:en:Adderall
{{Short description|Drug mixture used mainly to treat ADHD and narcolepsy}}
{{About|a common mixture of amphetamine salts|general information about the drug and its racemate|Amphetamine|the 2023 EP by Slipknot|Adderall (EP){{!}}Adderall (EP)}}
{{Good article}}
{{Use dmy dates|date=August 2024}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Infobox drug
| verifiedrevid = 578643702
| drug_name = Amphetamine/dextroamphetamine
salt mixture (1:1){{#tag:ref|Salts of racemic amphetamine and dextroamphetamine are mixed in a (1:1) ratio to produce this drug. Because the racemate is composed of equal parts dextroamphetamine and levoamphetamine, this drug can also be described as a mixture of the D and (L)-enantiomers of amphetamine in a (3:1) ratio, although none of the components of the mixture are levoamphetamine salts.|group=note}}
| type = combo
| image = Amfetamin.svg
| image_class = skin-invert-image
| alt = an image of the amphetamine skeletal formula
| caption =
| image2 = D-Amphetamine-3D-balls.png
| alt2 = a 3d image of the dextroamphetamine compound found in Adderall
| caption2 = Top: racemic amphetamine skeleton
Bottom: (D)-amphetamine ball-and-stick model
| component1 = amphetamine aspartate monohydrate
| class1 = 25% – stimulant
({{nowrap|12.5% {{abbr|levo|levoamphetamine}}; 12.5% {{abbr|dextro|dextroamphetamine}}}})
| component2 = amphetamine sulfate
| class2 = 25% – stimulant
({{nowrap|12.5% {{abbr|levo|levoamphetamine}}; 12.5% {{abbr|dextro|dextroamphetamine}}}})
| component3 = dextroamphetamine saccharate
| class3 = 25% – stimulant
({{nowrap|0% {{abbr|levo|levoamphetamine}}; 25% {{abbr|dextro|dextroamphetamine}}}})
| component4 = dextroamphetamine sulfate
| class4 = 25% – stimulant
({{nowrap|0% {{abbr|levo|levoamphetamine}}; 25% {{abbr|dextro|dextroamphetamine}}}})
| tradename = Adderall, Adderall XR, Mydayis
| Drugs.com = {{drugs.com|monograph|Adderall}}
| MedlinePlus = a601234
| DailyMedID = Adderall
| pregnancy_AU =
| pregnancy_category =
| legal_AU = S8
| legal_CA = Schedule I
| legal_DE = Anlage III
| legal_NZ = Class B
| legal_UK = Class B
| legal_US = Schedule II{{Cite web |last=Ingersoll |first=John |date=July 7, 1971 |title=Amphetamine, Methamphetamine, and Optical Isomers |url=https://archives.federalregister.gov/issue_slice/1971/7/7/12730-12734.pdf |url-status=live |archive-url= https://archive.today/20241127164332/https://archives.federalregister.gov/issue_slice/1971/7/7/12730-12734.pdf |archive-date=November 27, 2024 |access-date=November 27, 2024 |website=Federal Register|publisher=Bureau of Narcotics and Dangerous Drugs}}
| legal_UN = Psychotropic Schedule II
| legal_status =
| dependency_liability = Moderate{{cite journal | vauthors = Vitiello B | title = Understanding the risk of using medications for attention deficit hyperactivity disorder with respect to physical growth and cardiovascular function | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 17 | issue = 2 | pages = 459–74, xi | date = April 2008 | pmid = 18295156 | pmc = 2408826 | doi = 10.1016/j.chc.2007.11.010}}{{cite journal | vauthors = Graham J, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Dittmann RW, Döpfner M, Hamilton R, Hollis C, Holtmann M, Hulpke-Wette M, Lecendreux M, Rosenthal E, Rothenberger A, Santosh P, Sergeant J, Simonoff E, Sonuga-Barke E, Wong IC, Zuddas A, Steinhausen HC, Taylor E | title = European guidelines on managing adverse effects of medication for ADHD | journal = European Child & Adolescent Psychiatry | volume = 20 | issue = 1 | pages = 17–37 | date = January 2011 | pmid = 21042924 | pmc = 3012210 | doi = 10.1007/s00787-010-0140-6 | eissn = 1435-165X}} – high{{cite journal | vauthors = Kociancic T, Reed MD, Findling RL | title = Evaluation of risks associated with short- and long-term psychostimulant therapy for treatment of ADHD in children | journal = Expert Opinion on Drug Safety | volume = 3 | issue = 2 | pages = 93–100 | date = March 2004 | pmid = 15006715 | doi = 10.1517/14740338.3.2.93 | s2cid = 31114829 | eissn = 1744-764X}}{{cite journal | vauthors = Clemow DB, Walker DJ | title = The potential for misuse and abuse of medications in ADHD: a review | journal = Postgraduate Medicine | volume = 126 | issue = 5 | pages = 64–81 | date = September 2014 | pmid = 25295651 | doi = 10.3810/pgm.2014.09.2801 | s2cid = 207580823 | eissn = 1941-9260}}
| routes_of_administration = By mouth, insufflation, rectal, sublingual
| bioavailability = Oral: ~90%
| ATC_prefix = N06
| ATC_suffix = BA02
| ATC_supplemental = {{ATC|N06|BA01}}
| class = Stimulant
| CAS_number = 300-62-9
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_supplemental = {{CAS|51-64-9}}
| PubChem = 3007
| IUPHAR_ligand = 4804
| DrugBank = DB00182
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| ChemSpiderID = 13852819
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| UNII = CK833KGX7E
| UNII_Ref = {{fdacite|correct|FDA}}
| KEGG = D11624
| KEGG_Ref = {{keggcite|correct|kegg}}
| ChEBI = 2679
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 405
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| synonyms = Mixed amphetamine salts; MAS
}}
Adderall and Mydayis{{cite news | vauthors = Sagonowsky E |title=Shire launches new ADHD drug Mydayis as it weighs a neuroscience exit |url =https://www.fiercepharma.com/marketing/shire-launches-new-adhd-drug-mydayis-as-it-weighs-a-neuroscience-exit |newspaper=Fierce Pharma |date=28 August 2017 |publisher=Questex LLC |access-date=2 May 2020 |archive-date=16 December 2019 |archive-url=https://web.archive.org/web/20191216011722/https://www.fiercepharma.com/marketing/shire-launches-new-adhd-drug-mydayis-as-it-weighs-a-neuroscience-exit |url-status=live}} are trade names{{#tag:ref|The trade name Adderall is used primarily throughout this article because the four-salt composition of the drug makes its nonproprietary name (dextroamphetamine sulfate 25%, dextroamphetamine saccharate 25%, amphetamine sulfate 25%, and amphetamine aspartate 25%) excessively lengthy.{{cite web | title = National Drug Code Amphetamine Search Results | url = http://www.accessdata.fda.gov/scripts/cder/ndc/results.cfm?beginrow=1&numberperpage=160&searchfield=amphetamine&searchtype=ActiveIngredient&OrderBy=ProprietaryName | website = National Drug Code Directory|publisher=United States Food and Drug Administration | access-date = 16 December 2013 | archive-url = https://web.archive.org/web/20131216080856/http://www.accessdata.fda.gov/scripts/cder/ndc/results.cfm?beginrow=1&numberperpage=160&searchfield=amphetamine&searchtype=ActiveIngredient&OrderBy=ProprietaryName | archive-date=16 December 2013}} Mydayis is a relatively new trade name that is not commonly used to refer generally to the mixture.