Global InformationAdderall information
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 Top: racemic amphetamine skeleton Bottom: (D)-amphetamine ball-and-stick model | |
| Combination of | |
|---|---|
| amphetamine aspartate monohydrate | 25% – stimulant (12.5% levo; 12.5% dextro) |
| amphetamine sulfate | 25% – stimulant (12.5% levo; 12.5% dextro) |
| dextroamphetamine saccharate | 25% – stimulant (0% levo; 25% dextro) |
| dextroamphetamine sulfate | 25% – stimulant (0% levo; 25% dextro) |
| Clinical data | |
| Trade names | Adderall, Adderall XR, Mydayis |
| Other names | Mixed amphetamine salts; MAS |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a601234 |
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| Dependence liability | Moderate[3][4] – high[5][6][7] |
| Routes of administration | By mouth, insufflation, rectal, sublingual |
| Drug class | CNS stimulant |
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| Pharmacokinetic data | |
| Bioavailability | Oral: ~90%[9] |
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Adderall and Mydayis[10] are trade names[note 2] for a combination drug called mixed amphetamine salts containing four salts of amphetamine. The mixture is composed of equal parts racemic amphetamine and dextroamphetamine, which produces a (3:1) ratio between dextroamphetamine and levoamphetamine, the two enantiomers of amphetamine. Both enantiomers are stimulants, but differ enough to give Adderall an effects profile distinct from those of racemic amphetamine or dextroamphetamine,[1][2] which are marketed as Evekeo and Dexedrine/Zenzedi, respectively.[1][12][13] Adderall is used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is also used illicitly as an athletic performance enhancer, cognitive enhancer, appetite suppressant, and recreationally as a euphoriant. It is a central nervous system (CNS) stimulant of the phenethylamine class.[1]
Adderall is generally well-tolerated and effective in treating symptoms of ADHD and narcolepsy. At therapeutic doses, Adderall causes emotional and cognitive effects such as euphoria, change in sex drive, increased wakefulness, and improved cognitive control. At these doses, it induces physical effects such as a faster reaction time, fatigue resistance, and increased muscle strength. In contrast, much larger doses of Adderall can impair cognitive control, cause rapid muscle breakdown, provoke panic attacks, or induce a psychosis (e.g., paranoia, delusions, hallucinations). The side effects of Adderall vary widely among individuals, but most commonly include insomnia, dry mouth, loss of appetite, and weight loss. The risk of developing an addiction or dependence is insignificant when Adderall is used as prescribed at fairly low daily doses, such as those used for treating ADHD; however, the routine use of Adderall in larger daily doses poses a significant risk of addiction or dependence due to the pronounced reinforcing effects that are present at high doses. Recreational doses of amphetamine are generally much larger than prescribed therapeutic doses, and carry a far greater risk of serious adverse effects.[sources 1]
The two amphetamine enantiomers that compose Adderall (levoamphetamine and dextroamphetamine) alleviate the symptoms of ADHD and narcolepsy by increasing the activity of the neurotransmitters norepinephrine and dopamine in the brain, which results in part from their interactions with human trace amine-associated receptor 1 (hTAAR1) and vesicular monoamine transporter 2 (VMAT2) in neurons. Dextroamphetamine is a more potent Central nervous system (CNS) stimulant than levoamphetamine, but levoamphetamine has slightly stronger cardiovascular and peripheral effects and a longer elimination half-life than dextroamphetamine. The levoamphetamine component of Adderall has been reported to improve the treatment response in some individuals relative to dextroamphetamine alone. Adderall's active ingredient, amphetamine, shares many chemical and pharmacological properties with the human trace amines, particularly phenethylamine and N-methylphenethylamine, the latter of which is a positional isomer of amphetamine.[sources 2] In 2021, Adderall was the seventeenth most commonly prescribed medication in the United States, with more than 30 million prescriptions.[33][34]
- ^ a b c d Heal DJ, Smith SL, Gosden J, Nutt DJ (June 2013). "Amphetamine, past and present--a pharmacological and clinical perspective". Journal of Psychopharmacology. 27 (6): 479–496. doi:10.1177/0269881113482532. PMC 3666194. PMID 23539642.
- ^ a b Joyce BM, Glaser PE, Gerhardt GA (April 2007). "Adderall produces increased striatal dopamine release and a prolonged time course compared to amphetamine isomers". Psychopharmacology. 191 (3): 669–677. doi:10.1007/s00213-006-0550-9. PMID 17031708. S2CID 20283057.
- ^ Vitiello B (April 2008). "Understanding the risk of using medications for attention deficit hyperactivity disorder with respect to physical growth and cardiovascular function". Child and Adolescent Psychiatric Clinics of North America. 17 (2): 459–74, xi. doi:10.1016/j.chc.2007.11.010. PMC 2408826. PMID 18295156.
- ^ Graham J, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Dittmann RW, et al. (January 2011). "European guidelines on managing adverse effects of medication for ADHD". European Child & Adolescent Psychiatry. 20 (1): 17–37. doi:10.1007/s00787-010-0140-6. eISSN 1435-165X. PMC 3012210. PMID 21042924.
- ^ Kociancic T, Reed MD, Findling RL (March 2004). "Evaluation of risks associated with short- and long-term psychostimulant therapy for treatment of ADHD in children". Expert Opinion on Drug Safety. 3 (2): 93–100. doi:10.1517/14740338.3.2.93. eISSN 1744-764X. PMID 15006715. S2CID 31114829.
- ^ Clemow DB, Walker DJ (September 2014). "The potential for misuse and abuse of medications in ADHD: a review". Postgraduate Medicine. 126 (5): 64–81. doi:10.3810/pgm.2014.09.2801. eISSN 1941-9260. PMID 25295651. S2CID 207580823.
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handbook2022was invoked but never defined (see the help page). - ^ a b Sagonowsky E (28 August 2017). "Shire launches new ADHD drug Mydayis as it weighs a neuroscience exit". Fierce Pharma. Questex LLC. Archived from the original on 16 December 2019. Retrieved 2 May 2020.
- ^ "National Drug Code Amphetamine Search Results". National Drug Code Directory. United States Food and Drug Administration. Archived from the original on 16 December 2013. Retrieved 16 December 2013.
- ^ "Pharmacology". Evekeo CII (amphetamine sulfate) HCP. Arbor Pharmaceuticals, LLC. Archived from the original on 21 September 2020. Retrieved 2 May 2020.
- ^ "Prescribing Information & Medication Guide" (PDF). Zenzedi (dextroamphetamine sulfate, USP). Arbor Pharmaceuticals LLC. Archived (PDF) from the original on 11 November 2020. Retrieved 2 May 2020.
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- ^ Howell LL, Kimmel HL (January 2008). "Monoamine transporters and psychostimulant addiction". Biochemical Pharmacology. 75 (1): 196–217. doi:10.1016/j.bcp.2007.08.003. PMID 17825265.
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- ^ "Dextroamphetamine; Dextroamphetamine Saccharate; Amphetamine; Amphetamine Aspartate - Drug Usage Statistics". ClinCalc. Retrieved 14 January 2024.
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