Dextroamphetamine (Dexedrine) is a stimulant drug commonly used to treat ADHD and narcolepsy. Dexedrine is also among the most abused substances for focus and energy. Understand how it works and the health risks.
What is Dextroamphetamine (Dexedrine)?
Dextroamphetamine (brand name Dexedrine) is a prescription medication that is FDA-approved to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. It acts as a stimulant, similar to other amphetamine drugs such as lisdexamfetamine (Vyvanse) and Adderall.
Amphetamine medications, including dextroamphetamine, are also commonly abused due to their effects on concentration, physical performance, and energy [1].
Mechanism of Action
Amphetamines, like dextroamphetamine, work by increasing the release of certain neurotransmitters in the brain, including dopamine, norepinephrine, and serotonin. These neurotransmitters play many key roles in the body, including effects on memory, attention, mood, motivation, and movement, to name a few [2, 3].
Amphetamines also reduce levels of the enzyme monoamine oxidase, which helps prevent the breakdown of neurotransmitters [2].
There is also evidence that amphetamines promote the release of adrenaline, which can lead to increased blood pressure and heart rate [2].
Dextroamphetamine vs. Other Stimulants
Dextroamphetamine is a member of the amphetamine family, making it similar to other amphetamine drugs such as Adderall and Vyvanse.
The term amphetamine refers to a specific chemical that has two forms. These two forms are [4]:
- Dextroamphetamine (also known as the “right-handed” or “D” form)
- Levoamphetamine (also known as the “left-handed” or “L” form)
Dextroamphetamine and levoamphetamine are mirror images of each other, similar to how a person’s left hand is a mirror image of their right hand. This difference causes these two forms to have slightly different biological effects [2].
For example, research shows that dextroamphetamine has stronger effects on the brain. Its effect on dopamine release in the brain is up to 3 to 5 times stronger than levoamphetamine [2].
However, researchers have also found that combining both dextroamphetamine and levoamphetamine into one drug can provide additional benefits, such as making the effects of the drug stronger and last longer [2].
For this reason, some stimulant medications, such as Adderall, contain both dextroamphetamine and levoamphetamine.
Other, newer medications, like Vyvanse, contain specially-designed prodrug forms of amphetamine that only become active when processed (metabolized) inside the body after ingestion [5].
Uses of Dextroamphetamine
FDA-Approved Uses
ADHD
ADHD is a mental disorder that can cause difficulties with focusing and staying still. Although it might seem counterintuitive, stimulants like dextroamphetamine can help people with ADHD regain focus and are usually the preferred medications for treating this disorder [6, 7].
Research shows that stimulant medications, such as dextroamphetamine, can help improve a number of outcomes related to ADHD, including improvements to concentration, impulsiveness, self-esteem, social function, academics, and antisocial behavior [8, 9].
According to some estimates, stimulant medications improve ADHD symptoms in about 80% of patients [9, 10].
Stimulant medications are often used to treat ADHD in children and adolescents.
A systematic review of 23 trials including 2,675 children found that amphetamines are effective for reducing ADHD symptoms in the short term, but the frequency of side effects was high. Researchers also found there was not enough evidence to suggest one type of amphetamine is more effective than the other [11].
Narcolepsy
Dextroamphetamine is FDA-approved to treat narcolepsy, a sleep disorder that often causes involuntary sleep episodes [12, 13, 14].
As stimulants, dextroamphetamine and other amphetamines can promote wakefulness and alertness by increasing levels of dopamine and norepinephrine in the brain [15, 13].
In a study of 169 narcoleptic patients, dextroamphetamine improved normal sleep levels, but their sleep levels were still below the levels seen in healthy subjects [13].
Although dextroamphetamine can prevent sudden or excessive sleepiness, narcoleptic patients with other symptoms, such as cataplexy (the sudden loss of muscle control in response to strong emotions), may require additional medications to control their illness, such as antidepressants [15, 14].
