Adderall – A Brief Walkthrough Of The Commonly Used Drug

If you are suffering from narcolepsy or attention deficit hyperactivity disorder (ADHD), you might have been familiar with the drug, ‘Adderall’. It is usually used for controlling the levels of chemicals present in our brains; that are Norepinephrine and Dopamine. Adderall 30mg comprises of a mishmash of amphetamine and dextroamphetamine – two central nervous system stimulants affecting Norepinephrine and Dopamine (chemicals in the brain). It plays a huge role in controlling hyperactivity. Adderall works by raising the dopamine levels within the brain. Dopamine is considered the body’s “feel good” chemical and causes a pleasing effect. However, our body produces dopamine naturally, but certain drugs such as Adderall increase its level by producing it unnaturally, eventually making the patient happy and less impulsive. Moreover, Adderall 30mg also treats sleep disorder narcolepsy that can assist in keeping the patient stay awake throughout the day and ADHD (Attention Deficit Hyperactivity Disorder as a constituent of a complete treatment plan along with other social and psychological treatments. It is recommended not to use it to treat fatigue or to delay sleep in people who actually do not have any sleeping disorder. Furthermore, it elevates the capability of the patient to focus and reduce twiddling.

Dosage and Administration

As stated before, Adderall comprises two stimulants, i-e., Amphetamine, and Dextroamphetamine. It is available in a couple of forms: short acting and long acting. The shot acting one can usually last for 4 hours whereas the long-acting form can last for a whole day when taken in the morning. The capsules are made up of two sorts of beads, one of them (usually half of the whole capsule) dissolves right away showing the effects of one dose of the drug, while the second portion or type of beads are coated and do not dissolve in the blood till the right time for the second dose. Adderall’s long-acting version usually last for 10 to 12 hours.

Usage of Adderall 30mg

Take Adderall orally (by mouth) just as prescribed by your doctor. Usually, it is taken 1-3 times per day. The first dosage is for the morning as the patient wakes up. If your doctor has prescribed more than three doses, make sure to keep in line with your doctor’s instructions, and make a gap of around 4-6 hours between every dose. If you are taking the medication in the mid of the day, it may cause trouble sleeping or insomnia. The dosage varies as per the medical condition of the patient and how the body responds to the treatment and dosage. Your doctor may line up your dose to discover the right dose for you, therefore, it is very important to take heed to your doctor’s guidelines. Besides, you need to take Adderall 30mg daily to drive the best out of it. In order to make sure you don’t forget to take the medicine, try to set a specific time for taking medication and stick to it. As your treatment escalate, your doctor may ask you to discontinue the medication for a short while to check if it causes any changes in the pattern of your behaviors and if you further need the treatment to get well completely. Since this medication has a very pleasing effect on the mind, withdrawing the dosage can cause some reaction, particularly when the patient has been taking for a long period of time or high dosage. Such patients may suffer from severe fatigue, sleeping disorders, mood swings, depression, and so on. The best way to withdraw from the medication is to reduce the dosage gradually.

Precautions

The known side effect of using Ambien is dizziness which can make you sleepy during the day. Other side effects associated with using Zolpidem are changes in behaviour, abnormal thoughts, depression, memory loss, agitation, anxiety, hallucinations, and thought of suicide among so many others. Since your doctor prescribed the drug, he has probably judged that the benefits of the medication to you supersede the side effects. If you notice any of the side effects, tell your doctor or pharmacist immediately, your dose may need to be adjusted. In some rare occasions, after using Zolpidem, people have sleep-drive, had sex, prepared or eaten foods without being fully awake. Ambien side effects are often aggravated when you consume alcohol. It is advised not to take Adderall 30mg if the patient has advanced arteriosclerosis, hypertension, hyperthyroidism, glaucoma, symptomatic cardiovascular disease, history of drug abuse, agitated states, or throughout the administration of MAOIs (monoamine oxidase inhibitors) There are no authentic studies on the effects of this medication in pregnant women. Only a few reports show tracheoesophageal fistula, congenital bony deformity, and anal atresia in the newborn if the mother takes dextroamphetamine sulfate with lovastatin at the time of the first trimester of pregnancy. Don’t forget to consult your doctor if you are on Adderall and planning to be pregnant. Amphetamines should be used while pregnancy only when the possible benefit sounds reasonable and overcome the possible danger to the fetus.