|name="Adderall"| group="note"}} for a combination drug containing four salts of amphetamine. The mixture is composed of equal parts racemic amphetamine and dextroamphetamine, which produces a (3:1) ratio between dextroamphetamine and levoamphetamine, the two enantiomers of amphetamine.{{cite journal | vauthors = Babiskin AH, Zhang X | title = Application of Physiologically Based Absorption Modeling for Amphetamine Salts Drug Products in Generic Drug Evaluation | journal = Journal of Pharmaceutical Sciences | volume = 104 | issue = 9 | pages = 3170–3182 | date = September 2015 | pmid = 25973928 | doi = 10.1002/jps.24474}} Both enantiomers are stimulants, but differ enough to give Adderall an effects profile distinct from those of racemic amphetamine or dextroamphetamine.{{cite journal | vauthors = Heal DJ, Smith SL, Gosden J, Nutt DJ | title = Amphetamine, past and present--a pharmacological and clinical perspective | journal = Journal of Psychopharmacology | volume = 27 | issue = 6 | pages = 479–496 | date = June 2013 | pmid = 23539642 | pmc = 3666194 | doi = 10.1177/0269881113482532}}{{cite journal | vauthors = Joyce BM, Glaser PE, Gerhardt GA | title = Adderall produces increased striatal dopamine release and a prolonged time course compared to amphetamine isomers | journal = Psychopharmacology | volume = 191 | issue = 3 | pages = 669–677 | date = April 2007 | pmid = 17031708 | doi = 10.1007/s00213-006-0550-9 | s2cid = 20283057}} Adderall is indicated in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is also used illicitly as an athletic performance enhancer, cognitive enhancer, appetite suppressant, and recreationally as a euphoriant. It is a central nervous system (CNS) stimulant of the phenethylamine class.
At therapeutic doses, Adderall causes emotional and cognitive effects such as euphoria, change in sex drive, increased wakefulness, and improved cognitive control. At these doses, it induces physical effects such as a faster reaction time, fatigue resistance, and increased muscle strength. In contrast, much larger doses of Adderall can impair cognitive control, cause rapid muscle breakdown, provoke panic attacks, or induce psychosis (e.g., paranoia, delusions, hallucinations). The side effects vary widely among individuals but most commonly include insomnia, dry mouth, loss of appetite and weight loss. The risk of developing an addiction or dependence is insignificant when Adderall is used as prescribed and at fairly low daily doses, such as those used for treating ADHD.{{Cite web |last=Susan |first=Dr |date=2025-03-29 |title=The Adderall Crisis 2025: Your Complete Guide to Safe Medication Access |url=https://pharmacarenet.com/adderall-shortage-2025-safe-access-alternatives/ |access-date=2025-04-03 |website=Pharma Care |language=en}} However, the routine use of Adderall in larger and daily doses poses a significant risk of addiction or dependence due to the pronounced reinforcing effects that are present at high doses. Recreational doses of Adderall are generally much larger than prescribed therapeutic doses and also carry a far greater risk of serious adverse effects.{{#tag:ref|{{Cite book | vauthors = Stolerman IP | veditors = Stolerman IP | title = Encyclopedia of Psychopharmacology | year = 2010 | publisher = Springer | location = Berlin, Germany; London, England | isbn = 9783540686989 | page = 78}}{{cite journal | vauthors = Howell LL, Kimmel HL | title = Monoamine transporters and psychostimulant addiction | journal = Biochemical Pharmacology | volume = 75 | issue = 1 | pages = 196–217 | date = January 2008 | pmid = 17825265 | doi = 10.1016/j.bcp.2007.08.003}}|group="sources"}}
The two amphetamine enantiomers that compose Adderall, such as Adderall tablets/capsules (levoamphetamine and dextroamphetamine), alleviate the symptoms of ADHD and narcolepsy by increasing the activity of the neurotransmitters norepinephrine and dopamine in the brain, which results in part from their interactions with human trace amine-associated receptor 1 (hTAAR1) and vesicular monoamine transporter 2 (VMAT2) in neurons. Dextroamphetamine is a more potent CNS stimulant than levoamphetamine, but levoamphetamine has slightly stronger cardiovascular and peripheral effects and a longer elimination half-life than dextroamphetamine. The active ingredient in Adderall, amphetamine, shares many chemical and pharmacological properties with the human trace amines, particularly phenethylamine and {{nowrap|N-methylphenethylamine}}, the latter of which is a positional isomer of amphetamine.{{#tag:ref|{{cite journal |author=Broadley KJ |title=The vascular effects of trace amines and amphetamines |journal=Pharmacology & Therapeutics |volume=125 |issue=3 |pages=363–375 |date=March 2010 |pmid=19948186 |doi=10.1016/j.pharmthera.2009.11.005 |quote=}}|group="sources"}} In 2022, Adderall was the fourteenth most commonly prescribed medication in the United States, with more than 34{{nbsp}}million prescriptions.{{cite web | title=The Top 300 of 2022 | url=https://clincalc.com/DrugStats/Top300Drugs.aspx | website=ClinCalc | access-date=30 August 2024 | archive-date=30 August 2024 | archive-url=https://web.archive.org/web/20240830202410/https://clincalc.com/DrugStats/Top300Drugs.aspx | url-status=live}}{{cite web | title = Dextroamphetamine; Dextroamphetamine Saccharate; Amphetamine; Amphetamine Aspartate Drug Usage Statistics, United States, 2013 - 2022 | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/DextroamphetamineDextroamphetamineSaccharateAmphetamineAmphetamineAspartate | access-date = 30 August 2024}}
{{TOC limit|3}}
Uses
{{multiple image
| align = right
| direction = vertical
| width = 300
| image1=30xAdderall10mg.jpg
| caption1=30 capsules of 10 mg Adderall XR
| alt1=30 Adderall XR 10 mg capsules
| image2=Amph salts.jpg
| caption2=A group of 20 mg Adderall tablets, some broken in half, with a lengthwise-folded US dollar bill along the bottom (3.07 inches; 7.8 cm) for size comparison
| alt2=Adderall 20 mg tablets
}}
=Medical=
