What is Dexedrine?
Dexedrine is a brand name for the central nervous system (CNS) stimulant medication dextroamphetamine sulfate. It belongs to the class of drugs known as amphetamines and is available by prescription only. Due to its potential for abuse and dependence, the Drug Enforcement Administration (DEA) and the US Food and Drug Administration (FDA) classify Dexedrine as a Schedule II controlled substance. It is an effective component of a comprehensive treatment plan that often includes other therapeutic approaches, such as counseling and education.
Therapeutic Uses of Dexedrine
Dexedrine is officially approved by the FDA for the treatment of two main conditions: Attention-Deficit/Hyperactivity Disorder (ADHD) and narcolepsy.
Attention-Deficit/Hyperactivity Disorder (ADHD)
In patients with ADHD, Dexedrine works to address core symptoms of the disorder, helping to increase focus, improve attention span, and decrease restlessness. It is used as part of a total treatment program that can also involve psychological and educational interventions. For children aged 3 to 16, it is used to manage symptoms such as distractibility, hyperactivity, and impulsivity. The therapeutic benefits are attributed to its effect on certain neurotransmitters in the brain, helping to regulate behavior that is disorganized or difficult to control.
Narcolepsy
For individuals suffering from narcolepsy, a sleep disorder characterized by excessive daytime sleepiness, Dexedrine is used to help them stay awake and alert during the day. By acting as a CNS stimulant, it counteracts the overwhelming urges to sleep that are characteristic of this condition. While effective, the American Academy of Sleep Medicine (AASM) has noted that other medications, such as modafinil and pitolisant, may be preferred for managing daytime sleepiness in adults.
How Dexedrine Works in the Brain
Dextroamphetamine works by increasing the activity of key neurotransmitters in the brain, specifically dopamine and norepinephrine. Its mechanism involves several distinct actions:
- Promotes Neurotransmitter Release: It stimulates the release of these monoamine neurotransmitters from presynaptic vesicles into the synapse.
- Inhibits Reuptake: It blocks the transporter proteins responsible for reabsorbing dopamine and norepinephrine back into the neuron, leading to higher concentrations of these chemicals in the synaptic cleft.
- Increases Activity: By increasing the availability of dopamine and norepinephrine, Dexedrine enhances communication between neurons, leading to increased attention, focus, and improved behavioral control.
Dosage and Administration
Dexedrine is available in multiple forms, and a healthcare provider will determine the appropriate form and administration for each patient.
- Immediate-release and oral solution: These forms may require administration multiple times a day.
- Extended-release capsules (Spansule): These are designed for once-daily administration to provide a longer duration of effect, lasting 8 to 10 hours. These capsules should be swallowed whole or sprinkled on a soft food like applesauce, not chewed or crushed.
Administration late in the day should generally be avoided to prevent sleep disturbances. The specific amount and frequency of use are individualized based on the patient's response and tolerability.
Comparison: Dexedrine vs. Adderall
Both Dexedrine and Adderall are stimulant medications used for ADHD and narcolepsy, but they differ in their active ingredients and composition. Here is a comparison:
| Feature | Dexedrine (Dextroamphetamine) | Adderall (Amphetamine/Dextroamphetamine) |
|---|---|---|
| Composition | Contains only dextroamphetamine sulfate. | Contains a mixture of amphetamine salts, specifically a 3:1 ratio of dextroamphetamine to levoamphetamine. |
| Effects on CNS | Considered to have a stronger central nervous system effect due to dextroamphetamine being the more potent isomer. | Provides both a central and peripheral stimulating effect due to the presence of both d- and l-isomers. |
| FDA Approval (ADHD) | Approved for ADHD in children aged 3 to 16, depending on the formulation. | Approved for ADHD in children 3 and older, and adults. |
| Mechanism | More specific for dopaminergic neurons. | Acts on both dopaminergic and noradrenergic neurons. |
Important Side Effects and Precautions
Like all medications, Dexedrine carries a risk of side effects and serious adverse events. It is essential to be aware of these potential issues and discuss them with a healthcare provider.
Common Side Effects
- Headache
- Dry mouth
- Decreased appetite and weight loss
- Insomnia
- Upset stomach or gastrointestinal issues
Serious Side Effects and Risks
- Cardiovascular Issues: Includes risk of sudden death, heart attack, and stroke, especially in patients with pre-existing heart problems. Blood pressure and heart rate must be monitored regularly.
- Psychiatric Adverse Events: Can cause or worsen mood swings, anxiety, agitation, and, in rare cases, psychosis or manic symptoms.
- Abuse and Dependence: As a Schedule II controlled substance, Dexedrine has a high potential for abuse and physical dependence. Long-term use can lead to tolerance, and abrupt discontinuation can cause withdrawal symptoms like severe fatigue and depression.
- Growth Suppression: Monitoring height and weight is recommended in pediatric patients taking Dexedrine.
- Circulation Problems: Can cause peripheral vasculopathy, leading to symptoms like numbness, coldness, or color changes in fingers or toes.
Contraindications Dexedrine should not be used in patients with:
- Moderate to severe hypertension
- Advanced arteriosclerosis
- Hyperthyroidism
- Glaucoma
- Agitated states
- A history of drug abuse
- Within 14 days of taking a monoamine oxidase inhibitor (MAOI)
Conclusion
Dexedrine is a powerful central nervous system stimulant with proven efficacy in treating ADHD and narcolepsy by increasing the levels of dopamine and norepinephrine in the brain. Its use requires careful medical supervision due to potential side effects and a high risk of abuse and dependence. While it can be a vital part of a treatment plan for these specific conditions, it is not appropriate for all individuals and requires a thorough evaluation of a patient's overall health and history. Patients and caregivers should always follow a doctor's instructions closely and monitor for any adverse effects.
Visit the MedlinePlus Dextroamphetamine page for additional information