Adderall is the brand name for a combination drug that contains four salts of amphetamine. Racemic amphetamine and dextroamphetamine are present in equal parts in the mixture. In addition, two enantiomers of amphetamine are also present, which are also stimulants but different enough to give Adderall pharmacodynamics distinct from racemic amphetamine and dextroamphetamine. Amphetamine is a psychomotor stimulant that causes excitement and euphoria, decreases feelings of fatigue, and increases motor activity. Initially, it was used to diminish appetite and control weight. Students not only take it to get away from stress but also to enhance their memory to be more productive. This sort of artificial stimulation has existed on school grounds for quite a long time. Presently, It is an FDA (U.S Food and drug authority) approved drug for Attention Deficit Hyperactivity Disorder (ADHD). It is also used for patients with Narcolepsy.

History and background:

Adderall is the brand name for amphetamines, which are categorized as CNS STIMULANTS. Amphetamine was first integrated by a Romanian physicist named Lazăr Edeleanu in 1887 at the University of Berlin. Edeleanu composed broadly on amphetamine yet never found its physiological impacts. In 1929, a biochemist in California named Gorden Alles infused himself with 50 milligrams of the medication to encounter its physiological impacts. He was attempting to foster a medication that would be more viable than ephedrine, which was utilized for asthma, hypersensitivities, and colds.

After taking medication, he found his nose to be dry but felt an unusual feeling of wellbeing. The following day he had a “somewhat restless evening,” since his psyche was hustling due to stimulant effect. He licensed amphetamine sulfate and amphetamine hydrochloride in 1932 and was quick to distribute the impacts.

Alles went to the drug organization Smith, Kline, and French and helped with the revealing of a decongestant inhaler called Benzedrine (a form of the drug amphetamine) by 1934. That is the place where the school kids come in. Before the finish of the 1930s, Adderall had assumed control over the students, professionals who use Benzedrine to remain active and conscious late at night to complete their school work (and likely to make some great memories). Both the partnered powers and the Nazis utilized amphetamine and methamphetamine during World War II to combat fatigue and invigorate the soldiers. It has been recorded that over 200 million methamphetamine pills were conveyed to German soldiers somewhere in the range of 1939 and 1945.

Amphetamine-based medications, similar to Benzedrine Sulfate, got mainstream among moms during the 1950s. It was used to treat Parkinson’s disease. Benzedrine was later a medication of decision for a considerable lot of the mavericks of the 1950s and 60s. The FDA approved Adderall under the name Obetrol in 1960 which is used as a drug to decrease appetite. The FDA approved Adderall in 1996.

That may seem like the nail in the final resting place for legitimate use of amphetamine and methamphetamine in the country, yet it is a long way from it. Adderall is still very famous among undergraduates. While it very well may be gotten as a solution to treat ADHD, it is ordinarily acquired by students illicitly through a companion. Around 33% of undergrads are said to utilize the medication sooner or later during their initial four years of school.

Methamphetamine and medications, for example, Adderall are viewed as Schedule II medications by the Drug Enforcement Administration(DEA), which implies they have a “high potential for misuse” and can prompt “serious mental disorder” The ADHD drug industry earn more than $9 billion in 2012 and it doesn’t appear to back off.

Uses:

It is an FDA-approved drug for Attention Deficit Hyperactivity Disorder (ADHD). It is also used for Narcolepsy. It produces euphoria, wakefulness, and a feeling of wellbeing. That’s the reason it’s being used by students, to relieve stress and enhance productivity, by athletes for enhancing performance and for recreational purposes for example as an aphrodisiac and euphoriant. It is also used for reducing appetite and controlling weight. It acts on the Central and peripheral Nervous System indirectly by enhancing catecholamine neurotransmitters in the synaptic cleft. It enhances neurotransmitters not only by releasing neurotransmitters but also by inhibiting Monoamine Oxidase Inhibitors (MOI) thus stimulating the entire cerebrospinal axis, cortex, brainstem, and medulla. This leads to decreased fatigue, decreased appetite, increased alertness, and insomnia. In addition to its marked action on the CNS, amphetamine acts on the adrenergic system, indirectly stimulating the receptors through norepinephrine release.

