Examples of Amphetamine Medications for ADHD
Amphetamine medications used to treat ADHD include dextroamphetamine (Dexedrine), mixed amphetamine salts (Adderall), and lisdexamfetamine (Vyvanse), available in both short-acting and long-acting formulations. 1, 2, 1
Specific Amphetamine Formulations
Short-Acting Amphetamines
- Dextroamphetamine (Dexedrine): Available as immediate-release tablets, typically dosed 2.5-10 mg 3
- Mixed amphetamine salts (Adderall): Immediate-release formulation containing dextroamphetamine sulfate, dextro- and levoamphetamine sulfate, dextroamphetamine aspartate, levoamphetamine aspartate, and dextroamphetamine saccharate 3, 4
Long-Acting Amphetamines
- Dextroamphetamine extended-release (Dexedrine Spansule): Provides extended duration of action 3
- Mixed amphetamine salts extended-release (Adderall XR): Long-acting formulation with usual starting dose of 10 mg, titrated up to 50 mg 5
- Lisdexamfetamine dimesylate (Vyvanse): A prodrug that is converted to dextroamphetamine in the body, starting at 20-30 mg and titrated up to 70 mg daily 5, 1, 6
Mechanism of Action
Amphetamines work through multiple mechanisms including inhibition of dopamine and norepinephrine transporters, vesicular monoamine transporter 2, and monoamine oxidase activity 1. This enhances dopamine and norepinephrine neurotransmission in the prefrontal cortex, optimizing executive function and attention in ADHD patients 1.
Clinical Considerations
Long-acting formulations are generally preferred because they provide better medication adherence and lower risk of rebound effects compared to short-acting formulations, though short-acting options allow more dosing flexibility 1. Lisdexamfetamine has demonstrated reduced abuse liability compared to short-acting amphetamines 7.
All amphetamine formulations are FDA-approved stimulants for ADHD treatment and are considered first-line pharmacological options alongside methylphenidate 1, 2, 1. The choice between specific amphetamine formulations should be based on duration of symptom coverage needed throughout the day, with long-acting formulations providing all-day coverage and short-acting options allowing for more targeted dosing windows 1.