From the Guidelines
Dextroamphetamine extended-release (ER) is a highly effective medication for treating Attention Deficit Hyperactivity Disorder (ADHD), with a strong evidence base supporting its use, as noted in the 2019 clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents 1. The medication is typically prescribed at starting doses of 5-10mg once daily, with gradual increases as needed up to a maximum of 40mg daily for most adults. Key benefits of dextroamphetamine ER include:
- Improved attention, focus, and impulse control in people with ADHD
- Extended-release formulation providing symptom control for 8-12 hours
- Once-daily dosing that covers the school or work day Common side effects include:
- Decreased appetite
- Insomnia
- Increased heart rate
- Potential anxiety It's essential to take the medication in the morning to minimize sleep disruption and to have regular check-ups to monitor blood pressure, heart rate, and weight, as recommended by the 2019 guideline 1. As a controlled substance with potential for dependence, dextroamphetamine ER should be used exactly as prescribed. Some patients may need to try different stimulant medications to find the optimal balance between symptom control and side effects, as individual responses vary. The 2011 guideline also notes that stimulant medications, including dextroamphetamine, have a strong evidence base and are highly effective for most children in reducing core symptoms of ADHD 1. However, it's crucial to consider the potential risks and benefits, including the rare occurrence of hallucinations and other psychotic symptoms, as well as the importance of monitoring cardiac symptoms and family history before initiating therapy with stimulant medications, as emphasized in the 2019 guideline 1.
From the FDA Drug Label
INDICATIONS AND USAGE Dextroamphetamine Sulfate Oral Solution is indicated in: ... Attention Deficit Disorder with Hyperactivity: As an integral part of a total treatment program that typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in pediatric patients (ages 3 years to 16 years) with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms: Moderate to severe distractibility, short attention span, hyperactivity, emotionally lability, and impulsivity.
The question asks about dextroamphetamine Extended Release (ER), but the provided drug label only mentions the oral solution, not the ER formulation. Therefore, no conclusion can be drawn about the effectiveness of dextroamphetamine ER for ADHD based on this information 2.
From the Research
Efficacy of Dextroamphetamine ER for ADHD
- Dextroamphetamine is a stimulant medication used to treat Attention Deficit Hyperactivity Disorder (ADHD) 3.
- A study published in 2018 found that amphetamines, including dextroamphetamine, reduced the severity of ADHD symptoms in adults, but the evidence was of low to very low quality 3.
- Another study published in 2011 found that dextroamphetamine was efficacious in treating symptoms of ADHD in children with comorbid tic disorders, but high doses may worsen tics in some cases 4.
- A 2022 study demonstrated the efficacy and safety of a dextroamphetamine transdermal system for the treatment of ADHD in children and adolescents, with significant improvements in ADHD symptoms and a favorable safety profile 5.
Safety and Side Effects
- Dextroamphetamine can cause side effects such as hyperactivity, hyperthermia, tachycardia, and seizures, especially in cases of overdose 6.
- The medication has a high potential for abuse and is classified as a DEA Schedule II controlled substance 6.
- Treatment for dextroamphetamine overdose or intoxication typically involves controlling life-threatening central nervous system and cardiovascular signs, and may include the use of benzodiazepines, phenothiazines, and beta-blockers 6.
Comparison to Other Medications
- Dextroamphetamine has been compared to other medications for ADHD, including methylphenidate and lisdexamfetamine, with varying results 3, 4.
- A 2018 study found that lisdexamfetamine and mixed amphetamine salts (MAS) reduced the severity of ADHD symptoms, but dexamphetamine did not show significant efficacy 3.
- However, a 2022 study demonstrated the efficacy of a dextroamphetamine transdermal system, suggesting that it may be a beneficial treatment option for ADHD 5.