Dextroamphetamine dosage and effects
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Dextroamphetamine Dosage: Clinical Uses and Ranges
Dextroamphetamine is used in a variety of clinical settings, and dosages vary depending on the condition being treated. For methamphetamine dependence, a sustained-release dose of 60 mg per day was used for 8 weeks, showing significant reductions in withdrawal and craving, though not in methamphetamine use itself . In the treatment of cocaine dependence, sustained-release doses ranged from 15–30 mg initially, increasing to 30–60 mg, with the 15–30 mg group showing the best retention and the higher dose group showing the lowest cocaine-positive urine screens . For hypothalamic obesity, doses started at 5 mg per day and were titrated up to 20 mg per day, resulting in stabilization or reduction of BMI z-scores without significant adverse effects . In a study on depression and low energy in AIDS patients, a median dose of 10 mg per day led to substantial improvement in mood and energy . For cognitive and attention studies in healthy adults, single doses of 10 mg and 20 mg were used, both improving attention and response accuracy . In pediatric populations, a single dose of 0.5 mg/kg was used, leading to decreased motor activity and improved cognitive performance . For pain management, dextroamphetamine was combined with morphine in doses of 5 mg or 10 mg, enhancing analgesia and reducing sedation . In rare cases of severe gastroparesis and chronic pancreatitis, very high doses (up to 150 mg and 90 mg, respectively) were reported to be effective and well-tolerated, though these are exceptional cases and not standard practice 910.
Cognitive and Behavioral Effects of Dextroamphetamine
Dextroamphetamine has been shown to improve attention, cognitive performance, and response accuracy in both healthy adults and children. In healthy young adults, doses of 10 mg and 20 mg improved signal detection, hit rate, response accuracy, and reduced reaction time variability in attention tests . In normal prepubertal boys, a single dose of 0.5 mg/kg decreased motor activity and reaction time, and improved cognitive test performance . These effects are consistent across species, as similar improvements were observed in mice at moderate doses .
Effects on Withdrawal, Craving, and Mood
In individuals with methamphetamine dependence, 60 mg of sustained-release dextroamphetamine significantly reduced withdrawal and craving scores, though it did not reduce methamphetamine use . For cocaine dependence, dextroamphetamine improved retention in treatment and reduced cocaine-positive urine screens, especially at higher doses . In AIDS patients with depression and low energy, a median dose of 10 mg per day led to rapid and substantial improvements in both mood and energy .
Analgesic and Pain-Relief Effects
Dextroamphetamine, when combined with morphine, increased the analgesic potency of morphine and reduced its sedative side effects. A combination of 10 mg dextroamphetamine with morphine was twice as potent as morphine alone, and 5 mg was 1.5 times as potent . In cases of severe gastroparesis and chronic pancreatitis, high doses of dextroamphetamine (up to 150 mg and 90 mg, respectively) provided marked pain relief when other treatments failed, with minimal reported side effects 910.
Effects on Weight and Obesity
In patients with hypothalamic obesity, dextroamphetamine (5–20 mg/day) led to stabilization or reduction in BMI z-scores over one to two years, with no significant adverse events reported . This suggests a potential role for dextroamphetamine in managing weight gain associated with hypothalamic injury.
Safety and Adverse Effects
Across studies, dextroamphetamine was generally well-tolerated at therapeutic doses, with minimal adverse effects reported in most clinical settings 1357. In a study on traumatic brain injury, 10 mg daily was safe but did not accelerate recovery, and some increase in agitation was noted . Even at very high doses used in exceptional cases, no significant side effects were reported, though such dosing is not standard and should be approached with caution 910.
Conclusion
Dextroamphetamine is used in a range of dosages depending on the clinical context, from as low as 5 mg per day for obesity to as high as 150 mg in rare, refractory cases. It consistently shows benefits in improving attention, reducing withdrawal and craving in substance dependence, enhancing mood and energy, and augmenting pain relief when combined with opioids. Most studies report good tolerability at therapeutic doses, but careful titration and monitoring are essential, especially at higher doses or in vulnerable populations.
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