Attention deficit hyperactivity disorder (ADHD) requires a combination of prescription stimulants and behavioral therapy to manage symptoms of this condition. Prescription drugs used to treat ADHD typically fall into two families: methylphenidate drugs like Ritalin and Concerta, and amphetamine drugs like Adderall, Vyvanse, and Dexedrine. It is important that people with ADHD have access to different forms of these medications to manage their symptoms since there are several subtypes of ADHD, and each person’s body chemistry is slightly different.
Within amphetamine drugs, Dexedrine and Adderall have been prescribed to treat ADHD for decades. While Adderall remains popular, Dexedrine has fallen out of favor.
Dexedrine is the brand name version of the stimulant drug dextroamphetamine. This substance is in the amphetamine family. Like other prescription amphetamines, it is primarily prescribed to treat ADHD and sometimes prescribed to treat narcolepsy or similar sleep disorders. The Food and Drug Administration (FDA) approved Dexedrine for prescription use in 1975. While it is not the most popular ADHD treatment on the market, it is still occasionally prescribed.
Physical Effects from Dexedrine
Common physical side effects associated with Dexedrine include:
- Dry mouth or an unpleasant taste in the mouth
- Uncontrollable shaking
- Diarrhea or constipation
- Changes to appetite, typically leading to weight loss
There are some serious side effects associated with Dexedrine, which are more likely to occur if a person abuses these drugs. High-risk side effects include:
- Racing or pounding heartbeat
- Chest pain
- Shortness of breath
- Slow or difficult speech
- Feeling very tired
- Dizziness or fainting
- Feeling numbness or weakness in extremities, like in the arms or legs
- Rapid mood changes
- Abnormal movements
- Changes to vision, including blurry vision
Some of these are symptoms of a Dexedrine overdose. It is important to call 911 immediately in the event of an overdose because emergency medical attention is required for the person’s survival.
Dexedrine’s Mental Effects
Dexedrine acts on norepinephrine and dopamine, two important neurotransmitters in the central nervous system (CNS) that affect mood and behavior. People with ADHD have an imbalance of these chemicals, and releasing more into the brain help to improve focus, control impulsive behaviors, and reduce tics, distractions, and hyperactivity.
Abusing Dexedrine can cause psychotic symptoms, mood changes, high energy, and behavioral changes. Especially in large, nonmedical doses, a person may show signs of Dexedrine intoxication like:
- Rapid mood changes
- Acting suspicious or paranoid
- Experiencing hallucinations or delusions
- Frenzied or highly excited mood
- Aggressive or hostile behaviors, including violence toward oneself or others
- Verbal tics
Chemistry, Dose Sizes, and Potency
Dexedrine is in the amphetamine class of medications, like Adderall, but it only contains dextroamphetamine while Adderall also contains pure amphetamine. As a prescription drug, Dexedrine comes in tablet, liquid, or extended-release capsule – all of which are intended to be orally consumed. This prescription is typically taken two or three times per day, depending on the size of the dose, which can last between four and six hours, although short-acting tablets only last for two hours.
Typical Dexedrine prescription doses may include:
- 5 mg short-acting tablets, lasting for two hours
- 5 mg, 10 mg, and 15 mg long-acting capsules, lasting up to eight hours
- Up to 40 mg can be prescribed, if symptoms are very difficult to treat
Dexedrine is more potent than many other ADHD medications, including Ritalin and Adderall, when taken in equivalent doses. In part, this is because Dexedrine only contains dextroamphetamine, and there are few inactive ingredients in this older medication to slow the release of the stimulant into the body. For people with tough-to-control ADHD symptoms, Dexedrine may still be an effective treatment; however, because of its potency and immediate release, it is prone to abuse, and it is rarely prescribed to avoid diversion.
In general, prescription stimulants including Dexedrine are abused because many falsely believe that stimulant medications can enhance performance. The “study drug” craze, starting in the 1990s, led to abuse of ADHD medications, including Ritalin, Adderall, and Dexedrine. Students believed that the stimulants would improve their focus and help them retain information, although studies have shown that adolescents and young adults who abuse these drugs perform poorly on memory-based tests and academics. Some people abuse Dexedrine and other stimulants to lose weight while athletes may abuse the drugs to have more energy during games. These are all dangerous forms of abuse and can lead to addiction.
Dexedrine in particular led to a great deal of stimulant abuse because it is rapidly metabolized into the bloodstream, directly affects the CNS, and is very potent.
