Dexedrine is a stimulant drug commonly used to treat ADHD and narcolepsy. Dexedrine is also among the most abused substances for focus and energy. Read on to understand more about the side effects, abuse, and medical uses of Dexedrine.
Disclaimer: By writing this post, we are not recommending this drug. Some of our readers who were already taking the drug requested that we commission a post on it, and we are simply providing information that is available in the scientific and clinical literature. Please discuss your medications with your doctor.
What is Dexedrine?
Dexedrine is the brand name for dextroamphetamine, a drug that stimulates the brain. Like all stimulants, it promotes wakefulness, enhances concentration, and increases energy.
Night shift workers use the medication in order to stay awake during their job. Athletes take the drug to boost their athletic ability and combat fatigue. Students take it in hopes of improving studying ability. Others abuse Dexedrine recreationally, to get high [R].
But Dexedrine abuse can have harmful consequences. It can increase blood pressure and cause heart problems, headaches, drug dependence, panic attacks, and suicidal or aggressive behavior [R].
Mechanism of Action
As you can probably guess from its name, the main active ingredient of Dexedrine, dextroamphetamine, is a member of the amphetamine family of drugs.
Amphetamines also reduce levels of the enzyme monoamine oxidase, which results in an increase in neurotransmitters in the brain [R].
Amphetamines also increase the release of adrenaline, which can lead to increased blood pressure and heart rate [R].
While these drugs affect many different systems in the body, amphetamines’ effects on the neurotransmitters dopamine and norepinephrine are by far the strongest out of all of them and are the main causes of their stimulating and attention-enhancing effects [R, R, R, R, R].
However, amphetamines’ strong ability to boost dopamine levels can also cause feelings of reward and pleasure (euphoria), which gives these drugs high potential for abuse and can easily lead to addiction if not taken correctly [R].
Dexedrine vs. Other Stimulants
Like your hands and ears, the forms of amphetamine are referred to by whether they are “left-handed” or “right-handed”. Levoamphetamine – also known as the “L-” form – is the “left-handed” version (levo = left), whereas dextroamphetamine – or the “D-” form – is the “right-handed” version (dextro = right) [R].
Even though both of these compounds are technically the “same” drug, their different orientations have different effects on the brain and body [R].
In general, dextroamphetamine is the form with the strongest effects on the brain and is the primary type used for treating medical conditions such as ADHD and narcolepsy. For example, its effect on dopamine release in the brain is up to 3 – 5 times stronger than that of the L- form [R].
However, scientists later discovered that pairing the D- form with a bit of the L- form can provide additional benefits, such as making the stimulation effects stronger and allowing amphetamine medications to last longer in the brain and body [R].
For these reasons, different stimulant medications often contain different mixtures of these two compounds. Dexedrine contains the “D-” form only, whereas other common ADHD drugs, such as Adderall, contain a mix of both D- and L- forms [R].
Other, newer medications, like Vyvanse, contain specially-designed prodrug forms of amphetamine that only become active when processed (metabolized) inside the body after ingestion [R].
Uses of Dexedrine
People with ADHD have difficulty focusing and staying still. Although it might seem counterintuitive, stimulants like Dexedrine can help people with ADHD regain focus and are the preferred medications for treating this disorder [R, R, R].
Dextroamphetamine was found to reduce feelings of sleepiness by 50% in a study of 169 narcoleptic patients. However, the treated narcoleptic patients still reported more sleepiness compared to healthy people [R].
Although Dexedrine can prevent sudden or excessive sleepiness, narcoleptic patients with other symptoms, such as cataplexy (the sudden loss of muscle control in response to strong emotions), may require additional medications to control their illness, such as antidepressants [R, R].
3) Attention and Focus Issues
Dexedrine can enhance performance on tests of attention, resulting in faster response speed and more accurate choices [R].
One of the earliest uses of stimulants was to overcome the effects of sleep deprivation in military personnel, who often work extremely long hours in cognitively-demanding jobs with little or no sleep [R, R].
These drugs’ ability to enhance wakefulness also make them useful in treating a variety of conditions involving excessive sleepiness [R].
Two studies of 18 total people found that dextroamphetamine can enhance alertness after a day of sleep deprivation. Although the drug affected how the subjects slept the following night, it did not negatively impact their mood or cognitive function the next day, and their sleep quality quickly returned to normal [R, R].