Adderall is commonly used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy.{{Cite web |title=Adderall and Prescription Amphetamines |url=https://redemptionrecoverygroup.com/addiction-recovery-resources/adderall-and-prescription-amphetamines/ |access-date=2025-03-21 |website=Redemption Recovery |language=en-US}}{{cite web |date=November 8, 2019 |title=Adderall- dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate tablet |url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f22635fe-821d-4cde-aa12-419f8b53db81 |url-status=live |archive-url=https://web.archive.org/web/20191002150413/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f22635fe-821d-4cde-aa12-419f8b53db81 |archive-date=October 2, 2019 |access-date=December 22, 2019 |website=DailyMed |publisher=Teva Pharmaceuticals USA, Inc.}}
==ADHD==
{{#lsth:Amphetamine|ADHD}}
==Narcolepsy==
{{#lsth:Amphetamine|Narcolepsy}}
==Available forms==
Adderall is available as immediate-release (IR) tablets and extended-release (XR) capsules.{{cite web | title = Adderall XR Prescribing Information | url = https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf | publisher = Shire US Inc | website = United States Food and Drug Administration | date = December 2013 | access-date = 30 December 2013 | archive-date = 30 December 2013 | archive-url = https://web.archive.org/web/20131230233702/http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf | url-status = live}} Mydayis is only available as an extended-release formulation.{{Cite web|url=http://pi.shirecontent.com/PI/PDFs/Mydayis_USA_ENG.pdf|title=Mydayis medication guide|website=Mydayis.com|language=en|access-date=6 February 2024|date=October 2023}} Adderall XR is approved to treat ADHD for up to 12 hours in individuals 6 years and older and uses a double-bead formulation. The capsule can be swallowed like a tablet, or it can be opened and the beads sprinkled over applesauce for comparable absorption. Upon ingestion, half of the beads provide immediate administration of medication, while the other half are enveloped in a coating that must dissolve, delaying absorption of its contents. It is designed to provide a therapeutic effect and plasma concentrations identical to taking two doses of Adderall IR four hours apart. Mydayis uses a longer-lasting triple-bead formulation and is approved to treat ADHD for up to 16 hours in individuals 13 years and older. In the United States, the immediate and extended-release formulations of Adderall are both available as generic drugs.{{Cite web|url=https://www.drugs.com/availability/generic-adderall.html|title=Generic Adderall Availability|website=Drugs.com|language=en|access-date=6 February 2020|archive-date=28 May 2020|archive-url=https://web.archive.org/web/20200528223452/https://www.drugs.com/availability/generic-adderall.html|url-status=live}}{{Cite web|url=https://www.drugs.com/availability/generic-adderall-xr.html|title=Generic Adderall XR Availability|website=Drugs.com|language=en|access-date=6 February 2020|archive-date=6 February 2020|archive-url=https://web.archive.org/web/20200206144135/https://www.drugs.com/availability/generic-adderall-xr.html|url-status=live}} Generic formulations of Mydayis became available in the US in October 2023.{{Cite web|url=https://professionals.optumrx.com/content/dam/optum3/professional-optumrx/news/rxnews/new-generics/newgenerics_mydayis_2023-1012.pdf|title=Mydayis® (mixed-salts of a single-entity amphetamine product) – First-time generic|website=OptumRx|language=en|access-date=6 February 2023}}
=Enhancing performance=
{{transcluded section|source=Amphetamine|part=yes}}
{{trim|{{#section-h:Amphetamine|Enhancing performance}}}}
Adderall has been banned in the National Football League (NFL), Major League Baseball (MLB), National Basketball Association (NBA), and the National Collegiate Athletics Association (NCAA).{{cite web| vauthors = Moore DL |title=Do pro sports leagues have an Adderall problem?|publisher=USA TODAY|access-date=4 May 2014|url= https://www.usatoday.com/story/sports/nfl/2012/11/27/adderall-in-pro-sports/1730431/ |archive-date=23 November 2014|archive-url= https://web.archive.org/web/20141123131934/http://www.usatoday.com/story/sports/nfl/2012/11/27/adderall-in-pro-sports/1730431/ |url-status=live}} In leagues such as the NFL, there is a very rigorous process required to obtain an exemption to this rule even when the athlete has been medically prescribed the drug by their physician.
=Recreational=
{{See also|History and culture of substituted amphetamines}}
Adderall has a high potential for misuse as a recreational drug.{{cite web |url=http://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs/commonly-abused-prescription-drugs-chart |title=Commonly Abused Prescription Drugs Chart |publisher=National Institute on Drug Abuse |access-date=7 May 2012 |archive-url=https://web.archive.org/web/20120501092302/http://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs/commonly-abused-prescription-drugs-chart |archive-date=1 May 2012 |url-status=dead}}{{cite web |url=http://www.drugabuse.gov/publications/infofacts/stimulant-adhd-medications-methylphenidate-amphetamines |title=Stimulant ADHD Medications – Methylphenidate and Amphetamines |publisher=National Institute on Drug Abuse |access-date=7 May 2012 |archive-date=2 May 2012 |archive-url=https://web.archive.org/web/20120502072325/http://www.drugabuse.gov/publications/infofacts/stimulant-adhd-medications-methylphenidate-amphetamines |url-status=dead}}{{Cite journal| vauthors = Abelman DD |date=6 October 2017|title=Mitigating risks of students use of study drugs through understanding motivations for use and applying harm reduction theory: a literature review|journal=Harm Reduction Journal|volume=14|issue=1|pages=68|doi=10.1186/s12954-017-0194-6|pmid=28985738|pmc=5639593|issn=1477-7517 |doi-access=free}} Adderall tablets can either be swallowed, crushed and snorted, or dissolved in water and injected.{{cite web|title=National Institute on Drug Abuse. 2009. Stimulant ADHD Medications – Methylphenidate and Amphetamines|url=https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/overview|publisher=National Institute on Drug Abuse|access-date=27 February 2013|archive-url=https://web.archive.org/web/20130312110514/http://www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medications-methylphenidate-amphetamines|archive-date=12 March 2013|url-status=dead}} Injection into the bloodstream can be dangerous because insoluble fillers within the tablets can block small blood vessels.
