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Understanding Stimulant-Induced Essential Tremor: Ritalin vs. Adderall

A case study involves a 31-year-old individual weighing 167 pounds and standing at 5'3". They have been diagnosed with several conditions: inattentive type ADHD, level 1 autism, anxiety, seasonal affective disorder, migraines, and cerebral palsy. The individual is prescribed the following medications daily: Lamictal, Prozac, Seroquel, Minipress, trazodone, baclofen, and Ritalin. As needed, they take flexeril and rizatriptan. **Inquiry:** If the observed essential tremor is potentially linked to Ritalin, can it be assumed that Adderall would undoubtedly have the same effect? Or are the two stimulants distinct enough in their mechanisms that a switch may not be detrimental? The patient prefers not to risk a medication that may have similar side effects. Additional context reveals the patient is undergoing tests to rule out multiple sclerosis, particularly given their family medical history. An EEG has returned normal results, with an MRI currently scheduled. The tremors are bilateral, notably more pronounced in the left (dominant) hand. The neurologist, who is handling the cerebral palsy case, provided the diagnosis of the tremor and has been supervising the necessary tests. Recently, the patient eliminated morning caffeine from their routine and has increased their morning protein intake. They have noted improvement, leading to the suspicion that the tremors could be stimulant-related. The psychiatrist is considering adjusting their medications depending on the results of the MRI. However, the patient is hesitant to transition from Ritalin, which has been effective, to Adderall if it risks recreating the tremor issues.

Multiple SclerosisCrohn's DiseaseCOPD
Male25-34
16 minutes ago

Inquiries for Podiatrists

Subject: Seeking Guidance on Toe Injury Symptoms Hello, I would like to share my experience and ask for some advice. I am a 21-year-old female, standing 5'5" tall. Back in 2020, during the height of the COVID pandemic and the resulting lockdown, I experienced paronychia due to an ingrown toenail. For about six months, I was unable to receive any treatment or antibiotics, which was quite challenging. During that time, I did my best to maintain cleanliness of the affected area, frequently using gauze and allowing the toe to air out between changes. Eventually, I had surgery, and for the last five years, I've been largely free of any problems, aside from the typical changes in the appearance of that toenail. The podiatrist who performed the procedure applied a solution to ensure that the edges of the toenail would not grow back in. Recently, I stubbed my toe rather hard. While the toenail does not seem to be ingrown, I have begun to notice familiar symptoms returning—swelling, redness, a small bloody lump, and a dull ache. Is it possible for an injury to re-trigger these symptoms even after so much time has passed since the initial issue was resolved? I plan to schedule a doctor’s appointment tomorrow, where I hope to receive either antibiotics or antifungal cream, depending on what the issue might be. In the meantime, I am trying to keep the area clean and dry, applying a thin layer of Sudocrem before bed each night for the past few days. Thankfully, it’s not nearly as severe as it was previously, but I’m out of gauze, which is frustrating. Any advice on how to manage this situation would be greatly appreciated!

Cuts & WoundsOrthopedicsEmergency Medicine
Male25-34
25 minutes ago

Strange Tingling Across My Body

Age 39, Weight 205 lbs, Height 5'5". I regularly use e-cigarettes and cannabis and started experiencing unusual sensations last Friday. Initially, there was a persistent tingling sensation in my nervous system, particularly around my left breast and shoulder. As of today, I've felt tightness behind my knee and in my calf, along with various odd sensations coursing through my body. I find myself in a state of panic, uncertain whether these symptoms are simply a result of aging. My anxiety, however, is making me fear that I might be dealing with blood clots or deep vein thrombosis (DVT). These symptoms erupted shortly after having a few puffs of legal cannabis (just three, obtained from a local dispensary) and half a seltzer. I chose not to continue drinking because of how I felt. This was when I first noticed the tingling near my breast, followed by tremors that made me feel disconnected from myself. I've plunged into extensive online research, and I desperately need clarity on whether I could have a blood clot, anxiety issues, perimenopause complications, neuropathy, or multiple sclerosis (MS). As a mother of two, the thought of something happening to me is distressing. I've scheduled a doctor's appointment for tomorrow afternoon, but I don't feel any improvement today. Additionally, my family has a history of health issues, with my mother suffering from neuropathy and my father from MS, which makes me wonder if they might have any impact on my current condition.

Multiple SclerosisLupusCrohn's Disease
Male25-34
36 minutes ago