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Adderall

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]

This article is about a common mixture of amphetamine salts. For general information about the drug and its racemate, see Amphetamine. For the 2023 EP by Slipknot, see Adderall (EP).

Combination of

25% – stimulant
(12.5% levo; 12.5% dextro)

25% – stimulant
(12.5% levo; 12.5% dextro)

25% – stimulant
(0% levo; 25% dextro)

25% – stimulant
(0% levo; 25% dextro)

Adderall, Adderall XR, Mydayis

Mixed amphetamine salts; MAS

Oral: ~90%[9]

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]

(MAOIs) taken with amphetamine may result in a hypertensive crisis if taken within two weeks after last use of an MAOI type drug.[159]

Monoamine oxidase inhibitors

that directly metabolize amphetamine (particularly CYP2D6 and FMO3) will prolong the elimination of amphetamine and increase drug effects.[159][160][161]

Inhibitors of enzymes

drugs (such as most antidepressants) co-administered with amphetamine increases the risk of serotonin syndrome.[161]

Serotonergic

and antidepressants (sedatives and depressants) may increase (decrease) the drug effects of amphetamine, and vice versa.[159]

Stimulants

Gastrointestinal and urinary affect the absorption and elimination of amphetamine, respectively. Gastrointestinal alkalinizing agents increase the absorption of amphetamine. Urinary alkalinizing agents increase concentration of non-ionized species, decreasing urinary excretion.[159]

pH

(PPIs) modify the absorption of Adderall XR and Mydayis.[159][161]

Proton-pump inhibitors

may reduce the minimum effective dose of amphetamine when it is used for the treatment of ADHD.[note 13][165]

Zinc supplementation

In Canada, amphetamines are in Schedule I of the , and can only be obtained by prescription.[210]

Controlled Drugs and Substances Act

In Japan, the use, production, and import of any medicine containing amphetamines is prohibited.

[211]

In South Korea, amphetamines are prohibited.

[212]

In Taiwan, amphetamines including Adderall are Schedule 2 drugs with a minimum five years prison term for possession. Only Ritalin can be legally prescribed for treatment of ADHD .

[213]

In Thailand, amphetamines are classified as Type 1 Narcotics.

[214]

In the United Kingdom, amphetamines are regarded as drugs. The maximum penalty for unauthorized possession is five years in prison and an unlimited fine. The maximum penalty for illegal supply is 14 years in prison and an unlimited fine.[215]

Class B

In the United States, amphetamine is a prescription drug, classified as a central nervous system (CNS) stimulant.[216]

Schedule II

Internationally, amphetamine is in Schedule II of the .[217][218]

Convention on Psychotropic Substances

. MedlinePlus.

"Amphetamine"