Amphetamine and dextroamphetamine are the two drug components of Adderall. These are stimulants that are responsible for the stimulation of the central nervous system. They are responsible for increasing the levels of dopamine and norepinephrine in the brain.

Attention deficit hyperactivity disorder (ADHD) is treated through Adderall. It is also used for the treatment of narcolepsy.

This medicine comes in two forms: Adderall immediate release and Adderall extended-release (Adderall XR). Doctors prescribe Adderall immediate release for both ADHD and narcolepsy. Adderall XR is a medication that is only prescribed for ADHD; narcolepsy is not treated through this medication.

Generic name: Amphetamine and Dextroamphetamine

Common brand names:

• Adderall
• Adderall XR
• Mydayis

How does this medicine work?

To understand how this medicine works, we need to know what happens when a person suffers from ADHD. In ADHD, there is not enough dopamine in the brain for normal brain activity. The person with ADHD cannot stay focused and exhibits impulsiveness and inattentiveness.

When they are treated with Adderall, amphetamine helps in increasing the dopamine level in their brain by stimulating the release of dopamine from the presynaptic neurons. Besides dopamine, Adderall also increases the level of norepinephrine in the brain.

Adderall also plays a role in inhibiting the reuptake of dopamine and norepinephrine by the presynaptic neurons.

Clinical indications

The two conditions treated by Adderall are:

1.     Attention deficit hyperactive disorder (ADHD)

People suffering from ADHD have a hard time being attentive. Moreover, they are hyperactive and impulsive.

Adderall immediate release and Adderall extended release can be used for the treatment of ADHD patients it helps to control the symptoms of this condition.

2.      Narcolepsy

People having narcolepsy exhibit excessive daytime sleepiness, which is the main symptom of the disorder.

Adderall immediate release is the medication used to treat narcolepsy. The medication alleviates the symptom of narcolepsy.

Dosage

The dosage of Adderall for the people suffering from ADHD or narcolepsy depends on:

• The age of the patient
• The condition that is being treated by the medicine
• The severity of the condition
• The type of Adderall being given

There can be adjustments in the dosage according to how the patient is responding.

The dosages of Adderall immediate release available in the pharmacy are: 5mg, 7.5mg, 10mg, 12.5mg, 15mg, 20mg and 30 mg.

The dosages of Adderall XR available in the pharmacy are 5mg, 10mg, 15mg, 20mg, and 30 mg.

If you forget to take a dose, take the medication immediately. If the timing of the next dose is near, you can just take the next dose without making up for the missed dose.

Dosage for ADHD

Adderall immediate release

Children under 3 years are not given Adderall immediate release for the treatment of ADHD.

• For children who are 3 to 5 years, the starting dose is 2.5mg daily. Every week the doctor may increase the dose by 2.5mg so the effective dosage level can be achieved.

• For children who are 6 to 17 years, the starting dose is 5mg once or twice a day. Every week the doctor may increase the dose by 5mg so the effective dosage level can be achieved.

• For adults, the starting dose is 5mg once or twice daily. Every week the doctor may increase the dose by 5mg so the effective dosage level can be achieved.

Adderall XR

Children under 6 years are not given Adderall XR for treating ADHD.

• For children who are 6 to 12 years old, the starting dose is 5mg or 10mg per day. There can be an increment in the dosage level by 5mg or 10mg weekly to obtain optimum results.

• For children who are 13 to 17 years old, the starting dose is 10mg per day. The dosage can be increased to 20mg taken daily after a week has passed.

• For adults, the starting dose is 20mg per day.

Dosage for Narcolepsy

Adderall XR is not given for narcolepsy. Children who are younger than 6 years old are not given Adderall for narcolepsy.

• The dosage for children in the age range of 6 to 11 years old is 5mg per day. There can be an increase in the dose by 5mg every week to reach the fully effective dosage level.

• The dosage for children in the age range of 12 to 17 years old is 10mg per day. There can be an increase in the dose by 10mg every week to reach the fully effective dosage level.

• The dosage for adults is 10mg per day. There can be an increase in the dose by 10mg every week to reach the fully effective dosage level.

Route of administration of Adderal

Both Adderall immediate release and XR, are tablets that are taken orally. You can take the tablet with or without food as per the directions of your doctor.

The first dose of Adderall should be taken after the person wakes up. The second dose should be taken after 4 to 6 hours.

