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*[[Xerostomia|Dry Mouth]]
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====Less common side effects====
====Less common side effects====

Revision as of 17:42, 2 June 2006

Adderall® CII is a pharmaceutical stimulant amphetamine used to treat attention-deficit hyperactivity disorder and narcolepsy. It was first prescribed in the 1970s as an anorectic (under the brand name Obetrol®), but such usage is now rare.

Adderall 25 mg XR Capsules

Use

The four component salts are claimed to be metabolised at different rates.

The average elimination half-life for dextroamphetamine is 10 hours in adults, and for levoamphetamine, 13 hours. Its effects are otherwise similar to other central nervous system stimulants (see amphetamine for details.).

The manufacturer claims that the mixture of salts makes Adderall's effects smoother, with softer highs and lows, than those of other treatments for the same disorders.

There is little evidence, however, to support this claim for immediate-release Adderall. A recent patent application for Adderall (USP #6,384,020) was a pharmaceutical composition patent listing a rapid immediate release oral dosage form. No claim of increased or smooth drug delivery was made. A recent double-blind, placebo-controlled crossover study, conducted among children, indicated that Adderall behaved similarly to other immediate release amphetamines. The authors found that sustained-release dexamphetamine (the main isomeric-amphetamine component of Adderall) had a longer duration of action, and cost less than Adderall, though dexamphetamine was less effective in the first few hours of morning dosing. [1]

Adderall is now sold in either an immediate-release tablet or an extended-release capsule, marketed as Adderall XR (for "eXtended Release"). Doses for both immediate-release and extended-release form come in 5, 10, 15, 20, 25, and 30 mg increments. Adderall XR utilizes the Microtrol® delivery system to achieve the extended-release mechanism. This delivery system incorporates two beads: the first type of bead dissolves immediately and the second type releases four hours later. Maximum plasma concentration is achieved in seven hours, compared to regular Adderall IR (immediate-release) which reaches maximum plasma concentration within three hours. As a result of its high bioavailability, Adderall XR's effectiveness is not altered by food absorption in the gastrointestinal tract. However, tmax (mean plasma concentration) is prolonged by 2.5 hours (using a standard high-fat meal as the control). Acidic beverages should not be taken with Adderall XR as they alter the pH balance of the stomach.[citation needed]

Effects

While the exact mechanism is unknown, it is believed that Adderall works by blocking the reuptake of dopamine and norepinephrine into the presynaptic neuron and increasing their release from the presynaptic neuron into the extraneuronal space. In other words, Adderall reverses the reuptake mechanism, turning it into a pump instead of a vacuum. Sources note that amphetamine and related compounds (ephedrine, etc.) displace noradrenaline from the presynaptic neuron and do not act as reuptake inhibitors as referenced above. [citation needed]

The increased flow of dopamine and norepinephrine into the extraneuronal space causes the brain, as one psychiatrist explains, to experience a more intense level of concentration, causing an increased ability to focus for extended periods of time, and a heightened interest in performing mental tasks.

Though rare, it is possible for Adderall to cause psychotic episodes at recommended doses in patients with a history of psychosis.

Some people feel that they are less creative while taking Adderall, while others report that the focusing effect can aid in creative work. The famous Beat generation writer Jack Kerouac, for instance, is said to have written much of his classic On The Road in a span of three weeks, aided by amphetamine (an active ingredient in Adderall) from Benzedrine inhalers; country music star Johnny Cash had a long period of amphetamine use in the 1960s; and mathematician Paul Erdős was noted for habitual use of prescription amphetamine throughout the final decades of his life; Smile was written by Brian Wilson and Van Dyke Parks with heavy amphetamine use, among others.

Side effects

Common side effects of Adderall include:

Less common side effects

Rare side effects

Contraindications

Using Amphetamines and similar drugs (Methamphetamine, Ecstasy) within 1-2 weeks of taking a monoamine oxidase inhibitor - in some antidepressants - can cause a significant adverse reaction.

Performance-enhancing use and abuse

Because Adderall uses amphetamine stimulants to help the user concentrate for extended periods of time, many students today request Adderall from doctors in order to use it as a study aid. Thus, it is increasingly popular on college campuses. The largest benefit to students however is Adderall's ability to give students the power to focus on and learn what would usually be uninteresting material. Because of the appetite-suppressing properties of amphetamines, it is also sought after by those wishing to lose weight. Another less common use for students is to take Adderall before or during a night of heavy drinking in order to remain alert and active despite being intoxicated.

On the street, Adderall is sold illegally for $2 to $8 a pill (pills ranging from 5 to 35 mg) (Purdie) or about $4-$10 for 20 mg (Peter). Slang terms for Adderall are: "study buddies", "ralls", "smart pills", "beenies", "amps", "a-bombs", "addies", "blue buddies", "Blue Betties", "orange tic-tacs", "jollies", "smurphs", "diet coke", "Davies", "team blue", "the A train", "A+" in reference to its stimulant effect (Ambien or Zolpidem is often referred to as "A-", the reverse effect of Adderall), and in some regions of the U.S., "railguns" and "that'da boy(s)" (from noted increase in productivity). On some college campuses taking Adderall is known as "taking the A train" or "getting some vitamin A", most likely inspired by the song "Take The A Train" by Duke Ellington. The 5 and 10 mg doses are also known in the northwest as "BBs",[citation needed] which is short for "Blueberries", named for their blue color. Heavier users tend to use the term "GBs", short for "goof balls", referring to the "goofy" feeling from taking in excess of 100 mg in a night.

Controversies

Adderall XR contains the FDA black box warning for a prescription drug. [3] In addition to this, Adderall is prohibited for sale in Europe and was briefly banned in Canada due to this drug's high risk of serious ADHD side effects. [4]

More on the Canadian Ban

On January 23, 2004, the Canadian Health Products Directorate approved the sale and consumption of Adderall XR, the extended release version of Adderall which only requires one dose daily. Over one year later, on February 9, 2005, Health Canada suspended all sales of Adderall XR when it was discovered that the drug was linked to twenty international reports of sudden death in its users; fourteen of the deaths occurred in children, while six occurred in adults. [5] The Canadian Health agency claimed that the incidence of serious adverse reactions was higher in Adderall than in any other drug of its class, so as a precaution, it halted all sales of the drug in Canada.

Following Adderall’s Canadian suspension in February 2005, a formal committee was established to investigate the drug’s true side effects. A three person committee, consisting of independent physicians, was formed in order to evaluate the issues of safety and efficacy pertaining to Adderall XR compared to its competitors. Ultimately the Committee recommended that the drug be re-introduced into the market under the condition that it contains stronger labeling. [6]

According to the summary report, “ an increased risk of sudden/cardiac death and/or stroke with Adderall XR compared to alternate active treatments has not been proven. It is also recognized, however, by the NDC that such an increase has not been ruled out due to limitations in the data currently available for analysis." [7]

Manufacturers

Adderall is manufactured by Catalytica Pharmaceuticals Inc. of Greenville, North Carolina and is distributed by Shire Pharmaceuticals. Generic equivalents (known to pharmacists as "amphetamine salts," "mixed amphetamines," or simply "amphetamines," inter alia) are also distributed in the United States by Barr Pharmaceuticals, Mallinckrodt Pharmaceuticals, Eon Labs and Ranbaxy Laboratories.

See also

Reference

Emily Purdie. "The Use of Legal Drugs for Recreation Among College Students". Retrieved March 16, 2006.
Peter. "Adderall". Retrieved March 16, 2006.