Dextroamphetamine and Amphetamine are central nervous system stimulants primarily used to treat Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy. This medication improves attention, hyperactivity, and impulsive behavior by enhancing the neurotransmission of dopamine and norepinephrine. In the treatment of narcolepsy, it helps regulate sleep cycles and reduces excessive daytime sleepiness.
This medication is classified as a controlled substance and must be prescribed by a physician after careful evaluation. Its mechanism of action differs from other ADHD medications, and it has a longer half-life, so it is usually recommended to be taken once or twice daily. Patients should be regularly monitored for side effects and efficacy during treatment to avoid misuse or abuse.
Common brand names for this medication include "Adderall®", while the generic name is referred to as "Dextroamphetamine and Amphetamine Combination." Different countries may have other brand names, but the main ingredients are a combination of dextroamphetamine sulfate and amphetamine sulfate/dextroamphetamine saccharate/amphetamine aspartate.
Generic medications must meet bioequivalence standards in terms of ingredients and efficacy, but patients should not change formulations or dosages on their own and should follow their physician's instructions. The packaging of the medication is usually color-coded by dosage, such as 5mg, 10mg, 30mg, etc.
This medication is classified as a central nervous system stimulant (CNS stimulant) and falls under Schedule II controlled substances. Its molecular structure is similar to that of other stimulants, but strict adherence to medication guidelines is required for medical use. The drug classification also includes medications for the treatment of ADHD and narcolepsy.
In pharmacological classification, its mechanism of action is similar to that of methylphenidate, but it has a longer half-life and a different plasma concentration curve. This classification determines its prescription restrictions, storage conditions, and regulatory standards.
The primary indications include Attention Deficit Hyperactivity Disorder (ADHD) in children over 6 years old and adults, used to improve attention, hyperactivity, and impulsive behavior. The second main use is for the treatment of narcolepsy, alleviating uncontrollable daytime sleepiness and cataplexy symptoms.
In rare cases, it may be used for short-term adjunctive treatment of obesity, but this use has gradually decreased due to addiction risks. Physicians may combine it with other behavioral therapies or psychotherapy based on individual needs.
Contraindications: This medication is contraindicated in individuals allergic to amphetamine components. Patients with a history of severe heart disease (such as cardiomyopathy, arrhythmias) or atherosclerosis should not use it. Those with glaucoma, severe hypertension, or severe anxiety disorders are also contraindicated.
Pregnancy is classified as Category C, and it should only be used during pregnancy when necessary. It should be avoided during breastfeeding, as the medication may be secreted in breast milk. Patients under 18 should have their growth and development monitored regularly, while adults should monitor blood pressure and heart rate.
Co-administration with monoamine oxidase inhibitors (MAOIs) may induce hypertensive crises and should be spaced at least 14 days apart. Co-administration with antidepressants (such as SSRIs) may increase the risk of serotonin syndrome.
Combining with antihypertensive medications may reduce efficacy, and interactions with antipsychotic medications may produce antagonistic effects. Avoid combining with alcohol or stimulant substances, as this may exacerbate cardiac load.
The initial dose for ADHD treatment is usually 5-10mg taken in the morning after meals, adjusted based on efficacy to a maximum of 40-60mg/day, divided into 1-3 doses. The initial dose for narcolepsy treatment is 20-25mg in the morning, which can be gradually increased to a maximum of 60mg/day.
Oral capsules should be swallowed whole and not crushed or chewed. Extended-release formulations must be swallowed whole to maintain blood drug concentration. If treatment response is poor, the physician may adjust the dosage or change the treatment plan; patients should not adjust their medication on their own.
If a dose is missed and it is more than 2 hours until the next dose, it should be taken immediately, and subsequent dosing times should be adjusted. If it is close to the next dose, the missed dose should be skipped, and doubling up should not occur. The total daily dose should not exceed the prescribed maximum.
If multiple doses are missed leading to symptom rebound, the physician should be contacted immediately to reassess the medication plan. Do not increase the next dose due to a missed dose to avoid triggering an overdose reaction.
Acute Overdose Symptoms: Severe anxiety, high fever, muscle tremors, seizures, chest pain, and a dramatic rise in blood pressure. If these symptoms occur, seek medical attention immediately; β-blockers or anticonvulsants may be required.
Chronic overdose risks include addiction, tolerance formation, and psychological dependence. If signs of non-prescription use are observed, the medication should be stopped immediately, and an addiction medical assessment should be conducted. Substance abuse may lead to cardiac events or exacerbation of mental illnesses, requiring monitoring by a specialist.
It is recommended to adjust the timing of medication based on treatment goals. For ADHD, it is usually effective to take it on an empty stomach in the morning, but this may increase the risk of palpitations; if concerned about insomnia, the medication can be taken later in the afternoon, avoiding use within 6 hours of bedtime. The physician may adjust the dosage or timing based on individual responses.
If long-term use of this medication leads to increased blood pressure, what non-medication methods can help control it?Regular aerobic exercise (such as jogging or swimming) can help lower slight increases in blood pressure, but training should be avoided during treatment breaks. In terms of diet, reducing high-caffeine beverages (such as coffee or energy drinks) and increasing potassium intake (such as bananas or spinach) may help alleviate symptoms. If blood pressure remains elevated, a follow-up appointment should be made to adjust the medication.
What potential risks should be noted when used in combination with selective serotonin reuptake inhibitors (SSRIs)?The combination may increase the risk of serotonin syndrome, which presents as high fever, muscle rigidity, and palpitations, necessitating regular monitoring of neurological symptoms. If the patient is receiving antidepressant treatment simultaneously, the physician may recommend spacing out the dosing times or adjusting the antidepressant dosage, closely monitoring serotonin levels.
How can patients alleviate dry mouth symptoms caused by the medication?Using alcohol-free lip balm or fluoride mouthwash can relieve short-term discomfort, but caffeinated stimulating beverages should be avoided. In the long term, the physician may suggest switching to an extended-release formulation or lowering the dosage; if severe, an assessment of the treatment plan may be necessary. At home, increasing fluid intake is advisable, but avoid drinking large amounts at once to reduce frequent urination.
If a patient plans to become pregnant during treatment, how should the medication strategy be adjusted?Using the medication during pregnancy may increase the risk of preterm birth, so it is recommended to discuss alternative treatment options with the physician before pregnancy. If treatment is necessary, the dosage should be gradually reduced before the second trimester, along with fetal ultrasound monitoring. When resuming treatment postpartum, the dosage should be reassessed, as the medication may be secreted into breast milk during breastfeeding.
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