Many postsecondary students have reported using Adderall for study purposes in different parts of the developed world. Among these students, some of the risk factors for misusing ADHD stimulants recreationally include: possessing deviant personality characteristics (i.e., exhibiting delinquent or deviant behavior), inadequate accommodation of disability, basing one's self-worth on external validation, low self-efficacy, earning poor grades, and having an untreated mental health disorder.
Contraindications
{{Excerpt|Amphetamine|Contraindications}}
Adverse effects
{{transcluded section|source=Amphetamine|part=yes}}
The adverse side effects of Adderall are many and varied, but the amount of substance consumed is the primary factor in determining the likelihood and severity of side effects. Adderall is currently approved for long-term therapeutic use by the USFDA. Recreational use of Adderall generally involves far larger doses and is therefore significantly more dangerous, involving a much greater risk of serious adverse drug effects than dosages used for therapeutic purposes.
{{trim|{{#section-h:Amphetamine|Adverse effects}}}}
Overdose
{{Excerpt|Amphetamine|Overdose}}
Interactions
- Monoamine oxidase inhibitors (MAOIs) taken with amphetamine may result in a hypertensive crisis if taken within two weeks after last use of an MAOI type drug.{{cite web | title = Adderall XR Prescribing Information | url = https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf | pages = 8–10 | website = United States Food and Drug Administration | date = December 2013 | access-date = 30 December 2013 | archive-date = 30 December 2013 | archive-url = https://web.archive.org/web/20131230233702/http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf | url-status = live}}
- Inhibitors of enzymes that directly metabolize amphetamine (particularly CYP2D6 and FMO3) will prolong the elimination of amphetamine and increase drug effects.{{cite web|title=Mydayis Prescribing Information|url=https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/022063s000lbl.pdf|website=United States Food and Drug Administration|publisher=Shire US Inc.|access-date=8 August 2017|pages=1–21|date=June 2017|archive-date=9 June 2019|archive-url=https://web.archive.org/web/20190609083453/https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/022063s000lbl.pdf|url-status=dead}}
- Serotonergic drugs (such as most antidepressants) co-administered with amphetamine increases the risk of serotonin syndrome.
- Stimulants and antidepressants (sedatives and depressants) may increase (decrease) the drug effects of amphetamine, and vice versa.
- Gastrointestinal and urinary pH affect the absorption and elimination of amphetamine, respectively. Gastrointestinal alkalinizing agents increase the absorption of amphetamine. Urinary alkalinizing agents increase the concentration of non-ionized species, decreasing urinary excretion.
- Proton-pump inhibitors (PPIs) modify the absorption of Adderall XR and Mydayis.
- Zinc supplementation may reduce the minimum effective dose of amphetamine when it is used for the treatment of ADHD.{{#tag:ref|The human dopamine transporter contains a high affinity extracellular zinc binding site which, upon zinc binding, inhibits dopamine reuptake and amplifies amphetamine-induced dopamine efflux in vitro.{{cite journal | vauthors = Krause J | title = SPECT and PET of the dopamine transporter in attention-deficit/hyperactivity disorder | journal = Expert Rev. Neurother. | volume = 8 | issue = 4 | pages = 611–625 | date = April 2008 | pmid = 18416663 | doi = 10.1586/14737175.8.4.611 | s2cid = 24589993 | quote = Zinc binds at ... extracellular sites of the DAT [103], serving as a DAT inhibitor. In this context, controlled double-blind studies in children are of interest, which showed positive effects of zinc [supplementation] on symptoms of ADHD [105,106]. It should be stated that at this time [supplementation] with zinc is not integrated in any ADHD treatment algorithm.}}{{cite journal | vauthors = Sulzer D | title = How addictive drugs disrupt presynaptic dopamine neurotransmission | journal = Neuron | volume = 69 | issue = 4 | pages = 628–649 | date = February 2011 | pmid = 21338876 | pmc = 3065181 | doi = 10.1016/j.neuron.2011.02.010 | quote = They did not confirm the predicted straightforward relationship between uptake and release, but rather that some compounds including AMPH were better releasers than substrates for uptake. Zinc, moreover, stimulates efflux of intracellular [3H]DA despite its concomitant inhibition of uptake (Scholze et al., 2002).}}{{cite journal | vauthors = Scholze P, Nørregaard L, Singer EA, Freissmuth M, Gether U, Sitte HH | title = The role of zinc ions in reverse transport mediated by monoamine transporters | journal = J. Biol. Chem. | volume = 277 | issue = 24 | pages = 21505–21513 | date = June 2002 | pmid = 11940571 | doi = 10.1074/jbc.M112265200 | quote = The human dopamine transporter (hDAT) contains an endogenous high affinity Zn2+ binding site with three coordinating residues on its extracellular face (His193, His375, and Glu396). ... Although Zn2+ inhibited uptake, Zn2+ facilitated [3H]MPP+ release induced by amphetamine, MPP+, or K+-induced depolarization specifically at hDAT but not at the human serotonin and the norepinephrine transporter (hNET). ... Surprisingly, this amphetamine-elicited efflux was markedly enhanced, rather than inhibited, by the addition of 10 μM Zn2+ to the superfusion buffer (Fig. 2 A, open squares). We stress that Zn2+ per se did not affect basal efflux (Fig. 2 A). ... In many brain regions, Zn2+ is stored in synaptic vesicles and co-released together with glutamate; under basal conditions, the extracellular levels of Zn2+ are low (~10 nM; see Refs. 39, 40). Upon neuronal stimulation, however, Zn2+ is co-released with the neurotransmitters and, consequently, the free Zn2+ concentration may transiently reach values that range from 10–20 μM (10) up to 300 μM (11). The concentrations of Zn2+ shown in this study, required for the stimulation of dopamine release (as well as inhibition of uptake), covered this physiologically relevant range, with maximum stimulation occurring at 3–30 μM. It is therefore conceivable that the action of Zn2+ on hDAT does not merely reflect a biochemical peculiarity but that it is physiologically relevant. ... Thus, when Zn2+ is co-released with glutamate, it may greatly augment the efflux of dopamine.