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What Is Adderall?
Adderall is are trade names for a combination drug containing four salts of amphetamine. The mixture is composed of equal parts racemic amphetamine and dextroamphetamine, which produces a (3:1) ratio between dextroamphetamine and levoamphetamine, the two enantiomers of amphetamine. Both enantiomers are stimulants, but differ enough to give Adderall an effects profile distinct from those of racemic amphetamine or dextroamphetamine, which are marketed as Evekeo and Dexedrine/Zenzedi, respectively.
Adderall is used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is also used as an athletic performance enhancer, cognitive enhancer, appetite suppressant, and recreationally as an aphrodisiac and euphoriant. It is a central nervous system (CNS) stimulant of the phenethylamine class.
Adderall is generally well tolerated and effective in treating the symptoms of ADHD and narcolepsy. At therapeutic doses, Adderall causes emotional and cognitive effects such as euphoria, change in sex drive, increased wakefulness, and improved cognitive control. At these doses, it induces physical effects such as a faster reaction time, fatigue resistance, and increased muscle strength. In contrast, much larger doses of Adderall can impair cognitive control, cause rapid muscle breakdown, provoke panic attacks, or induce a psychosis (e.g., paranoia, delusions, hallucinations). The side effects of Adderall vary widely among individuals, but most commonly include insomnia, dry mouth, loss of appetite, and weight loss. The risk of developing an addiction or dependence is insignificant when Adderall is used as prescribed at fairly low daily doses, such as those used for treating ADHD; however, the routine use of Adderall in larger daily doses poses a significant risk of addiction or dependence due to the pronounced reinforcing effects that are present at high doses. Recreational doses of amphetamine are generally much larger than prescribed therapeutic doses, and carry a far greater risk of serious adverse effects.
The two amphetamine enantiomers that compose Adderall (levoamphetamine and dextroamphetamine) alleviate the symptoms of ADHD and narcolepsy by increasing the activity of the neurotransmitters norepinephrine and dopamine in the brain, which results in part from their interactions with human trace amine-associated receptor 1 (hTAAR1) and vesicular monoamine transporter2 (VMAT2) in neurons. Dextroamphetamine is a more potent CNS stimulant than levoamphetamine, but levoamphetamine has slightly stronger cardiovascular and peripheral effects and a longer elimination half-life than dextroamphetamine.
The levoamphetamine component of Adderall has been reported to improve the treatment response in some individuals relative to dextroamphetamine alone.[citation needed] Adderall's active ingredient, amphetamine, shares many chemical and pharmacological properties with the human trace amines, particularly phenethylamine and N-methylphenethylamine, the latter of which is a positional isomer of amphetamine. In 2018, Adderall was the 24th most commonly prescribed medication in the United States, with more than 25 million prescriptions.
Dopamine is directly related to feelings of happiness. For instance, when a person eats something they like, dopamine is released, telling the brain to feel pleasure. This forms a reward pathway. Normally, dopamine is reabsorbed back into receptors in the brain and released again when something pleasurable stimulates that release. Adderall floods the brain with dopamine and prevents it from being reabsorbed quickly.
Adderall works by increasing levels of dopamine, serotonin, and norepinephrine in the brain. Dopamine is one of the brain’s chemical messengers, or neurotransmitters, that sends signals throughout the central nervous system, helping to regulate moods, movement, thinking, learning, and memory functions.
In high amounts, the drug can be considered neurotoxic, as the dopaminergic system is damaged by the drug’s disruption. The journal Molecular Psychiatry warns that prolonged exposure of the brain to the amphetamine contained in Adderall can have neurotoxic effects. This may occur because high levels of dopamine can cause the brain to actually strip itself of dopamine receptors in an effort to “balance” itself.
When levels of dopamine drop after the drug wears off and is no longer active in the bloodstream, less dopamine can be produced and reabsorbed naturally. This can make it difficult for a person to then feel happiness without Adderall. Fatigue, appetite changes, trouble sleeping, depression, anxiety, panic attacks, irritability, agitation, tremors, trouble concentrating and thinking straight, memory lapses, disruption of motor control, stomach upset, and lethargy are all possible side effects of an Adderall comedown when the drug processes out of the body.
Even medically approved use of Adderall can cause side effects; abusing the drug, however, can cause side effects to occur with higher frequency and intensity. Common symptoms of abuse include:
Headache.
Dry mouth. Hoarseness. Nausea. Stomach upset. Digestive issues. Reduced appetite. Diarrhea or constipation. Anxiety. Restlessness. Pounding or fast heartbeat. Shortness of breath. Difficulty sleeping and staying to sleep. Excessive fatigue. Changes in sex drive.
Continued use can lead to more severe effects. With long-term abuse or abuse that involves high doses of Adderall, the symptoms can compound and lead to even more dangerous effects. These effects include:
Weakness or numbness in the arms or legs.
Dizziness. Slowed or difficult speech. Chest pain. Hives or rash. Blistering or peeling skin Changes in vision. Aggressive behavior. Paranoia. Mania. Seizures.
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