However, although Dexedrine was able to help sleep-deprived people maintain focus and energy, the sleep that they got after this period was less restful. Therefore, while there might be short-term benefits to using Dexedrine to stay awake, it has possible long-term drawbacks [R].
Although depression is usually treated with serotonin-based drugs (like selective serotonin-reuptake inhibitors or SSRIs), a considerable number of depression patients do not respond fully to these drugs (a condition called treatment-resistant unipolar depression) [R].
Two case studies have reported that dextroamphetamine was able to help patients with treatment-resistant unipolar depression and postpartum depression who were not helped by other common antidepressants [R, R].
6) Brain Injury
Strokes and traumatic brain injuries are serious conditions which can take several months to recover from and that often leave patients considerably impaired. Brain injury patients also often experience long-term difficulties with cognition and speech.
A few studies looked at the potential of drugs like Dexedrine to temporarily boost cognitive abilities in these patients, thereby aiding in brain injury recovery. A combination of dextroamphetamine and transcranial direct current stimulation (tDCS) treatment improved language and speech abilities in a study of 10 stroke patients [R].
However, in another clinical study, dextroamphetamine did not enhance brain injury recovery in 32 traumatic brain injury patients [R].
Dexedrine, like many amphetamines, can cause a variety of unwanted side-effects, even when the drug is used legally for legitimate medical purposes.
- Anxiety [R]
- Constipation or diarrhea
- Dry mouth
- Elevated blood pressure (hypertension)
- Erectile dysfunction
- Excessive sweating
- High or low blood pressure
- Increased heart rate (tachycardia)
- Irregular heart rate
- Loss of appetite/weight loss/anorexia
- Muscle spasms/tics
- Psychotic symptoms (such as hallucinations and mania)
- Stomach cramps/pain
- Stunted growth in children (potentially) [R, R]
Although they are relatively rare in people without a pre-existing heart condition, cardiovascular side effects can occur and can be fatal for patients with existing heart problems or abnormalities. Tests and screening are recommended before starting Dexedrine or other stimulants [R, R].
Misuse and Abuse
Because Dexedrine is an amphetamine, the increase in dopamine levels caused by taking it can produce positive feelings or euphoria, in many people, meaning it has a high potential for abuse. Thus, all amphetamines are considered class II drugs and are only legally available via prescription [R, R].
Some people misuse amphetamines for other purposes, such as to suppress their appetite and aid in weight loss, to boost their athletic performance, or to help them study or work for longer hours. Those who misused prescribed stimulants were also more likely to be abusing other drugs [R, R].
Between 2005 and 2010, visits to the emergency room due to stimulant use have more than doubled. Recreational users also often combine Dexedrine with alcohol and other drugs, which can lead to serious side effects and can potentially be fatal [R, R].
Physical signs of stimulant abuse include [R]:
- Difficulty sleeping
- Drug cravings
- Irregular sweating
- Increased heartbeat
- Nausea or vomiting
- Severe weight loss
Emotional or mental signs include [R]:
- Feelings of invincibility
- Mood swings
- Loss of interest in activities
Because amphetamines cause the release of dopamine — the main neurotransmitter involved in the brain’s reward system — these drugs can be highly “reinforcing,” meaning that using them can easily lead to addiction [R].
Prolonged abuse can cause the brain to become unable to function normally without the drug. This causes dependence, resulting in a cycle of increasing abuse [R].
Long-term use of amphetamines can also cause tolerance, which is when the brain adapts to the presence of the drug and becomes less sensitive to it over time. This causes the user to require higher and higher doses of the drug to achieve the same effect [R, R].
It is important to note that tolerance can occur both through abuse as well as regular medical use. Nonetheless, it is more common as a result of abuse, where drug dosage is less controlled [R].
Tolerance can also increase the likelihood of overdosing [R].
- Rapid breathing
- Uncontrollable or exaggerated reflexes (hyperreflexia)
In a hospital setting, overdoses can be treated with benzodiazepines or antipsychotics, which can counteract the negative effects long enough to stabilize the patient. Because of this, overdoses are rarely fatal if the person seeks immediate medical care [R].