| doi-access = free}} The human serotonin transporter and norepinephrine transporter do not contain zinc binding sites.|group="note"}}{{cite journal |vauthors=Scassellati C, Bonvicini C, Faraone SV, Gennarelli M | title = Biomarkers and attention-deficit/hyperactivity disorder: a systematic review and meta-analyses | journal = J. Am. Acad. Child Adolesc. Psychiatry | volume = 51 | issue = 10 | pages = 1003–1019.e20 | date = October 2012 | pmid = 23021477 | doi = 10.1016/j.jaac.2012.08.015 | quote = Although we did not find a sufficient number of studies suitable for a meta-analysis of PEA and ADHD, three studies20,57,58 confirmed that urinary levels of PEA were significantly lower in patients with ADHD compared with controls. ... Administration of D-amphetamine and methylphenidate resulted in a markedly increased urinary excretion of PEA,20,60 suggesting that ADHD treatments normalize PEA levels. ... Similarly, urinary biogenic trace amine PEA levels could be a biomarker for the diagnosis of ADHD,20,57,58 for treatment efficacy,20,60 and associated with symptoms of inattentivenesss.59 ... With regard to zinc supplementation, a placebo controlled trial reported that doses up to 30 mg/day of zinc were safe for at least 8 weeks, but the clinical effect was equivocal except for the finding of a 37% reduction in amphetamine optimal dose with 30 mg per day of zinc.110}}
- Norepinephrine reuptake inhibitors (NRIs) like atomoxetine prevent norepinephrine release induced by amphetamines and have been found to reduce the stimulant, euphoriant, and sympathomimetic effects of dextroamphetamine in humans.{{cite journal | vauthors = Treuer T, Gau SS, Méndez L, Montgomery W, Monk JA, Altin M, Wu S, Lin CC, Dueñas HJ | title = A systematic review of combination therapy with stimulants and atomoxetine for attention-deficit/hyperactivity disorder, including patient characteristics, treatment strategies, effectiveness, and tolerability | journal = J Child Adolesc Psychopharmacol | volume = 23 | issue = 3 | pages = 179–193 | date = April 2013 | pmid = 23560600 | pmc = 3696926 | doi = 10.1089/cap.2012.0093 | url =}}{{cite book | vauthors = Heal DJ, Smith SL, Findling RL | title = Behavioral Neuroscience of Attention Deficit Hyperactivity Disorder and Its Treatment | chapter = ADHD: current and future therapeutics | series = Current Topics in Behavioral Neurosciences | volume = 9 | issue = | pages = 361–390 | date = 2012 | pmid = 21487953 | doi = 10.1007/7854_2011_125 | isbn = 978-3-642-24611-1 | chapter-url = | quote = Adjunctive therapy with DL-methylphenidate in atomoxetine partial responders has been successful (Wilens et al. 2009), but this also increases the rates of insomnia, irritability and loss of appetite (Hammerness et al. 2009). This combination therapy has not included amphetamine because blockade of NET by atomoxetine prevents entry of amphetamine into presynaptic noradrenergic terminals (Sofuoglu et al. 2009).}}{{cite journal | vauthors = Sofuoglu M, Poling J, Hill K, Kosten T | title = Atomoxetine attenuates dextroamphetamine effects in humans | journal = Am J Drug Alcohol Abuse | volume = 35 | issue = 6 | pages = 412–416 | date = 2009 | pmid = 20014909 | pmc = 2796580 | doi = 10.3109/00952990903383961 | url =}}
Pharmacology
=Mechanism of action=
{{For|a more complete and detailed description of amphetamine pharmacodynamics|Amphetamine#Pharmacodynamics}}
{{Amphetamine pharmacodynamics}}
Amphetamine, the active ingredient of Adderall, works primarily by increasing the activity of the neurotransmitters dopamine and norepinephrine in the brain.{{cite book |vauthors=Malenka RC, Nestler EJ, Hyman SE |veditors=Sydor A, Brown RY |title=Molecular Neuropharmacology: A Foundation for Clinical Neuroscience |year=2009 |publisher=McGraw-Hill Medical |location=New York, USA |isbn=9780071481274 |pages=154–157 |edition=2nd |chapter=Chapter 6: Widely Projecting Systems: Monoamines, Acetylcholine, and Orexin}} It also triggers the release of several other hormones (e.g., epinephrine) and neurotransmitters (e.g., serotonin and histamine) as well as the synthesis of certain neuropeptides (e.g., cocaine and amphetamine regulated transcript (CART) peptides).{{cite web |title=Amphetamine: Biomolecular Interactions and Pathways |url=https://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3007#x301 |website=PubChem Compound | publisher=National Center for Biotechnology Information |access-date=13 October 2013 |archive-date=13 October 2013 |archive-url=https://web.archive.org/web/20131013122604/http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3007#x301 |url-status=live}} Both active ingredients of Adderall, dextroamphetamine and levoamphetamine, bind to the same biological targets, but their binding affinities (that is, potency) differ somewhat. Dextroamphetamine and levoamphetamine are both potent full agonists (activating compounds) of trace amine-associated receptor 1 (TAAR1) and interact with vesicular monoamine transporter 2 (VMAT2), with dextroamphetamine being the more potent agonist of TAAR1. Consequently, dextroamphetamine produces more {{abbr|CNS|central nervous system}} stimulation than levoamphetamine;{{cite journal |vauthors=Lewin AH, Miller GM, Gilmour B |title=Trace amine-associated receptor 1 is a stereoselective binding site for compounds in the amphetamine class |journal=Bioorg. Med. Chem. |date=December 2011 |volume=19 |issue=23 |pages=7044–7048 |pmid=22037049 |doi=10.1016/j.bmc.2011.10.007 |pmc=3236098}}{{cite journal |vauthors=Smith RC, Davis JM |title=Comparative effects of d-amphetamine, l-amphetamine, and methylphenidate on mood in man |journal=Psychopharmacology |volume=53 |issue=1 |pages=1–12 |date=June 1977 |pmid=407607 |doi=10.1007/bf00426687 |s2cid=37967136}} however, levoamphetamine has slightly greater cardiovascular and peripheral effects. It has been reported that certain children have a better clinical response to levoamphetamine.{{cite book |title=Explorations in Child Psychiatry |url=https://books.google.com/books?id=Ob7eBwAAQBAJ |publisher=Springer Science & Business Media |date=11 November 2013 |isbn=9781468421279 |vauthors=Anthony E |pages=93–94 |access-date=28 April 2015 |archive-date=21 May 2016 |archive-url=https://web.archive.org/web/20160521053637/https://books.google.com/books?id=Ob7eBwAAQBAJ |url-status=live}}{{cite journal |title=Methyiphenidate vs. Amphetamine: Comparative review |year=2000 |author=Arnold LE |s2cid=15901046 |journal=Journal of Attention Disorders |volume=3 |issue=4 |pages=200–211 |doi=10.1177/108705470000300403}}