Adderall is available as immediate-release (IR) tablets or two different extended-release (XR) formulations. The extended-release capsules are generally used in the morning. A shorter, 12-hour extended-release formulation is available under the brand name Adderall XR and is designed to provide an effect required and concentration in plasma identical to taking two doses with 4 hours in between.

ADHD

Attention Deficit Hyperactivity Disorder (ACHD) is a neurobehavioral disorder that is characterized by hyperactivity and attention deficit. People suffering from this disease experience lack of focus. The pathology of this disorder isn’t obviously seen yet there is proof that this is brought about by an irregularity in the neurotransmitters as well as structural and functional defects.

Adderall is effective in treating ADHD because it increases neurotransmitter activity. Lisdexamfetamine [lis-dex-am-FET-ameen] is a prodrug that is converted to the active component dextroamphetamine after GI absorption and metabolism. Lisdexamfetamine prolongs the patient’s span of attention, allowing better function in a school atmosphere. Different studies have proved that Adderall is very effective in treating ATTENTION Deficit Hyperactivity Disorder (ADHD). According to the Journal of the American Academy of Child & Adolescent Psychiatry, significant improvement was seen in children taking Adderall. It also states that it is well-tolerated with mild adverse effects.

According to a study “Neurocognitive, Autonomic, and Mood Effects of Adderall on healthy School Going Students”, it is evidenced that it is not effective in improving the cognitive behavior of normal healthy students. So, its use should be discouraged.

The dose recommended for ADHD is 5mg to 20mg a day, depending on a patient’s age and whether the drug is immediate-release(IR) tablets or two different extended-release(XR). Adderall is not indicated for children age less than 3 years or Adderall XR under 6 years of age. It should be taken strictly as prescribed by your physician and should be taken early in the morning to avoid insomnia.

Narcolepsy:

Narcolepsy is a chronic sleep disorder that is characterized by extreme daytime drowsiness followed by sudden severe sleep attacks. These patients are usually found sleeping in offices, schools, and workplaces. Narcolepsy is a lifelong disease that does not have any cure. It is sometimes accompanied by catalepsy, a loss in muscle control, and even paralysis brought on by strong emotions such as laughter. However, the patient is usually treated for sleepiness with such drugs, amphetamine or methylphenidate but some patients also show improvement in cataplexy. Adderall is used as a second-line drug treatment for narcolepsy after modafinil which is the first line. Modafinil is also a stimulant that is approved by FDA(Food and Drug Authority) for narcolepsy.

According to studies, Adderall is a very effective medication after Modafinil for the treatment of narcolepsy but it comes with the potential to be misused causing tolerance and dependence.

Its dose ranges from 5 to 10 mg depending on the age and symptoms of the patient. Adderall is not recommended for children age less than 6 years for narcolepsy and Adderall XR is not approved for treating narcolepsy at all.

Other Off-label use of Adderall includes depression, anxiety, and bipolar disorders.

Routes of administration:

  • Oral
  • Insufflation
  • Rectal
  • Sublingual

Adderall VS Ritalin:

Adderall is amphetamine and Ritalin is methylphenidate. Methylphenidate is a dopamine transport inhibitor and may act by enhancing dopamine in the synaptic space. Dopamine is the neurotransmitter that increases the sense of reward so Ritalin does not produce the feeling of pleasure or reward.

They are both equally addictive controlled substances and are categorized as Schedule II medications by the Drug Enforcement Administration (DEA). As per efficacy, Adderall is two times more potent than Ritalin according to the study of “Official Journal of the American Academy of Pediatrics”. According to the research in The Lancet psychiatry by Dr.Samuele Cortese and Colleagues, Adderall is better for adults and Ritalin should be preferred for children.

Adderall VS Strattera:

Strattera is the brand name for atomoxetine. Atomoxetine is a non-stimulant drug approved for Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. Unlike amphetamine, atomoxetine is a norepinephrine-reuptake inhibitor. Therefore, it is not addictive and is not a controlled substance leading to less dependency and withdrawal effects. According to the journal of attention deficit, Adderall is more efficacious than Strattera.

