Amphetamine/dextroamphetamine - From Chew RH, Hales RE, Yudofsky SC: What Your Patients Need to Know About Psychiatric Medications, Third Edition

Adderall (amphetamine/dextroamphetamine mixture) is a psychostimulant, or simply a stimulant. Adderall immediate-release tablets and the extended-release capsules contain a mixture of amphetamine and dextroamphetamine. Amphetamine has two mirror-image forms known as enantiomers: levoamphetamine and dextroamphetamine. The two enantiomers have the exact same chemical composition but differ in their spatial orientation (one cannot be superimposed on the other, just as the right and left hands cannot). Dextroamphetamine is the “right-handed” molecule, whereas levoamphetamine is the “left-handed” molecule. Dextroamphetamine is the purified form of amphetamine and the more active of the two enantiomers. Adderall and Adderall XR contain about 75% dextroamphetamine and 25% levoamphetamine. The strength of each Adderall tablet or Adderall XR capsule is given as the total amount of amphetamine and dextroamphetamine. Adderall is used primarily in treatment of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy, a condition marked by daytime somnolence, in which the person experiences excessive daytime sleepiness. Narcolepsy is a neurological disorder, a dysfunction of the brain in regulating normal sleepwake cycles. Stimulants allow the person to function during the day. Adderall and Adderall XR were approved by the U.S. Food and Drug Administration (FDA) for treatment of ADHD in both adults and children age 6 years and older. The FDA approved Adderall, but not Adderall XR, for treating adults and children age 6 years and older with narcolepsy. The use of a medication for its FDA-approved indications is called its labeled use. In clinical practice, however, practitioners often prescribe medications for unapproved indications (off-label uses) when published clinical studies indicate the efficacy, and the standards of medical practice support the safety, of those treatments. Stimulants are also used outside their approved indications. Adderall, for example, may be used to augment antidepressants in treating depression that fail to respond to standard antidepressant therapy. Stimulants in combination with antidepressants can provide symptomatic relief and improvement beyond that experienced with antidepressants alone. Generic names Amphetamine/dextroamphetamine mixture