Dextroamphetamine vs. Adderall: Comparing ADHD Medications

One of the most common neurodevelopmental disorders in children in the United States is attention deficit hyperactivity disorder, commonly known as ADHD. Up to 10 percent of children in the United States are estimated to have the disorder, which can make behaviors like paying attention, sitting still, and staying calm very challenging. ADHD may result in low levels of serotonin, dopamine, and norepinephrine. Adults and children ages three and older who are diagnosed with ADHD may be prescribed a stimulant medication for the treatment of their condition.

 Dextroamphetamine and Adderall are two popular prescription stimulant drugs commonly prescribed for treatment of ADHD. When comparing ADHD medications, there are similarities and differences associated with both.

Overview

Adderall and dextroamphetamine belong to a class of drugs called central nervous system (CNS) stimulants. Adderall is the brand name for a medication that contains amphetamine and dextroamphetamine as its active ingredients, while dextroamphetamine is the generic name for a medication sold under the brand name Dexedrine. 

Other drugs belonging to the central nervous system stimulants class of drugs include Ritalin and Vyvanse. Compared to Ritalin (methylphenidate), Adderall and dextroamphetamine are stronger, more stimulating medications. 

The medications work by acting on the balance of certain neurotransmitters in the brain that are associated with hyperactivity, impulsiveness, inattention.

Dextroamphetamine was first approved by the U.S. Food and Drug Administration (FDA)in 1976 under modern standards, but the drug was previously available on the market under different guidelines. By contrast, Adderall is a much newer medication, with the instant-release form of the drug approved by the FDA in 1996. The extended-release capsule of the drug, Adderall XR, was released in 2001. The brand name version of dextroamphetamine is called Dexedrine, while the generic version of Adderall is called dextroamphetamine and amphetamine; Adderall is a combination of the two amphetamine salts dextroamphetamine and amphetamine.

Both dextroamphetamine and Adderall are classified as Schedule II controlled substances by the U.S. Drug Enforcement Administration (DEA) due to their high potential for dependence, abuse, and addiction. They are available by prescription by a healthcare professional only but are tightly controlled.

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Conditions Treated

Adderall and dextroamphetamine are both used to treat attention deficit hyperactivity disorder, commonly referred to as ADHD, in children and adults, and narcolepsy, a type of sleep disorder, in adults. 

Attention Deficit Hyperactivity Disorder

ADHD is a common neurodevelopmental disorder that is most commonly diagnosed by healthcare providers in childhood or adolescence. Symptoms of ADHD may resolve in some patients as they become adults, while the majority find that their symptoms continue throughout their lives. It is also possible for people to be diagnosed as adults, and some people do not notice any symptoms until adulthood. 

There are three different presentations of ADHD: hyperactive-impulsive presentation, inattentive presentation, and combined presentation. 

The hyperactive-impulsive presentation is characterized by hyperactivity, difficulty controlling impulsive behaviors, talking excessively, squirming, and fidgeting. 

The inattentive type of ADHD was previously called Attention Deficit Disorder (ADD) and is most commonly associated with symptoms like difficulty concentrating, daydreaming, and forgetting or losing things regularly. 

The combined presentation of ADHD is said to occur when patients have symptoms of both the inattentive and hyperactive-impulsive presentation. It is common for a patient’s presentation to change as they age. 

Adderall and dextroamphetamine can both be used to treat ADHD in children and adults aged 3 years and older.

Common signs and symptoms of ADHD include: 

  • Hyperactivity
  • Squirming or fidgeting
  • Talking excessively
  • Making careless mistakes
  • Difficulty paying attention
  • Difficulty controlling impulsive behaviors
  • Difficulty resisting temptation
  • Daydreaming
  • Impulsivity
  • Difficulty getting along with others
  • Forgetting or losing things regularly

‚ÄčNarcolepsy

Narcolepsy is a sleep disorder that causes a number of symptoms, including sleep paralysis, hallucinations, excessive daytime sleepiness, sudden loss of muscle tone, and changes in rapid eye movement (REM) sleep. Some people with narcolepsy may nod off during social situations, but this manifestation of the condition is relatively rare.  Adderall and dextroamphetamine can both be used to help manage the symptoms of narcolepsy in adult patients. 

Cost

Adderall is a brand name drug that is available as a generic medication as dextroamphetamine and amphetamine. By contrast, dextroamphetamine is a generic medication that is also sold under the brand name Dexedrine. 

The brand name versions of both drugs are notably expensive and may be unaffordable for some patients, even with health insurance coverage. Patients can purchase a monthly prescription of Adderall (immediate release) or Adderall XR for approximately $230 a month, while brand name Dexedrine typically costs $737 for a 30-day supply of the medication. 

However, the generic versions of both drugs are far more affordable. The generic version of Adderall can be purchased for about $10 for a one-month prescription regardless of whether a patient is prescribed the immediate release or extended release version of the drug, while a one-month supply of generic dextroamphetamine costs approximately $55 per month. 

