Adult ADHD

Generic Name: amphetamine (am-FET-uh-meen) with dextroamphetamine (dex-trow-am-FET-uh-meen)

Brand Names: Adderall®, Adderall XR®

Manufacturer: Shire Pharmaceuticals

What Is Adderall®?

Adderall® is the brand name for a combination of amphetamine salts that function as central nervous system (CNS) stimulants, and have been FDA approved for the treatment of both adult and childhood attention deficit hyperactivity disorder (ADHD) as well as narcolepsy in adults.

Adderall® is now available in both generic and an extended release version, called Adderall XR® (an abbreviation for eXtended Release). Adderall XR® is an extended-release version of the drug which only needs to be taken once daily and is only indicated for ADHD, not narcolepsy. The XR formulation is still patented, meaning that it will not be available in generic form until at least 2009.

How Does Adderall® Work?

Although it is not known exactly how Adderall® works, it is believed to increase the flow of the neurotransmitters dopamine and norepinephrine, chemicals that carry the signal between neurons (cells of the nervous system). This can result in an increase in a person’s ability to focus over extended periods of time.

How Do I Take Adderall®?

Adderall® is an oral mediation available in capsule form. The individual doses for both Adderall® and Adderall XR® range from 5 - 30 milligrams (mg).

Although the time required for Adderall® to take effect may be different for each individual, instant-release drugs in this class generally take 1 – 3 hours. The amount of instant release Adderall® in the bloodstream peaks at about 3 hours. Adderall XR® lasts 24 hours, with the dose peaking about 8 hours after it is taken.

Is Adderall® Effective for Adult ADHD?

Adderall® has been used to treat ADHD in both children and adults for many years. In 2004, the Harvard investigators involved in analysis of Adderall XR® Phase III trials in adults concluded that the drug significantly improved subjects’ ability to maintain focus, concentrate, and pay attention for longer periods of time [1].

Adderall® Minor Side Effects
Common side effects are similar to those typically associated with the use of stimulants, and include:
· Dry mouth
· Loss of appetite
· Difficulty falling asleep
· Weight loss

Adderall® Precautions
Addiction & Abuse
Studies have been done to address concern that use of stimulant medications may lead to later drug dependency and abuse. Although, untreated ADHD has been linked to an increased risk of substance abuse later in life [2], the likelihood of future drug abuse disorder is actually decreased when ADHD is properly treated [3].

Still, because Adderall® is an amphetamine and stimulant, there is the potential for abuse. And this medication is not recommended for people who have a history of drug abuse.

Cardiac Precautions
Adderall® and other amphetamines may not be right for you if you have a history of heart problems, such as hardened arteries (arteriosclerosis), heart disease, high blood pressure (hypertension), or any other pre-existing cardiac condition.

Other Precautions
The drug is also not recommended for people with overactive thyroid, glaucoma, epilepsy and seizure disorders, severe anxiety or agitation and those who have taken MAO inhibitors within the past two weeks. Before taking Adderall®, be sure to tell your doctor if you have any of these problems.

Pregnancy Category C
As a category C medication, Adderall® may be harmful to an unborn baby. This drug can also pass into breast milk and may be harmful to your baby if you nurse. Be sure to tell your doctor if you are pregnant or plan to become pregnant while you are being treated for ADHD.

Total Treatment of ADHD
Adderall®, or any medication used to treat ADHD, should be used as a part of a total treatment program. Comprehensive treatment of the adult ADHD often includes education, support groups, regular doctor appointments and therapy or counseling.

Sources
1. Biederman, J, M.D. (2004) Long-Term Safety and Efficacy of Mixed Amphetamine Salts Extended-Release for Adult ADHD. APA Presentation # 106
2. Richardson. (2005) When Too Much Isn’t Enough, Ending The Destructive Cycle of AD/HD and Addictive Behavior, Piñon Press
3. Wilens, et al. (2003) Does Stimulant Therapy of Attention-Deficit/Hyperactivity Disorder Beget Later Substance Abuse? A Meta-analytic Review of the Literature, Pediatrics Vol. 111 (1).
4. Shire US Inc., Prescribing Information sheet (PDF) for Adderall XR, March, 2007.