Adderall, the brand name for a combination of dextroamphetamine and amphetamine, is a stimulant available as a prescription medication only. It works by balancing chemicals in the brain, namely dopamine and norepinephrine. In this manner, Adderall increases alertness, concentration and cognitive performance while decreasing fatigue. Abuse and addiction are possible with Adderall--it is a schedule II controlled substance. Adderall has two formulations, Adderall and Adderall XR.
Narcolepsy
The immediate release of Adderall is indicated for narcolepsy. Narcolepsy is a neurological disease characterized by sleep attacks, cataplexy, hypnagogic (when falling asleep) or hypnopompic (when waking), hallucinations and sleep paralysis. Cataplexy is a sudden loss of muscle tone that results in an individual collapsing. It occurs briefly, lasting from seconds to minutes; the individual does not lose consciousness. Sleep paralysis is characterized by an individual being unable to move or speak when falling asleep or when waking. Adderall has a fast onset of action and will improve alertness, elevate mood and prevent sleep. This leads to increased daytime performance. According to the "Drug Information Handbook," children 6 to 12 years of age are started on 5 milligrams per day given in the morning and increased by 5 milligrams intervals weekly until desired response is seen. In everyone over 12 years old, the initial dose will be 10 milligrams, increased by 10 milligrams at a time until desired response is seen. The maximum dose is 60 milligrams in one to three divided doses per day.
Attention-Deficit Hyperactivity Disorder
Stimulants are first-line therapy for most cases of attention-deficit hyperactivity disorder (ADHD). Adderall helps treat the main symptoms of ADHD, including inattention, difficulty organizing tasks and activities, distraction, forgetfulness, talking excessively, interrupting or intruding on others, and impulsivity. As can be seen in the "Drug Information Handbook," children between the ages of 3 and 5 are given 2.5 milligrams per day initially; the daily dose is increased by 2.5 milligrams weekly until desired response is observed. The maximum daily dose is 40 milligrams per day, divided into one to three doses. In children over 6, the initial dose is 5 milligrams.
Adderall XR
Adderall XR is the extended release form of the medication used only for ADHD. The advantage over Adderall is that Adderall XR only needs to be given once a day rather than multiple times. In children over 6 years old, 5 to 10 milligrams is given once in the morning and increased weekly as needed until desired response is seen. The maximum dose is 30 milligrams per day. In adolescents 13 to 17 years old, an Adderall XR 10 milligram dose is given initially. If necessary, the dose is increased to 20 milligrams per day a week later. In adults, 20 milligrams per day is the initial dose. Higher doses of up to 60 milligrams have been evaluated, but no data indicates that it provides additional benefit.
References
- "Drug Information Handbook 15th Edition"; Charles F. Lacy, RPh, PharmD, FCSHP, Lora L. Armstrong, RPh, PharmD, BCPS. et al; 2007
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro, Robert L. Talbert, et al; 2008