Dextroamphetamine Safety
Side Effects
Dextroamphetamine can cause many side effects. If any side effects persist or worsen, let your doctor know. This is not a complete list of possible side effects. Tell your doctor if you experience any serious side effects or notice any effects not listed here.
Potential side effects vary according to dosage and length of treatment, and may include [16, 2, 17, 18, 19, 20]:
- Anxiety [21]
- Constipation or diarrhea
- Dizziness
- Dry mouth
- Elevated blood pressure (hypertension)
- Erectile dysfunction
- Excessive sweating
- High or low blood pressure
- Increased heart rate (tachycardia)
- Irregular heart rate
- Insomnia
- Loss of appetite/weight loss/anorexia
- Muscle spasms/tics
- Nausea
- Stomach cramps/pain
- Vomiting
Some serious side effects include [3]:
- Heart attack
- Seizure
- Severe skin reactions (Stevens-Johnson syndrome)
- New or worsening psychotic symptoms and behavioral changes
Warnings
Cardiovascular Effects
Although they are relatively rare in people without a pre-existing heart condition, cardiovascular side effects can occur and can be fatal for patients with existing heart problems or abnormalities. Tests and screening are recommended before starting dextroamphetamine or other stimulants [22, 23].
Misuse and Abuse
Dextroamphetamine has a high potential for abuse because it can cause feelings of euphoria. All amphetamines are considered Schedule II drugs and are only legally available via prescription [2, 24].
Amphetamines are often illegally used for recreational purposes, to improve athletic performance, and to help people study or work for longer hours. However, misuse of amphetamines can cause serious side effects and can even be fatal [25, 26].
According to some studies, visits to the emergency room due to stimulant use has more than doubled between 2005 and 2010, mostly due to increased misuse, especially in adults [25].
Physical signs of stimulant abuse may include [27]:
- Difficulty sleeping
- Drug cravings
- Irregular sweating
- Increased heartbeat
- Nausea or vomiting
- Severe weight loss
- Tics
Emotional or mental signs may include [27]:
- Anxiety
- Feelings of invincibility
- Mood swings
- Loss of interest in activities
- Restlessness
- Depression
Contraindications
Dextroamphetamine should not be used in people with [28, 29]:
- Agitation
- Allergies to stimulant medications
- Glaucoma
- Heart disease
- History of drug abuse or addiction
- Moderate to severe high blood pressure
- Overactive thyroid (hyperthyroidism)
- While taking MAOI medications
Pregnancy and Breastfeeding
Some research suggests that dextroamphetamine may be associated with birth defects, although strong clinical evidence is lacking. There is also evidence that amphetamines may increase the risk of premature delivery and low birth weight. Dextroamphetamine should only be used during pregnancy if a doctor determines that the benefits outweigh risks [30].
Dextroamphetamine is excreted in breast milk. Again, a doctor will decide if dextroamphetamine can be used during breastfeeding [30].
If you are taking dextroamphetamine and are pregnant or planning to become pregnant, let your doctor know.
Drug Interactions
The following drugs have been reported to interact with dextroamphetamine. However, this is not a complete list, let your doctor know of all the medications you are currently taking to avoid any unexpected interactions.
Some potential drug interactions include [30]:
- Alcohol and other sedatives
- Antidepressants
- Antihistamines
- Antipsychotics
- Anti-Seizure medications
- Blood pressure medications
- Lithium
Dextroamphetamine Dosage
The dosing of dextroamphetamine can vary. Always take this medication as directed by a doctor.
The dosage depends on the issue being treated and starts at the lowest recommended dosage and is increased gradually until achieving the desired response [2, 28].
For narcolepsy:
- Initial dose of 5 mg/day for children aged 6 – 12
- Initial dose of 10 mg/day for children aged 12 – 18
- 5 – 60 mg/day for adults
For ADHD:
- Initial dose of 2.5 mg/day for children aged 3 – 5
- Initial dose of 5 mg/day for children aged 6 – 18
- 5 – 40 mg/day for adults