Adderall VS Provigil:

Provigil is the brand name for modafinil. Modafinil is a weaker stimulant than Adderall so it produces fewer psychoactive and euphoric effects as well as fewer alterations in mood, perception, thinking, and feelings typical of other CNS stimulants. It enhances wakefulness. The mechanism of action of this drug is different from that of amphetamine. Modafinil is effective orally. There is some evidence to indicate the potential for abuse and physical dependence with modafinil but overall it is categorized as SCHEDULE IV as compared to Adderall SCHEDULE I by the Drug and Enforcement Authority (DEA). It causes fewer side effects and less dependence and withdrawal effects According to Lippincott, Modafinil is more effective than Adderall for Narcolepsy and is considered the first-line for narcolepsy by FDA.

These are due to the extension of its pharmacological actions. It affects different systems:                              

Central Nervous System effects:

Adderall may cause addiction, leading to

  • Dependence
  • Tolerance
  • Drug-seeking behavior.

In addition, they have the following undesirable effects Undesirable side effects of Adderall usage include

  • insomnia,
  • irritability,
  • weakness,
  • dizziness,
  • tremor
  • hyperactive reflexes.
  • confusion,
  • delirium,
  • panic states
  • Suicidal tendencies especially in mentally ill patients.

A rare state of “amphetamine psychosis” can occurwith chronic use of Adderall that resembles the psychotic episodes related to schizophrenia. It also causes psychological and physical dependence, tolerance to its effects may occur within a few weeks. Overdoses of amphetamine are treated with chlorpromazine or haloperidol, which relieve the CNS symptoms as well as hypertension because of their α-blocking effects. The amphetamine reduces appetite by acting on the lateral hypothalamic feeding center.

Cardiovascular effects:

In addition to its CNS effects, Adderall causes

  • Palpitations
  • Cardiac arrhythmias
  • Hypertension
  • Anginal pain
  • Circulatory collapse
  • Headache, chills, and excessive sweating may also occur.

Because of its cardiovascular effects, Adderall should not be given to patients with cardiovascular disease and those receiving MAO inhibitors.

GI system effects:

Adderall acts on the GI system, causing:

  • Anorexia,
  • Nausea,
  • Vomiting,
  • Abdominal cramps
  • Diarrhea.

Dependence and Withdrawal symptoms:

Due to its effect of producing a feeling of wellbeing and enhancing cognitive functions, it is misused by students and other professionals. As it is used for a prolonged period, it causes dependence and withdrawal effects when stopped abruptly. Its Withdrawal symptoms include:

  • Depression
  • Irritability and mood changes
  • Unusual tiredness
  • Stomach aches
  • Vomiting
  • A hard sleeping

These symptoms appear a day or two after you stop taking it. It may take few days to weeks depending on age and period of use.

Tolerance:

Repeated use of a drug causes a gradual decrease in the response to the drug. Adderall develops a tolerance for chronic use. People who want to lose abuse this medicine and often face tolerance. A gradual increase in the dose of these drugs is required to keep the normal degree of their effects.

Adderall may debilitate the capacity of the patient to take part in conceivably unsafe exercises like working apparatus or vehicles, the patient should be warned accordingly. Prescribers or medical services experts ought to educate patients, their families, and their parental figures about the advantages and dangers related with therapy and appropriately counsel them

Contraindications:

Neither patients with hypertension, cardiovascular infection, hyperthyroidism, or glaucoma ought to be treated with this medication, nor should patients with a background of drug misuse, nor anybody taking MAO inhibitors.

Adderall is contraindicated for children less than age 3 years for attention Deficit hyperactivity disorder and children less than age 6 years for narcolepsy. Adderall XR should not be used for children with narcolepsy anyway.

Can I take Adderall if I am pregnant or breastfeeding?

Food and Drug Authority (FDA) for pregnancy categorized Adderall as Category C so it can be used in pregnancy with caution. If you have mild to moderate symptoms, it should be avoided but if severe, it should be taken for maintaining normal functioning. For breastfeeding it is classified as L3 i.e. moderately safe, however, there is the possibility that side effects to the breastfeeding infant may occur.

