Amphetamine adderall
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Cognitive and Pharmacological Effects of Amphetamine (Adderall)
Cognitive Enhancement with Mixed Amphetamine Salts (MAS)
Objective and Subjective Cognitive Effects
Mixed amphetamine salts (MAS), commonly known by the brand name Adderall, are frequently used by healthy young individuals for cognitive enhancement. However, research indicates that the actual cognitive benefits of MAS are limited. A comprehensive study involving a double-blind, placebo-controlled trial found no significant enhancement in cognitive abilities such as episodic memory, working memory, and intelligence among participants in general. Interestingly, participants perceived their cognitive performance to be enhanced despite the lack of objective improvement, suggesting a placebo effect.
Moderation by Baseline Ability and Genotype
The same study noted that MAS might have a slight cognitive enhancing effect on individuals with lower baseline cognitive abilities, particularly in tasks like word recall and problem-solving. Additionally, the COMT genotype appeared to play a role in moderating these effects, although this was observed in only a minority of tasks.
Pharmacokinetics and Bioequivalence
Comparison with Extended-Release Formulations
A study comparing a new extended-release amphetamine oral suspension (AMP XR-OS) with Adderall XR found that both formulations are bioequivalent. This means that they have similar pharmacokinetic profiles, including peak concentration (Cmax) and area under the curve (AUC) values. The most common side effects reported were nausea and decreased appetite, which are consistent with the known side effects of amphetamines.
Efficacy in ADHD Treatment
Comparison with Atomoxetine
In children with ADHD, Adderall XR has been shown to be more effective than atomoxetine (Strattera) in improving behavioral symptoms. This was demonstrated through significant improvements in SKAMP (Swanson, Kotkin, Agler, M-Flynn, and Pelham) behavioral rating scale scores over a period of several weeks.
Long-term Tolerability and Effectiveness
Long-term studies have confirmed that Adderall XR is both effective and well-tolerated in children with ADHD. Over a 24-month period, significant behavioral improvements were maintained, and most adverse events were mild and manageable. Common side effects included anorexia, insomnia, and headache, with the incidence of side effects increasing with higher doses.
Classroom Performance
In a controlled classroom setting, Adderall XR demonstrated significant improvements in attention and academic performance in children with ADHD. The drug's effects were dose-dependent and lasted up to 12 hours, making it a convenient once-daily treatment option.
Amphetamine Excretion and Abuse Potential
Excretion Profile
A study on the excretion profile of Adderall revealed that amphetamine concentrations in urine can be detected for up to 47 hours post-dose. The presence of both d- and l-enantiomers of amphetamine helps differentiate Adderall use from other amphetamine preparations, which is crucial for forensic toxicologists and medical review officers.
Abuse and Toxicity
Adderall is a DEA Schedule II controlled substance with a high potential for abuse. Overdose symptoms can include hyperactivity, hyperthermia, tachycardia, and seizures. Treatment for overdose focuses on managing these life-threatening symptoms.
Dopamine Release and Pharmacodynamics
Striatal Dopamine Release
Research using high-speed chronoamperometry has shown that Adderall produces a greater and more prolonged release of dopamine in the striatum compared to other amphetamine isomers. This prolonged dopamine release may contribute to its effectiveness in treating ADHD.
Conclusion
While Adderall (mixed amphetamine salts) is widely used for both cognitive enhancement and ADHD treatment, its cognitive benefits in healthy individuals are minimal and largely perceived rather than real. In contrast, its efficacy in treating ADHD, particularly in children, is well-documented and supported by long-term studies. The drug's pharmacokinetic properties and potential for abuse necessitate careful monitoring and responsible use.
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