI
My wife was on the team that discovered Seroquel. I was research support for a major pharmaceutical company. My job was to understand the science and deliver novel instrumentation to aid the researchers' progress where and when nothing commercial existed.
The human brain is absolutely far beyond amazing. Even a compromised one is hard-wired into seeking normalcy. I don't know why that concept isn't taught, it offers real hope. Anyway, nitrogen gets interesting under pressure. I would like to know how you feel at depth from a general "well-being" sort of feeling.
You may wish to remain on air.
But there are other issues if you are simply determined to worry yourself: [Oxidative tissue damage]. - PubMed - NCBI
My wife was on the team that discovered Seroquel. I was research support for a major pharmaceutical company. My job was to understand the science and deliver novel instrumentation to aid the researchers' progress where and when nothing commercial existed.
The human brain is absolutely far beyond amazing. Even a compromised one is hard-wired into seeking normalcy. I don't know why that concept isn't taught, it offers real hope. Anyway, nitrogen gets interesting under pressure. I would like to know how you feel at depth from a general "well-being" sort of feeling.
You may wish to remain on air.
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NOTE: The following discussion is for recreational, not technical scuba.
There is theoretical reason, anecdotal case report data, and diving medicine expert opinion suggesting that sympathomimetic drugs (drugs that mimic adrenalin in effect) such as dextroamphetimine, methylphenidate & pseudoephedrine may predispose one to central nervous system oxygen toxicity when using enriched air.
There is no evidence of which I am aware that supports vit E as prophylactic in either central nervous system or pulmonary oxygen toxicity.
The discussion thus far has not broached the issue of what are the possible adverse consequences of ADD/ADHD for recreational diving. Given that behavioral modulation, attention, concentration, and other behavioral factors are critical to safe scuba, this is not a trivial matter.
Unfortunately, the jury is still out on the safety of recreational diving with ADD/ADHD and the drugs used to attenuate it. For the foreseeable future, decisions of the recreational diver with ADD/ADHD will remain individual determinations meager of science and rich of professional judgment.
In the meantime, there appear to be 3 basic approaches to addressing this question:
1. Assume that ADD/ADHD and the drugs used to ameliorate it do not pose a danger to scuba great enough to advise against diving:
This position is not defensible simply given what we know about the potential topside dangers of both ADD/ADHD and the stimulant drugs used to treat it. Because of a dearth of research and necessary reliance on theory, a number of dive medicine experts have expressed serious reservations about the wisdom of diving while suffering from ADD/ADHD, especially while medicated. The popularity of modern stimulant drugs and their wide prescription by physicians not expert in their use suggests a somewhat cavalier attitude about these medications. Such an attitude can have grave result when it comes to pursuits like scuba.
2. Assume that ADD/ADHD and the drugs used to ameliorate it pose a danger to scuba great enough to advise not diving until the condition has entirely lifted and medication discontinued:
Qualified medical professionals rendering their best judgment in the absence of supportive science should not be too readily faulted for possibly erring on the side of caution. Liability issues no doubt contribute to this stance, but at the least it does seem prudent and ethical medicine, whose overarching dictum is, "First, do no harm." While it can be argued that this position is unduly conservative, it is not without defense.
3. Assume that ADD/ADHD and the drugs used to ameliorate it do not preclude diving provided that:
(a) mental status examination and longitudinal observation of behavior demonstrate the condition to be well controlled; (b) the diver on medication has been on for an extended period and side effects worrisome to scuba are neither reported nor observed upon careful examination; (c) there are no other contraindications in the clinical picture; and, (d) the diver feels he is up to it and fully comprehends the remaining risks.
I suspect that most divers will find perspective #3 the most appealing, and it is the one I'd want applied to myself if affected. It also seems to be gaining increasing credence within the dive medicine community.
In all such deliberations, it is important that the diver be entirely honest with treating sources, training agencies, dive ops, dive buddies and himself.
Regards,
DocVikingo
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice.
There is theoretical reason, anecdotal case report data, and diving medicine expert opinion suggesting that sympathomimetic drugs (drugs that mimic adrenalin in effect) such as dextroamphetimine, methylphenidate & pseudoephedrine may predispose one to central nervous system oxygen toxicity when using enriched air.
There is no evidence of which I am aware that supports vit E as prophylactic in either central nervous system or pulmonary oxygen toxicity.
The discussion thus far has not broached the issue of what are the possible adverse consequences of ADD/ADHD for recreational diving. Given that behavioral modulation, attention, concentration, and other behavioral factors are critical to safe scuba, this is not a trivial matter.
Unfortunately, the jury is still out on the safety of recreational diving with ADD/ADHD and the drugs used to attenuate it. For the foreseeable future, decisions of the recreational diver with ADD/ADHD will remain individual determinations meager of science and rich of professional judgment.
In the meantime, there appear to be 3 basic approaches to addressing this question:
1. Assume that ADD/ADHD and the drugs used to ameliorate it do not pose a danger to scuba great enough to advise against diving:
This position is not defensible simply given what we know about the potential topside dangers of both ADD/ADHD and the stimulant drugs used to treat it. Because of a dearth of research and necessary reliance on theory, a number of dive medicine experts have expressed serious reservations about the wisdom of diving while suffering from ADD/ADHD, especially while medicated. The popularity of modern stimulant drugs and their wide prescription by physicians not expert in their use suggests a somewhat cavalier attitude about these medications. Such an attitude can have grave result when it comes to pursuits like scuba.
2. Assume that ADD/ADHD and the drugs used to ameliorate it pose a danger to scuba great enough to advise not diving until the condition has entirely lifted and medication discontinued:
Qualified medical professionals rendering their best judgment in the absence of supportive science should not be too readily faulted for possibly erring on the side of caution. Liability issues no doubt contribute to this stance, but at the least it does seem prudent and ethical medicine, whose overarching dictum is, "First, do no harm." While it can be argued that this position is unduly conservative, it is not without defense.
3. Assume that ADD/ADHD and the drugs used to ameliorate it do not preclude diving provided that:
(a) mental status examination and longitudinal observation of behavior demonstrate the condition to be well controlled; (b) the diver on medication has been on for an extended period and side effects worrisome to scuba are neither reported nor observed upon careful examination; (c) there are no other contraindications in the clinical picture; and, (d) the diver feels he is up to it and fully comprehends the remaining risks.
I suspect that most divers will find perspective #3 the most appealing, and it is the one I'd want applied to myself if affected. It also seems to be gaining increasing credence within the dive medicine community.
In all such deliberations, it is important that the diver be entirely honest with treating sources, training agencies, dive ops, dive buddies and himself.
Regards,
DocVikingo
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice.
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