How quickly does the treatment work?

Adderall starts to work within 30 minutes to an hour and lasts for 5 to 7 hours. Treatment with Adderall should not extend beyond 4 weeks.

Is it safe to take Adderall?

Yes, it’s safe to take Adderall if you have Attention Deficit hyperactivity disorder if taken as directed by your physician but taking it for cognitive enhancement and stress relieving, is neither safe nor effective as per some studies.

How long does a dose of Adderall last?

A single dose of Adderall lasts for 5 to 7 hours, four to eight times longer than cocaine.

Are there any side effects of the treatment?

Yes, there are side effects of using Adderall such as nausea, loss of appetite, fever, trouble sleeping. You should get back to your doctor if these effects persist. It may also increase your blood pressure and cause palpitations.

Do I require a prescription for taking Adderall?

Yes, you need a proper prescription by certified Heath care professional for taking Adderall. Otherwise, it is illegal to have Adderall as it is classified as a controlled substance by Drug Enhancement Authority(DEA)

Why is it not safe to buy Adderall online?

It is not safe because this drug may be fake. FDA strongly discourages consumers from buying online because of the issue of counterfeit. Online Pharmacies which sell substance-controlled drugs without a prescription poses threat to public health.

I cannot swallow the capsule, what should I take?

If you are facing difficulty in swallowing capsules of Adderall, you can take out the content of the capsule and take it with some pudding or sauce. There is no liquid form of this medication available commercially.

Is this treatment a safe option for children?

Yes, For Attention Deficit hyperactivity Disorder, Adderall is safe for children age more than 3 years while Adderall XR is safe over 6 years of age. It should be taken strictly as prescribed by your physician and should be taken early in the morning to avoid insomnia. It is not recommended for children age less than 6 years for narcolepsy and Adderall XR is not approved for treating narcolepsy at all.

How long do I have to take Adderall?

This depends on your medical condition and response to the medication. The doctor may stop the medication to check whether there is improvement in symptoms and whether the medication is still needed. You need to adhere to the directions of your primary care physician cautiously.

Can I take Adderall with other medication?

Certain drugs shouldn’t be used alongside Adderall because some drugs decrease their efficacy and the interaction of some drugs with it can cause lethal effects. Drugs that cause severe interactions include

  • Cymbalta (duloxetine)
  • Lexapro (escitalopram)
  • Prozac (fluoxetine)

These drugs may increase the effect of amphetamine and cause exaggerated response causing nervousness, agitation, jitteriness, and tremors. It can also cause serotonin syndrome, a rare condition characterized by, hallucination confusion, seizure, increased heart rate, extreme changes in blood pressure fever, shivering or shaking, excessive sweating, blurred vision, tremor, incoordination muscle spasm or stiffness, stomach cramp, nausea, vomiting, and diarrhea. It can also lead to coma and death. Other medicines that should not be taken with amphetamine include:

  • Stomach acid drugs:
  • H2 receptor antagonists such as:
  • Famotidine
  • Ranitidine
  • Proton pump inhibitors such as:
  • omeprazole
  • esomeprazole
  • Tricyclic antidepressants (TCAs) .for example amitriptyline, clomipramine
  • Monoamine oxidase inhibitor (MAOI) antidepressants. For example selegiline
  • Antipsychotic drugs. For example haloperidol
  • Blood pressure drugs.
  • angiotensin-converting enzyme (ACE) inhibitors such as
  • enalapril
  • lisinopril
  • angiotensin II receptor blockers such as:
        • losartan
        • valsartan
        • irbesartan
  • diuretics such as:
    • hydrochlorothiazide
    • furosemide
  • Seizure drugs For example phenobarbital

Is Adderall hard on the liver?

In therapeutic doses, it rarely affects the liver. so it is completely safe for the liver. However, in case of overdosing it causes liver injury and ultimately liver failure if not treated promptly.

Is it true that Adderall should not be used in glaucoma?

Yes, it is contraindicated in patients with glaucoma.

Can I take Adderall for memory loss?

According to new research, it is evidenced that it brings very few and short-lived cognitive benefits to healthy individuals while placing their health at risk in long run. So these stimulants should not be taken by healthy individuals.