Withdrawal occurs when there is a quick decrease or halt in the amount of the drug in the body after continued long-term use. This can occur when stopping prescribed use, abuse, or even after frequent recreational use [R].
Withdrawal from amphetamines often involves intense withdrawal symptoms. In fact, this process is so unpleasant that avoiding the withdrawal process is one of the primary reasons people who abuse these drugs continue to stay addicted [R].
- Apathy/lack of pleasure (anhedonia)
- Drug cravings
Going through withdrawal can also make certain people prone to aggressive and violent behaviors. This can be especially difficult to prevent when a person attempts to detox from the drug without medical supervision [R, R].
There is currently no FDA-approved medication for treating stimulant dependence, although some drugs are being studied for this purpose. Several of these include non-amphetamine drugs with either stimulant-like effects (such as modafinil) or which target the dopamine system (such as bupropion, a dopamine-based antidepressant). Temporarily using these drugs could allow users to feel relatively normal while detoxing, thereby improving their chances of making it through the withdrawal phase without relapsing into using amphetamines again [R].
- Allergies to stimulant medication
- Heart disease
- History of drug abuse or addiction
- Moderate to severe high blood pressure
- Overactive thyroid (hyperthyroidism)
- Severe anxiety
- Taking antidepressant medication such as monoamine oxidase inhibitors
- Tics (though rare, it can worsen tics)
Dexedrine During Pregnancy and Breastfeeding
It is unknown whether taking amphetamines during pregnancy can potentially harm a developing child. Although a few animal studies have reported decreased birth weight and premature births, a lack of human trials makes it difficult to come to any conclusions about its safety during pregnancy [R].
When taken by nursing mothers, Dexedrine does not appear to have negative effects on breastfeeding children. However, some studies have suggested that Dexedrine may interfere with the ability to produce breast milk, especially at high dosages [R].
Acids, such as certain foods or fruit juices and medications such as methenamine, reduce the efficacy of amphetamines [R].
These drugs can increase absorption and thus, the effect, of amphetamines. Drugs of this category include acetazolamide, certain thiazides, and common items like sodium bicarbonate (baking soda) [R].
Alcohol and Other Sedatives
About 20% of emergency room visits for amphetamine abuse also involved mixing stimulant medications with alcohol. Alcohol in combination with Dexedrine is dangerous for the heart, blood vessels, and mental state. It can cause side effects such as [R, R, R]:
- Chest pains
- Increased heart rate
- Increased blood pressure
Several types of antidepressant medication including monoamine oxidase inhibitors should not be combined with Dexedrine, as that can result in very high blood pressure, internal bleeding, stroke [R, R].
Amphetamines can counteract antihistamines’ sedative effects [R].
Chlorpromazine and haloperidol work by blocking dopamine and norepinephrine reuptake and therefore can inhibit amphetamines [R].
Amphetamines can delay absorption of ethosuximide and phenytoin, anti-seizure medications as well as phenobarbital, a medication for epilepsy [R].
Adrenergic blockers, also known as beta blockers, are inhibited by amphetamines. Veratrum alkaloids are also inhibited by amphetamines. However, norepinephrine’s effect may be enhanced by amphetamines [R].
Lithium carbonate, a type of bipolar medication, treats and prevents manic episodes and can inhibit amphetamines [R].
Combining caffeine with Dexedrine may additionally trigger or worsen heart problems [R].
Certain pain medications, such as meperidine, can have a synergistic effect with amphetamines. Propoxyphene and amphetamines used together can be fatal [R].
The effects of dextroamphetamine reach their maximum strength at about 45 minutes. The dosage depends on the issue being treated and starts at the lowest recommended dosage and is increased gradually until achieving the desired response [R, R].
- 5 mg/day for children aged 6 – 12
- 10 mg/day for children aged 12 – 18
- 5 – 60 mg/day for adults
- 2.5 mg/day for children aged 3 – 5
- 5 mg/day for children aged 6 – 18
- 5 – 40 mg/day for adults
Limitations and Caveats
Although Dexedrine has mostly been found to be safe, there is a general lack of studies on the potential long-term effects of amphetamines. The few studies that have been done have reported mixed findings, making it had to draw any conclusions about the long-term safety of amphetamines [R].