Side effects of Adderall

The common side effects experienced due to medicine are:

• Loss of appetite
• Pain in stomach
• Weight loss
• Nausea
• Vomiting
• Constipation
• Feeling anxious
• Dry mouth
• Dizziness
• Trouble sleeping

There are also serious side effects associated with intake of Adderall, such as:

• Hallucinations
• Blurring of vision
• Increased heart rate
• Increased blood pressure
• Agitation or aggression
• Severe allergy to the drug
• Irritable behavior

The long-term use of Adderall can have the following side effects:

• Addiction to the drug
• Fatigue
• Damage to heart
• Moody behavior
• Psychosis
• Disorders of skin
• Anorexia

Contraindications

Discussing your medical history with your doctor is important before getting prescribed this medicine. If you suffer from the following conditions, you should not take Adderall:

• Overactive thyroid gland
• Glaucoma
• Coronary artery disease
• Abnormality in heart rhythm
• Cardiomyopathy
• A history of heart attack
• A history of stroke
• Arteriosclerosis has become severe
• Raynaud's phenomenon
• Hypertension
• Tourette's syndrome
• Drug abuse
• Psychotic behavior
• Aggressiveness
• Seizures
• Kidney dysfunction or failure
• Liver disease
• A history of weight loss
• Low appetite

Moreover, if you have an infant whom you breastfed after taking Adderall will lead to the development of the side effects in the child. Thus, lactating mothers who breastfed their children are not supposed to take Adderall.

Drug interactions of Adderal

1.     Acidifying agents

The acidifying agents are reserpine, ascorbic acid, glutamic acid hydrochloride, guanethidine, and fruit juice. If you take Adderall with acidifying agents, it will lead to reduced absorption of this medicine from the intestine.

2.     CYP2D6 inhibitors

Benadryl, Prozac, and Paxil are some of the CYP2D6 inhibitors. Taking Adderall with a CYP2D6 inhibitor disrupts the breakdown process of Adderall, leading to increased levels of this medicine in the blood.

3.     Adrenergic blockers

Adrenergic blockers are the drugs that are used to treat high blood pressure; drugs such as Doxazosin and Terazosin. If taken with Adderall, their efficacy is reduced.

4.     Tricyclic antidepressants

Desipramine, Doxepin, and Protriptyline are examples of tricyclic antidepressants, which are used for the treatment of depression. These drugs cause a sustained increase in the levels of dextroamphetamine in the brain. The person taking tricyclic antidepressants and Adderall may experience some cardiovascular problems.

5.     Serotonergic drugs

Serotonin-norepinephrine reuptake inhibitors (SNRI) and Serotonin reuptake inhibitors (SRI) are considered serotonergic drugs. Tricyclic antidepressants are also known as serotonergic drugs. If you take serotonergic drugs with Adderall, you are at risk of developing serotonin syndrome.

6.     Proton pump inhibitors

Proton pump inhibitors, such as Omeprazole, are drugs that can decrease acid production in the stomach. The effect of amphetamine on the body may increase if Adderall is taken along with these drugs. Doctors need to monitor those patients who are taking Adderall and proton pump inhibitors together.

7.     MAO Inhibitors:

MAO inhibitors are the drugs for the treatment of depression. Taking these drugs with Adderall leads to decreased metabolism of Adderall, increasing the time it spends in the body.

8.     Antihistamines

Antihistamines are drugs that act as sedatives. Adderall can prevent the sedatives effects of antihistamines.

9.     Meperidine

Meperidine is an analgesic drug. Taking Adderall with meperidine will enhance the analgesic effect of the drug.

10. Propoxyphene

Taking Adderall with propoxyphene can lead to the development of convulsions in the person's body, which can be fatal.

Besides these drugs, you should also inform your doctor if you are taking the following drugs:

• Antacids
• Thiazides
• Acetazolamide
• Phenobarbital
• Phenytoin
• Lithium carbonate
• Chlorpromazine
• Haloperidol
• Ethosuximide
• Antihypertensive

Overdosage

The mild symptoms that can occur after overdosing on Adderall are:

• Cramps in abdomen
• Nausea
• Vomiting
• Headaches
• The confused state of mind
• Breathing becomes rapid
• State of hyper activeness

The severe symptoms after having an Adderall overdosage are:

• Hallucinations
• Muscles breaking down; a condition called rhabdomyolysis
• Aggressiveness
• An increase in body temperature
• Tremors in body
• Panic
• Hypertensive state
• Heart attack
• Death

Seek immediate mediate care if you or anyone you know have overdosed on this medicine.

Storage

Tablets should be stored in an air-tight container at room temperature in a place that is cool and dry. Moreover, they should be kept away from sunlight and children.

When the tablets become expired, they should not be flushed. Dispose of them properly so children cannot get hold of them.