Dexedrine vs Adderall
Although Adderall is more popular than Dexedrine when treating ADHD and narcolepsy, the stimulant was actually approved by the FDA in 1960, and it has been used to treat both ADHD and sleep disorders often since then. The stimulant saw a resurgence in popularity with the approval of Adderall XR, the extended-release formula that reportedly made the medication less prone to abuse, and therefore safer for children and young adults struggling with ADHD. However, the popularity of Adderall means it is diverted more often and abused frequently.
Physical Effects from Adderall
Side effects associated with Adderall are like those for Dexedrine. They may include:
- Stomachaches and nausea
- Diarrhea or constipation
- Changes to appetite, leading to weight loss
- Dry mouth
There are more serious side effects associated with Adderall, like there are for Dexedrine. These are more likely to occur in people who abuse Adderall because of the large, nonmedical doses taken; however, they can occur in those who take Adderall as prescribed. Some of these side effects are associated with overdose, so if they occur and persist, it is important to call 911 to get emergency medical attention immediately. These include:
- Changes to vision
- Chest pain
- Rapid or irregular heartbeat
- Difficulty breathing
- Extreme dizziness and fainting
- Weakness or numbness in the body
- Skin rash and swelling in the face, tongue, or body
- Trouble swallowing or speaking
Adderall causes greater damage to the cardiovascular system when it is abused. This may be due to the combination of amphetamine and dextroamphetamine.
Side effects associated with cardiovascular changes include peripheral vasoconstriction, higher heart rate compared to Dexedrine doses, and hypertension.
Adderall’s Mental Effects
While Dexedrine affects the CNS, Adderall affects both the brain and the peripheral nervous system, so it can affect nerve endings throughout the body. This stimulant also predominantly affects the release of dopamine, which improves mood, calmness, focus, and stimulation. In people with ADHD, the increase in dopamine improves their ability to complete tasks, reduces impulsivity, and helps to control physical hyperactivity. In those without ADHD, however, the change in dopamine production in the brain can lead to addiction, as this neurotransmitter impacts the brain’s reward system directly.
Adderall also more effectively changes the brain’s production of norepinephrine compared to Dexedrine. This is due to the presence of levoamphetamine in Adderall, so the fight-or-flight response in the brain is stimulated more in those who do not have ADHD and those who abuse the drug.
Like Dexedrine, when Adderall is abused, it can cause psychotic symptoms, high anxiety, and delusions. Mental effects associated with Adderall, especially when the drug is abused, include:
- Aggressive behavior toward oneself or others
- Uncontrollable behavior
Chemistry, Dose Sizes, and Potency
Adderall has both amphetamine and dextroamphetamine while Dexedrine is just dextroamphetamine. This combination is more effective for more subtypes of ADHD and in controlling associated symptoms compared to Dexedrine. The drug also releases differently into the body and brain, so it typically lasts longer without as many side effects when it is taken as prescribed.
There are two versions of Adderall that may be prescribed depending on the individual’s needs: immediate release (IR) and extended release (XR). Typically, a person will take three doses of Adderall IR per day to control ADHD symptoms; however, only one dose of XR will be necessary, based on FDA studies and approval, as this formula lasts for 7-12 hours.
Dose sizes can range.
- IR versions come in increments of 2.5 mg, but start at 5 mg and go up to 30 mg.
- XR formulas come in 5 mg increments, and also range from 5 mg to 30 mg.
Because of the combination of amphetamine and dextroamphetamine, people who take Adderall as prescribed report feeling a difference between small doses of the substance; for example, a change from 2 mg to 3 mg can be felt by most people with ADHD.
Throughout the 1960s and 1970s, doctors struggled to understand ADHD and manage appropriate treatment. Alongside changes to the medical understanding of this condition, parents worried that their children would struggle with physical and mental damage from taking potent stimulants like Dexedrine and Adderall.
While longitudinal studies on ADHD have shown that the combination of prescription medication and behavioral therapy greatly improves outcomes for people with this condition, worry about stimulant abuse persists. This is primarily due to diversion of these drugs, especially Ritalin and Adderall in recent years among adolescents and young adults. Adderall is one of the most abused stimulant drugs on the market, and ongoing struggles with this prescription have led to the development of drugs like Vyvanse, which release more slowly into the body than amphetamine-based prescriptions like Dexedrine and Adderall, or methylphenidate-based stimulants like Ritalin.
While Dexedrine has fallen out of favor, Adderall remains popular, both as a prescription ADHD and narcolepsy treatment as well as a commonly abused stimulant.
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