Adderall is a combination of 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.
Adderall is used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy, 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.
Adderall tradename.
Routes of administration:
Oral, insufflation, rectal, sublingual
Class drug CNS stimulant.
US: Schedule II
Adderall is effective in treating the symptoms of ADHD and narcolepsy.
It causes emotional and cognitive effects such as euphoria, loss of sex drive, increased wakefulness, improves cognitive control, induces physical effects such as a faster reaction time, fatigue resistance, and increased muscle strength.
In larger doses of Adderall can impair cognitive control, cause rapid muscle breakdown, provoke panic attacks, or induce a psychosis, delusions, or hallucinations.
Adderall side effects vary widely: most commonly include insomnia, dry mouth, loss of appetite, and weight loss.
The risk of addiction or dependence is insignificant when used as prescribed at fairly low daily doses, such as those used for treating ADHD.
Use of Adderall in larger daily doses poses a significant risks: addiction or dependence due to the pronounced reinforcing effects that are present at high doses.
Recreational doses of amphetamines are generally much larger than prescribed therapeutic doses, carrying a far greater risk of serious adverse effects.
The two amphetamine enantiomers that compose Adderall are levoamphetamine and dextroamphetamine alleviate the symptoms of ADHD and narcolepsy by increasing the activity of the neurotransmitters norepinephrine and dopamine in the brain
They interact with human trace amine-associated receptor 1 (hTAAR1) and vesicular monoamine transporter 2 (VMAT2) in neurons.
Dextroamphetamine is a more potent CNS stimulant than levoamphetamine.
Levoamphetamine has slightly stronger cardiovascular and peripheral effects and a longer elimination half-life than dextroamphetamine.
Adderall’s active ingredient, amphetamine, shares many chemical and pharmacological properties with the human trace amines, particularly phenethylamine and N-methylphenethylamine.
With ADHD, amphetamines at therapeutic dosages appear to improve brain development and nerve growth.
Long-term treatment with amphetamine decreases abnormalities in brain structure and function found in ADHD, and improves function in several parts of the brain, such as the right caudate nucleus of the basal ganglia.
Safety and effectiveness of long-term continuous amphetamine use for the treatment of ADHD has been established.
Continuous stimulant therapy for the treatment of ADHD demonstrate treatment effectiveness and safety: reducing symptoms of ADHD, hyperactivity, inattention, and impulsivity, enhancing quality of life and academic achievement, and producing improvements in a large number of functional outcomes across 9 categories of outcomes related to academics, antisocial behavior, driving, non-medicinal drug use, obesity, occupation, self-esteem, service use and social function.
A controlled trial of amphetamine treatment for ADHD in children found an average increase of 4.5 IQ points, continued increases in attention, and continued decreases in disruptive behaviors and hyperactivity.
Lifetime stimulant therapy during childhood is continuously effective for controlling ADHD symptoms and reduces the risk of developing a substance use disorder as an adult.
Psychostimulants like methylphenidate and amphetamine are effective in treating ADHD because they increase neurotransmitter activity in these systems.
Approximately 80% of those who use these stimulants see improvements in ADHD symptoms.
Children with ADHD who use stimulant medications generally have better relationships with peers and family members, perform better in school, are less distractible and impulsive, and have longer attention spans.
Adderall is available as immediate-release tablets or two different extended-release formulations.
A systematic review and a meta-analysis found that, when used at low doses, amphetamine produces modest improvements in cognition, including working memory, long-term episodic memory, inhibitory control, and some aspects of attention, in normal healthy adults.
The cognition-enhancing effects of amphetamine are partially mediated through the indirect activation of both dopamine receptor D1 and adrenoceptor α2 in the prefrontal cortex.
Low doses of amphetamine improve memory consolidation, in turn leading to improved recall of information.
Amphetamine enhances cortical network efficiency, improving working memory in all individuals.
Amphetamines and other ADHD stimulants also improve motivation to perform a task, and increase arousal.
It promotes goal-directed behavior.
Stimulants can improve performance on difficult and boring tasks and are used by some students as a study and test-taking aid
5–35% of college students use ADHD stimulants.
High amphetamine doses that are above the therapeutic range can interfere with working memory and other aspects of cognitive control.
In healthy people amphetamines has been shown to increase muscle strength, acceleration, athletic performance in anaerobic conditions, and endurance, while improving reaction time.
Amphetamine improves endurance and reaction time primarily through reuptake inhibition and release of dopamine in the central nervous system.
Amphetamine and other dopaminergic drugs also increase power output at fixed levels of perceived exertion by overriding a safety switch, thus allowing the core temperature limit to increase in order to access a reserve capacity that is normally off-limits.
At therapeutic doses, the adverse effects of amphetamine do not impede athletic performance.
At much higher doses, amphetamines can induce effects that severely impair performance, such as rapid muscle breakdown and elevated body temperature.
Adderall has been banned by all major league sports societies.
Adderall has high potential for misuse as a recreational drug.
Adderall tablets can either be swallowed, crushed and snorted, or dissolved in water and injected.
Intravenous injection into the bloodstream can be dangerous because insoluble fillers within the tablets can block small blood vessels.
Students use Adderall for study purposes.
Risk factors for misusing ADHD stimulants recreationally include: possessing deviant personality characteristics, inadequate accommodation of disability, basing one’s self-worth on external validation, low self-efficacy, earning poor grades, and having an untreated mental health disorder.
Amphetamines like Adderall are contraindicated in people with a history of drug abuse, cardiovascular disease, severe agitation, or severe anxiety. in individuals with advanced arteriosclerosis, glaucoma, hyperthyroidism and moderate to severe hypertension.
Should not be taken with monoamine oxidase inhibitors (MAOIs).
Patients with anorexia nervosa, bipolar disorder, depression, hypertension, liver or kidney problems, mania, psychosis, Raynaud’s phenomenon, seizures, thyroid problems, tics, or Tourette syndrome should be monitored for symptoms while taking amphetamine.
The amount of substance consumed is the primary factor in determining the likelihood and severity of side effects of adderall.
Recreational use of Adderall generally involves far larger doses and is therefore significantly more dangerous.
Side effects:
Cardiovascular side effects can include hypertension or hypotension from a vasovagal response, Raynaud’s phenomenon and tachycardia.
Sexual side effects in males may include erectile dysfunction, frequent erections, or prolonged erections.
Gastrointestinal side effects may include abdominal pain, constipation, diarrhea, and nausea.
Other potential physical side effects include appetite loss, blurred vision, dry mouth, excessive grinding of the teeth, nosebleed, profuse sweating, rhinitis medicamentosa, reduced seizure threshold, tics and weight loss.
Dangerous physical side effects are rare at typical pharmaceutical doses.
The most common psychological side effects of amphetamine include increased alertness, apprehension, concentration, initiative, self-confidence and sociability, mood swings, insomnia or wakefulness, and decreased sense of fatigue.
Less commonly anxiety, change in libido, grandiosity, irritability, repetitive or obsessive behaviors, and restlessness effects are seen.
Side effects depend on the user’s personality and their current mental state.
Amphetamine psychosis of delusions and paranoia can occur in heavy drug users.
Psychosis can also occur rarely, at therapeutic doses during long-term therapy.