Most commercial health insurance plans, as well as Medicaid and Medicare, cover the price of generic dextroamphetamine and generic Adderall. Regardless of your insured status or any other eligibility criteria, USA Rx offers a free pharmacy discount card that offers discounts on all FDA-approved medications, including both brand name and generic drugs.

Side Effects

Central nervous system stimulants like dextroamphetamine and Adderall are associated with numerous side effects, some of which can be potentially dangerous and require medical attention. 

Adderall

Common side effects of Adderall that normally do not require medical attention include:

  • Stomach pain
  • Restlessness
  • Weight loss
  • Anxiety
  • Dry mouth
  • Constipation

Common serious side effects of Adderall that may require immediate medical attention include:

  • Difficult, burning, or painful urination
  • Lower back or side pain
  • Bloody or cloudy urine
  • Frequent urge to urinate
  • Bladder pain
  • Pounding or irregular heartbeat or pulse
  • Increased heart rate

Less common side effects of Adderall that may require immediate medical attention include:

  • Unusual tiredness or weakness
  • Allergic reactions
  • Trouble sleeping
  • Muscle aches and pains
  • Loss of appetite
  • Vomiting
  • Shivering
  • Headache
  • Sweating
  • Cough
  • Hoarseness
  • Chills
  • Runny nose
  • Fever
  • Diarrhea
  • Nausea
  • Sore throat
  • Joint pain
  • Psychosis

Dextroamphetamine

Side effects of dextroamphetamine range from common to serious, and each person is affected differently by the side effects of the drug. Common side effects associated with dextroamphetamine include:

  • Fast heartbeat
  • Tremors
  • Upset stomach
  • Dizziness
  • Weight loss
  • Dry mouth
  • Decreased appetite
  • Headache
  • Trouble sleeping
  • Feeling anxious

Some of the side effects associated with dextroamphetamine are serious, require medical attention, and could be life threatening. Serious side effects include:

  • Heart problems, as evidenced by:
    • High blood pressure 
    • Chest pain or tightness
    • Trouble breathing
    • Fast, irregular heartbeat
  • Vision problems, including:
    • Blurred vision
    • Other changes in eyesight
  • Circulation problems, including:
    • Fingers or toes that feel numb, cold, or hurt
  • Neurological problems, as evidenced by:
    • Hallucinations
    • Seizures
    • Confusion
  • Allergic reactions, as evidenced by:
    • Skin rash
    • Hives
    • Swelling of your face, lips, or tongue
    • Itching
  • Movement problems, as evidenced by:
    • Trouble walking 
    • Feeling dizzy 
    • Muscle twitching
    • Losing balance or coordination
    • Uncontrollable movements in your head, mouth, neck, arm, or leg
  • Slowed growth in children (height and weight)
  • Priapism (erection lasting longer than four hours) 

Warnings For Use

The FDA has assigned Adderall and dextroamphetamine a black box warning due to the addictive, habit-forming nature of these drugs; a black box warning is the strongest warning the FDA assigns to a medication. 

Patients that stop using Adderall or dextroamphetamine without medical advice and supervision may experience withdrawal symptoms. The two drugs are also classified as Schedule II controlled substances by the DEA for this reason. 

In order to minimize your risk of experiencing addiction, substance abuse, or dependence, patients can take the following steps:

  • Avoid the use of alcohol
  • Avoid substances that can change the absorption of their medication within one to two hours of taking the drug, such as citrus fruits and juices, antacids, and multivitamins
  • Take the medications as prescribed
  • Do not share medication with others

Prescription stimulants like Adderall and dextroamphetamine are known to interact with certain medications that can change the rate at which your body metabolizes the medication. Antihistamine drugs like Benadryl can cause the medications to be absorbed more slowly and take longer to take effect. Antidepressants and antacids can increase the rate at which the drugs are metabolized and take effect. 

Additionally, the FDA has given both Adderall and dextroamphetamine a black box warning due to their potential to cause “sudden death and serious cardiovascular adverse reactions.” 

Therefore, patients with certain cardiovascular conditions may not be able to use either medication safely. These conditions include:  

  • Symptomatic cardiovascular disease
  • Hyperthyroidism
  • Moderate to severe hypertension (high blood pressure)
  • Known sensitivity or idiosyncrasy to the sympathomimetic amines, agitated states, and glaucoma
  • Advanced arteriosclerosis

Summary

Both dextroamphetamine and Adderall are prescription medications for the treatment of ADHD that come with a variety of warnings for use and a long list of side effects. 

When used as directed by mental health or medical professionals in patients with a suitable medical history, Adderall and dextroamphetamine can be an effective treatment option for ADHD in children and adults and the management of narcolepsy in adults. 

Adderall and dextroamphetamine are each available by prescription in brand name and generic forms, and patients can save on the price of their prescription with a pharmacy discount card from USA Rx.

Sources:
https://www.addictioncenter.com/stimulants/adderall/ 
https://americanaddictioncenters.org/adderall/long-term-effects 
https://www.healthline.com/health/adhd/dextroamphetamine-vs-adderall 
https://www.cdc.gov/ncbddd/adhd/data.html
https://www.webmd.com/drugs/2/drug-11574/dextroamphetamine-oral/details

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