Dextroamphetamine/amphetamine er
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Dextroamphetamine/Amphetamine ER: Clinical Applications and Effects
Treatment of Methamphetamine Addiction
Sustained-Release Dextroamphetamine for Methamphetamine Dependence
A clinical trial investigated the use of sustained-release dextroamphetamine (d-AMP) as a replacement therapy for methamphetamine (MA) dependence. Sixty individuals participated in an 8-week study, receiving 60 mg of d-AMP along with psychotherapy sessions. The results showed no significant reduction in MA use compared to the placebo group. However, there were significant reductions in withdrawal and craving scores in the d-AMP group, suggesting potential benefits for managing MA dependence symptoms1.
Neuroendocrine and Behavioral Responses
Effects on Normal Individuals
A study on normal individuals administered 30 mg of dextroamphetamine and observed significant increases in well-being and growth hormone (GH) levels. The drug did not induce psychosis and had no significant effect on prolactin (PRL) levels. These findings indicate that dextroamphetamine can enhance mood and stimulate GH release without severe adverse effects2.
Psychologic and Neuroendocrine Effects
Further research involving healthy young men revealed that dextroamphetamine (20 mg) stimulated both GH and cortisol release. The drug also elicited euphoria, suggesting a link between GH response and euphoria. These results highlight the drug's potential to influence both psychological states and neuroendocrine activity6.
Cognitive and Behavioral Effects
Impact on Schizophrenia Patients
In patients with chronic schizophrenia, a single dose of dextroamphetamine improved performance on cognitive tests and increased psychomotor activity. Some patients showed improvements in affect and engagement with their environment. These effects were associated with enlarged cerebral ventricles and increased blink rates, suggesting selective enhancement of cortical dopaminergic activity3.
Effects on Prepubertal Boys
A study on prepubertal boys demonstrated that a single dose of dextroamphetamine significantly decreased motor activity and reaction time while improving cognitive performance. These findings challenge the notion that children with hyperactivity have a unique response to stimulants, as normal children exhibited similar improvements5.
Applications in Medical Conditions
Depression and Fatigue in HIV Patients
A trial involving men with HIV showed that dextroamphetamine significantly improved mood, energy, and quality of life. The drug was well-tolerated, with no evidence of abuse or dependence, suggesting its potential as a fast-acting antidepressant for patients with depression and debilitating fatigue8.
Postoperative Pain Management
Combining dextroamphetamine with morphine for postoperative pain management enhanced analgesia and reduced morphine's sedative effects. The combination was more effective than morphine alone, indicating that dextroamphetamine can potentiate opioid analgesia while mitigating some of its side effects9.
Mechanisms and Neural Effects
Amygdala Modulation
Research using fMRI revealed that dextroamphetamine potentiated the response of the amygdala during the processing of fearful and angry facial expressions. This finding suggests that the drug's anxiogenic effects may be mediated through its influence on the amygdala, aligning with animal models of dopaminergic activation7.
Endocrine Responses
Dextroamphetamine infusions in normal volunteers resulted in correlated increases in plasma beta-endorphin and cortisol levels. This response indicates that the drug can simulate stress-induced hormonal changes, implicating the endogenous opioid system in its effects10.
Conclusion
Dextroamphetamine/amphetamine ER has diverse clinical applications, from managing methamphetamine dependence and enhancing cognitive function in schizophrenia to improving mood and energy in HIV patients. Its effects on neuroendocrine responses and the amygdala further elucidate its potential mechanisms of action. These findings support the continued exploration of dextroamphetamine in various therapeutic contexts.
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Most relevant research papers on this topic
A Randomized, Placebo‐Controlled Trial of Sustained‐Release Dextroamphetamine for Treatment of Methamphetamine Addiction
Sustained-release dextroamphetamine significantly reduced withdrawal and craving scores in individuals with methamphetamine dependence, supporting further exploration as a pharmacologic intervention.
RCT
Rigorous Journal
Highly CitedThe neuroendocrine and behavioral response to dextroamphetamine in normal individuals.
Dextroamphetamine significantly improves well-being and increases growth hormone, but does not significantly affect prolactin levels or homovanillic acid levels.
RCTCognitive and behavioral effects of the coadministration of dextroamphetamine and haloperidol in schizophrenia.
Coadministration of amphetamine and haloperidol may improve cognitive performance and affect in schizophrenia patients, but its use as a routine clinical treatment is not recommended.
RCTHighly CitedApplication of Physiologically Based Absorption Modeling for Amphetamine Salts Drug Products in Generic Drug Evaluation.
Physiologically based absorption models for amphetamine salts extended-release capsules can help assess bioequivalence in various populations and predict pharmacokinetics for hypothetical formulations.
Dextroamphetamine: cognitive and behavioral effects in normal prepubertal boys.
Dextroamphetamine reduces motor activity and reaction time in normal prepubertal boys and improves cognitive performance, challenging the assumption that minimal brain dysfunction has a specific or paradoxical response to stimulants.
RCTHighly CitedAcute psychologic and neuroendocrine effects of dextroamphetamine and methylphenidate
Dextroamphetamine and methylphenidate both stimulate growth hormone release, while dextroamphetamine stimulates cortisol release, suggesting a common central mechanism underlies these effects.
RCTDextroamphetamine Modulates the Response of the Human Amygdala
Dextroamphetamine increases the response of the human amygdala to perceived angry and fearful facial expressions, contributing to its anxiogenic effects.
Highly CitedEffects of dextroamphetamine on depression and fatigue in men with HIV: a double-blind, placebo-controlled trial.
Dextroamphetamine is a potentially effective, fast-acting antidepressant treatment for HIV patients with depression and debilitating fatigue, without evidence of tolerance, abuse, or dependence.
RCTHighly CitedDextroamphetamine with morphine for the treatment of postoperative pain.
Dextroamphetamine combined with morphine is twice as effective as morphine alone for treating postoperative pain, with minimal side effects.
RCT
Large Human TrialHighly CitedDextroamphetamine infusions in normals result in correlated increases of plasma beta-endorphin and cortisol immunoreactivity.
Dextroamphetamine infusions in normal individuals result in correlated increases in plasma beta-endorphin and cortisol immunoreactivity, suggesting stress-induced effects may be simulated or potentiated by amphetamine administration.
RCT