In the absence of amphetamine, {{abbr|VMAT2|vesicular monoamine transporter 2}} will normally move monoamines (e.g., dopamine, histamine, serotonin, norepinephrine, etc.) from the intracellular fluid of a monoamine neuron into its synaptic vesicles, which store neurotransmitters for later release (via exocytosis) into the synaptic cleft.{{cite journal |vauthors=Eiden LE, Weihe E |date=January 2011 |title=VMAT2: a dynamic regulator of brain monoaminergic neuronal function interacting with drugs of abuse |journal=Ann. N. Y. Acad. Sci. |volume=1216 |issue=1 |pages=86–98 |bibcode=2011NYASA1216...86E |doi=10.1111/j.1749-6632.2010.05906.x |pmc=4183197 |pmid=21272013 |quote=VMAT2 is the CNS vesicular transporter for not only the biogenic amines DA, NE, EPI, 5-HT, and HIS, but likely also for the trace amines TYR, PEA, and thyronamine (THYR) ... [Trace aminergic] neurons in mammalian CNS would be identifiable as neurons expressing VMAT2 for storage, and the biosynthetic enzyme aromatic amino acid decarboxylase (AADC).}} When amphetamine enters a neuron and interacts with VMAT2, the transporter reverses its direction of transport, thereby releasing stored monoamines inside synaptic vesicles back into the neuron's intracellular fluid. Meanwhile, when amphetamine activates {{abbr|TAAR1|trace amine-associated receptor 1}}, the receptor causes the neuron's cell membrane-bound monoamine transporters (i.e., the dopamine transporter, norepinephrine transporter, or serotonin transporter) to either stop transporting monoamines altogether (via transporter internalization) or transport monoamines out of the neuron; in other words, the reversed membrane transporter will push dopamine, norepinephrine, and serotonin out of the neuron's intracellular fluid and into the synaptic cleft. In summary, by interacting with both VMAT2 and TAAR1, amphetamine releases neurotransmitters from synaptic vesicles (the effect from VMAT2) into the intracellular fluid where they subsequently exit the neuron through the membrane-bound, reversed monoamine transporters (the effect from TAAR1).
=Pharmacokinetics=
{{transcluded section|source=Amphetamine#Pharmacokinetics}}
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=Pharmacomicrobiomics=
{{Excerpt|Amphetamine|Pharmacomicrobiomics}}
=Related endogenous compounds=
{{transcluded section|source=Amphetamine#Related endogenous compounds}}
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History
{{main|History and culture of substituted amphetamines}}
The pharmaceutical company Rexar reformulated their popular weight loss drug Obetrol following its mandatory withdrawal from the market in 1973 under the Kefauver Harris Amendment to the Federal Food, Drug, and Cosmetic Act due to the results of the Drug Efficacy Study Implementation (DESI) program (which indicated a lack of efficacy). The new formulation simply replaced the two methamphetamine components with dextroamphetamine and amphetamine components of the same weight (the other two original dextroamphetamine and amphetamine components were preserved), preserved the Obetrol branding, and despite it lacking FDA approval, it still made it onto the market and was marketed and sold by Rexar for many years.
In 1994, Richwood Pharmaceuticals acquired Rexar and began promoting Obetrol as a treatment for ADHD (and later narcolepsy as well), now marketed under the new brand name of Adderall, a contraction of the phrase "A.D.D. for All" intended to convey that "it was meant to be kind of an inclusive thing" for marketing purposes.{{Cite news|url=https://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html|title=The Selling of Attention Deficit Disorder| vauthors = Schwarz A |date=14 December 2013|work=The New York Times|access-date=22 April 2017|issn=0362-4331|archive-date=1 March 2015|archive-url=https://web.archive.org/web/20150301054334/http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html|url-status=live}} The FDA cited the company for numerous significant CGMP violations related to Obetrol discovered during routine inspections following the acquisition (including issuing a formal warning letter for the violations), then later issued a second formal warning letter to Richwood Pharmaceuticals specifically due to violations of "the new drug and misbranding provisions of the FD&C Act". Following extended discussions with Richwood Pharmaceuticals regarding the resolution of a large number of issues related to the company's numerous violations of FDA regulations, the FDA formally approved the first Obetrol labeling/sNDA revisions in 1996, including a name change to Adderall and a restoration of its status as an approved drug product.{{cite web|title=(Collection of internal FDA information pertaining to the topic of Obetrol/Adderall)|url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/96/11522S010_Adderall.pdf|website=www.accessdata.fda.gov|publisher=US Food and Drug Administration|access-date=27 April 2017|archive-date=17 May 2017|archive-url=https://web.archive.org/web/20170517033551/https://www.accessdata.fda.gov/drugsatfda_docs/nda/96/11522S010_Adderall.pdf|url-status=live}}{{cite news|title=REGULATORY NEWS: Richwood's Adderall|url=http://www.elsevierbi.com/Publications/Health-News-Daily/1996/2/22/REGULATORY-NEWS-Richwoods-Adderall|archive-url=http://arquivo.pt/wayback/20160523200531/http://www.elsevierbi.com/Publications/Health-News-Daily/1996/2/22/REGULATORY-NEWS-Richwoods-Adderall|url-status=dead|archive-date=23 May 2016|access-date=29 May 2013|newspaper=Health News Daily|date=22 February 1996}} In 1997 Richwood Pharmaceuticals was acquired by Shire Pharmaceuticals in a $186 million transaction.
