Amphetamine
ADDERALL
What it isStimulant that releases norepinephrine, dopamine and serotonin; ADHD and narcolepsy.
Why this oneIts release mechanism can work when methylphenidate reuptake blockade has not, but it carries greater misuse pressure.
What limits itAppetite loss, insomnia and blood-pressure rise often limit it. Schedule II diversion matters; urinary alkalinization can raise exposure.
FDA-approved for
- ADHD (~1960)
- narcolepsy (~1960)
Off-label
- antidepressant augmentation (limited evidence)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Narcolepsy | Adult | 5-60 mg/day in divided doses | ||
| Narcolepsy | Pediatric 6-12 yr | 5 mg QD | ||
| Narcolepsy | 12 yr and older | 10 mg QD | ||
| ADHD (with hyperactivity) | Children 3-5 yr | 2.5 mg QD | ||
| ADHD (with hyperactivity) | Children 6 yr and older | 5 mg QD-BID |
Titration Increase in weekly increments (5 mg/week; 10 mg/week for patients 12+; 2.5 mg/week for ages 3-5) until optimal response.
Renal Undefined
Hepatic Undefined
Instructions
- Give first dose on awakening; additional doses at 4-6 hour intervals
- Avoid late evening doses because of resulting insomnia
- Use lowest effective dosage
Contraindications
- MAOIs (concurrently or within 14 days) due to risk of hypertensive crisis
- Pheochromocytoma or history of pheochromocytoma
Cautions
- Palpitations, tachycardia, elevation of blood pressure
- Psychotic episodes at recommended doses (rare)
- Overstimulation, restlessness, insomnia
Adverse reactions
- Palpitations, tachycardia, elevated blood pressure
- Overstimulation, restlessness, insomnia
- Dry mouth, unpleasant taste, diarrhea, constipation
- Dyskinesia, tremor, headache
- Anorexia, weight loss
Pregnancy Dextroamphetamine shown to have embryotoxic and teratogenic effects in mice at ~41x maximum human dose; no adequate studies in pregnant women.
Lactation Undefined
⚠ BOXED WARNING
- Abuse, misuse and addiction
Cost, est. cash$10–$500/month
Generic entry1984
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityMisuse, hypertension, hyperthermia, psychosis and potentially fatal sympathomimetic toxicity.
Mechanism of action: Amphetamine ballicule
Open Amphetamine in the interactive console ↗
Memory aids: mascots and interaction avatars
