From the Guidelines
Dexamphetamine can cause several side effects, including decreased appetite, weight loss, dry mouth, headache, difficulty sleeping, increased heart rate, and elevated blood pressure, as reported in the most recent study 1.
Common Side Effects
- Decreased appetite
- Weight loss
- Dry mouth
- Headache
- Difficulty sleeping (insomnia)
- Increased heart rate
- Elevated blood pressure These side effects are generally mild and temporary, but can be clinically relevant for a small subgroup of patients, especially those with preexisting cardiovascular diseases 1.
Less Common but More Serious Side Effects
- Heart palpitations
- Chest pain
- Severe headaches
- Hallucinations
- Paranoia
- Aggressive behavior
- In rare cases, seizures Long-term use of dexamphetamine may lead to psychological dependence or addiction, and it is essential to monitor patients for these potential side effects 1.
Monitoring and Precautions
Clinicians should monitor patients' pulse and blood pressure when prescribing dexamphetamine, especially those with preexisting cardiovascular diseases 1. Additionally, patients should be aware of the potential for reduced appetite, weight loss, and decreased growth velocity, particularly in children and adolescents 1. It is crucial to take dexamphetamine exactly as prescribed, starting at a low dose and gradually increasing if needed, and to avoid taking it late in the day to minimize interference with sleep 1.
From the FDA Drug Label
ADVERSE REACTIONS Cardiovascular: Palpitations, tachycardia, elevation of blood pressure. There have been isolated reports of cardiomyopathy associated with chronic amphetamine use. Central Nervous System: Psychotic episodes at recommended doses (rare), overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia. dysphoria, tremor, headache, exacerbation of motor and phonic tics and Tourette's syndrome. Gastrointestinal: Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances. Anorexia and weight loss may occur as undesirable effects. Allergic: Urticaria. Endocrine: Impotence, changes in libido. DRUG ABUSE AND DEPENDENCE ... Manifestations of chronic intoxication with amphetamines include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. The most severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia. OVERDOSAGE ... Manifestations of acute overdosage with amphetamines include restlessness, tremor, hyperreflexia, rhabdomyolysis, rapid respiration, hyperpyrexia, confusion, assaultiveness, hallucinations, panic states.
The side effects of dexamphetamine include:
- Cardiovascular: palpitations, tachycardia, elevation of blood pressure, and cardiomyopathy
- Central Nervous System: psychotic episodes, overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia, dysphoria, tremor, headache, and exacerbation of motor and phonic tics and Tourette's syndrome
- Gastrointestinal: dryness of the mouth, unpleasant taste, diarrhea, constipation, and other gastrointestinal disturbances
- Allergic: urticaria
- Endocrine: impotence and changes in libido
- Chronic intoxication: severe dermatoses, marked insomnia, irritability, hyperactivity, personality changes, and psychosis
- Acute overdosage: restlessness, tremor, hyperreflexia, rhabdomyolysis, rapid respiration, hyperpyrexia, confusion, assaultiveness, hallucinations, and panic states 2, 2, 2
From the Research
Dexamphetamine Side Effects
- The side effects of dexamphetamine have been studied in various contexts, including its use in patients with schizophrenia and amphetamine dependence 3, attention deficit hyperactivity disorder (ADHD) 4, and advanced cancer 5.
- In a study of patients with schizophrenia and amphetamine dependence, no patients exhibited exacerbation of psychosis as a result of treatment with dexamphetamine, and compliance with neuroleptics increased in most cases 3.
- A randomized, double-blind, placebo-controlled trial of dexamphetamine in adults with ADHD found that the only significant side effect was weight loss, and one patient on dexamphetamine discontinued the trial due to an event possibly related to the medication 4.
- A pharmacovigilance analysis of spontaneous reports submitted to the FDA Adverse Event Reporting System found that amphetamine was associated with psychosis and psychotic disorders, hostility/aggression, and other ischemic heart disease in children and adults 6.
- A review of the efficacy and safety of psychostimulants, including dexamphetamine, in patients with dementia found that psychostimulants may increase blood pressure, elevate heart rate, and lead to irritability, agitation, and psychosis, making careful patient selection critical 7.
- A randomized, double-blind, placebo-controlled trial assessing the impact of dexamphetamine on fatigue in patients with advanced cancer found that dexamphetamine was well tolerated, but did not significantly improve fatigue or quality of life in patients with advanced cancer 5.