Richwood Pharmaceuticals, which later merged with Shire plc, introduced the current Adderall brand in 1996 as an instant-release tablet.{{cite web|title=APPROVAL LETTER|url=http://www.accessdata.fda.gov/drugsatfda_docs/nda/96/11522S010_Adderall.pdf|website=United States Food and Drug Administration|access-date=30 December 2013|archive-date=22 August 2013|archive-url=https://web.archive.org/web/20130822033454/http://www.accessdata.fda.gov/drugsatfda_docs/nda/96/11522S010_Adderall.pdf|url-status=dead}} In 2006, Shire agreed to sell rights to the Adderall name for the instant-release form of the medication to Duramed Pharmaceuticals.{{cite web | title = August 2006 News Archives: Barr and Shire Sign Three Agreements | publisher = GenericsWeb | url = http://www.genericsweb.com/news/generics_industry_news_archive/August2006.html | access-date = 30 December 2013 | quote = WOODCLIFF LAKE, N.J., Aug. 14 /PRNewswire-FirstCall/ – Barr Pharmaceuticals, Inc. today announced that its subsidiary Duramed Pharmaceuticals, Inc. and Shire plc have signed a Product Acquisition Agreement for ADDERALL(R) (immediate-release mixed amphetamine salts) tablets and a Product Development Agreement for six proprietary products, and that its subsidiary Barr Laboratories, Inc. (Barr) has signed a Settlement and License Agreement relating to the resolution of two pending patent cases involving Shire's ADDERALL XR(R) ... | archive-date = 8 February 2014 | archive-url = https://web.archive.org/web/20140208010946/http://www.genericsweb.com/news/generics_industry_news_archive/August2006.html | url-status = dead}} DuraMed Pharmaceuticals was acquired by Teva Pharmaceuticals in 2008 during their acquisition of Barr Pharmaceuticals, including Barr's Duramed division.{{cite web |url=https://www.drugs.com/news/teva-completes-acquisition-barr-15356.html |title=Teva Completes Acquisition of Barr |publisher=Drugs.com |access-date=31 October 2011 |archive-date=8 March 2012 |archive-url=https://web.archive.org/web/20120308020446/http://www.drugs.com/news/teva-completes-acquisition-barr-15356.html |url-status=live}}
The first generic version of Adderall IR was introduced to the market in 2002. Later on, Barr and Shire reached a settlement agreement permitting Barr to offer a generic form of the extended-release drug beginning in April 2009.{{cite news| url=https://www.forbes.com/feeds/ap/2009/04/02/ap6248888.html| title=Teva sells 1st generic of Adderall XL in US| date=2 April 2009| access-date=22 April 2009| agency=Associated Press| work=Forbes Magazine| archive-url=https://web.archive.org/web/20090409082544/http://www.forbes.com/feeds/ap/2009/04/02/ap6248888.html| archive-date= 9 April 2009}}
=Commercial formulation=
Chemically, Adderall is a mixture of four amphetamine salts; specifically, it is composed of equal parts (by mass) of amphetamine aspartate monohydrate, amphetamine sulfate, dextroamphetamine sulfate, and dextroamphetamine saccharate. This drug mixture has slightly stronger {{abbr|CNS|central nervous system}} effects than racemic amphetamine due to the higher proportion of dextroamphetamine.{{cite journal | author = Miller GM | title = The emerging role of trace amine-associated receptor 1 in the functional regulation of monoamine transporters and dopaminergic activity | journal = J. Neurochem. | volume = 116 | issue = 2 | pages = 164–76 |date=January 2011| pmid = 21073468 | pmc = 3005101 | doi = 10.1111/j.1471-4159.2010.07109.x}} Adderall is produced as both an immediate-release (IR) and extended-release (XR) formulation. {{As of|2013|12}}, ten different companies produced generic Adderall IR, while Teva Pharmaceutical Industries, Actavis, and Barr Pharmaceuticals manufactured generic Adderall XR. {{As of|2013}}, Shire plc, the company that held the original patent for Adderall and Adderall XR, still manufactured brand name Adderall XR, but not Adderall IR.
=Comparison to other formulations=
Adderall is one of several formulations of pharmaceutical amphetamine, including singular or mixed enantiomers and as an enantiomer prodrug. The table below compares these medications (based on U.S.-approved forms):
{{Amphetamine base in marketed amphetamine medications}}
Society and culture
= Legal status =
- In Canada, amphetamines are in Schedule I of the Controlled Drugs and Substances Act, and can only be obtained by prescription.{{cite web|url=http://laws-lois.justice.gc.ca/eng/acts/C-38.8/|title=Controlled Drugs and Substances Act (S.C. 1996, c. 19)|date=25 April 2017|access-date=23 May 2013|archive-date=3 April 2011|archive-url=https://web.archive.org/web/20110403004630/http://laws-lois.justice.gc.ca/eng/acts/C-38.8/|url-status=live}}
- In Japan, the use, production, and import of any medicine containing amphetamines is prohibited.{{cite web | url = http://www.mhlw.go.jp/english/topics/import/ | title = Importing or Bringing Medication into Japan for Personal Use | publisher = Japan Ministry of Health, Labour and Welfare | access-date = 13 October 2013 | archive-date = 13 July 2013 | archive-url = https://web.archive.org/web/20130713064422/http://www.mhlw.go.jp/english/topics/import/ | url-status = live}}
- In South Korea, amphetamines are prohibited.{{cite web | url = https://www.koreatimes.co.kr/www/news/nation/2012/10/319_111757.html | title = Moving to Korea brings medical, social changes | author = P. | publisher = The Korean Times | date = 25 May 2012 | access-date = 8 February 2013 | archive-date = 3 October 2014 | archive-url = https://web.archive.org/web/20141003122116/http://www.koreatimes.co.kr/www/news/nation/2012/10/319_111757.html | url-status = live}}
- In Taiwan, amphetamines including Adderall are Schedule 2 drugs with a minimum five-year prison term for possession.{{cite web|url=http://www.taipeitimes.com/News/feat/archives/2002/08/11/0000159895/4|title=Caught in the Dragnet|date=2 August 2002|access-date=18 November 2018|archive-date=19 November 2018|archive-url=https://web.archive.org/web/20181119010732/http://www.taipeitimes.com/News/feat/archives/2002/08/11/0000159895/4|url-status=live}} On the contrary, Ritalin can be legally prescribed as a form of treatment of ADHD.{{cite web|url=https://www.commonhealth.com.tw/article/88370|title=吃「聰明藥」反而變笨?小孩能吃嗎?利他能副作用公開|date=28 June 2023}}
- In Thailand, amphetamines are classified as Type 1 Narcotics.{{cite web|url=http://narcotic.fda.moph.go.th/faq/upload/Thai%20Narcotic%20Act%202012.doc._37ef.pdf |title=Thailand Law |publisher=Government of Thailand |access-date=23 May 2013 |url-status=dead |archive-url=https://web.archive.org/web/20140308001155/http://narcotic.fda.moph.go.th/faq/upload/Thai%20Narcotic%20Act%202012.doc._37ef.pdf |archive-date= 8 March 2014}}
- In the United Kingdom, amphetamines are regarded as Class B drugs. The maximum penalty for unauthorized possession is five years in prison and an unlimited fine. The maximum penalty for illegal supply is 14 years in prison and an unlimited fine.{{cite web|title=Class A, B and C drugs |publisher=Home Office, Government of the United Kingdom |url=http://www.homeoffice.gov.uk/drugs/drugs-law/Class-a-b-c/ |access-date=23 July 2007 |archive-url=https://web.archive.org/web/20070804233232/http://www.homeoffice.gov.uk/drugs/drugs-law/Class-a-b-c/ |archive-date=4 August 2007 |url-status=dead}}
- In the United States, amphetamine is a Schedule II prescription drug, classified as a central nervous system (CNS) stimulant.
- Internationally, amphetamine is in Schedule II of the Convention on Psychotropic Substances.{{cite book | author = United Nations Office on Drugs and Crime | title = Preventing Amphetamine-type Stimulant Use Among Young People: A Policy and Programming Guide | publisher = United Nations | location = New York | year = 2007 | isbn = 978-92-1-148223-2 | url = http://www.unodc.org/pdf/youthnet/ATS.pdf | access-date = 7 February 2012 | archive-date = 16 October 2013 | archive-url = https://web.archive.org/web/20131016082310/http://www.unodc.org/pdf/youthnet/ATS.pdf | url-status = live}}{{cite web|title=List of psychotropic substances under international control |author=International Narcotics Control Board |publisher=United Nations |location=Vienna |url=http://www.incb.org/pdf/e/list/green.pdf |access-date=19 November 2005 |archive-url=https://web.archive.org/web/20051205125434/http://www.incb.org/pdf/e/list/green.pdf |archive-date=5 December 2005 |url-status=dead}}
= Shortages =
In February 2023, news organizations began reporting on shortages of Adderall in the United States that have lasted for over five months.{{cite news |title=The ADHD medication shortage is getting worse. What went wrong?—Neither drugmakers nor the DEA anticipated a sharp rise in ADHD diagnoses during the pandemic. Now an entire class of medications may be in short supply. |date=6 February 2023 |publisher=NBC |url=https://www.nbcnews.com/health/health-news/adderall-shortage-adhd-drugs-affected-will-end-rcna66766 |access-date=25 February 2023}}{{cite news |title=Adderall shortage raises questions about widespread dependency on the drug |date=25 November 2022 |work=PBS Newshour |url=https://www.pbs.org/newshour/show/adderall-shortage-raises-questions-about-widespread-dependency-on-the-drug |access-date=25 February 2023}} The Food and Drug Administration first reported the shortage in October 2022.{{cite news | vauthors = Hart B |title=Where's the Urgency on the Adderall Shortage? |url=https://nymag.com/intelligencer/2023/03/wheres-the-urgency-on-the-adderall-shortage.html |access-date=27 March 2023 |work=Intelligencer |date=27 March 2023 |language=en-us}} In May 2023, seven months into the shortage, the Food and Drug Administration commissioner Robert Califf stated that "a number of generic drugs are in shortage at any given time because there's not enough profit". He points out that Adderall is a special case because it is a controlled substance and the amount available for prescription is controlled by the Drug Enforcement Administration. He also faults a "tremendous increase in prescribing" due to virtual prescribing and general overprescribing and overdiagnosing, adding that "if only the people that needed these drugs got them, there probably wouldn't be a [stimulant medication] shortage".{{cite news |title='Exciting Time': FDA Commissioner Talks AI and Misinformation |date=31 May 2023|publisher=WebMD|url=https://www.webmd.com/a-to-z-guides/news/20230530/fda-commissioner-talks-ai-and-misinformation}}{{cite news |title=FDA Commissioner Blames Adderall Shortage on Stimulant Overuse, Telehealth, Generics |date=2 June 2023|publisher=Anni Layne Rodgers via Additidemag|url=https://www.additudemag.com/adderall-shortage-stimulant-use-telehealth-califf/}} The shortage has continued into 2024.{{Cite web|url=https://www.pharmamanufacturing.com/articles/2024/adderall-shortage-continues/|title=Adderall Shortage Persists in 2024|website=Pharma Manufacturing|date=1 June 2024|access-date=12 July 2024}}{{Dead link|date=February 2025 |bot=InternetArchiveBot |fix-attempted=yes}}{{Cite news|last=Smith|first=Jane|title=Ongoing Adderall Shortage Affects Millions|url=https://www.healthnews.com/adderall-shortage-2024|work=Health News|date=15 May 2024|access-date=12 July 2024}}{{Cite web|url=https://www.fda.gov/drugs/drug-safety-and-availability/adderall-shortage-2024-update|title=FDA Update on Adderall Shortage|website=U.S. Food and Drug Administration|date=20 June 2024|access-date=12 July 2024}}{{dead link|date=May 2025|bot=medic}}{{cbignore|bot=medic}} It has led to the creation and expansion of businesses that outsource the search for Adderall. One company charges $50 per U.S. customer to hire workers in the Philippines or another country to make phone calls to all the pharmacies located near the customer and check whether they have any Adderall. Celebrity endorsements have contributed to the increased demand for Adderall.{{Cite web |last=Maiberg |first=Emanuel |date=2024-06-11 |title=Americans Are Hiring People in the Philippines to Help Them Find Adderall |url=https://www.404media.co/people-in-the-philippines-are-calling-us-pharmacies-to-help-americans-find-adderall/ |access-date=2024-10-08 |website=404 Media |language=en}}
Notes
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Reference notes
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References
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External links
- {{cite web | title=Amphetamine | website=MedlinePlus | url=https://medlineplus.gov/druginfo/meds/a616004.html }}
{{Amphetamine|state=expanded}}
{{Phenethylamines}}
{{Stimulants}}
{{ADHD pharmacotherapies}}
{{Monoamine releasing agents}}
{{TAAR ligands}}
{{Portal bar|Medicine|Chemistry|Biology}}
{{Authority control}}
Category:Attention deficit hyperactivity disorder management
Category:Combination psychiatric drugs
Category:Drugs acting on the cardiovascular system
Category:Drugs acting on the nervous system
Category:Drugs developed by Takeda Pharmaceutical Company
Category:Excitatory amino acid reuptake inhibitors
Category:Norepinephrine-dopamine releasing agents
Category:Pro-motivational agents
Category:Substituted amphetamines