Amphetamine salts are stimulant medications used to address specific medical conditions. They are primarily utilized in the management of conditions that affect attention, focus, and wakefulness.
Amphetamine salts are not a single substance but a mixture of different amphetamine forms. These medications require careful medical supervision due to their effects on brain chemistry.
Chemical Nature and Common Forms
Amphetamine salts are formulated as salts to enhance their stability and absorption within the body. This chemical structure allows for effective processing once ingested.
Different types of amphetamine salts exist, each with distinct chemical compositions and effects. Dextroamphetamine (d-amphetamine) and levoamphetamine (l-amphetamine) are two common forms. Dextroamphetamine generally has a more potent central nervous system stimulant effect, while levoamphetamine exhibits stronger cardiovascular and peripheral effects. Mixed amphetamine salts, such as those found in Adderall, combine these isomers, typically in a 3:1 ratio of dextroamphetamine to levoamphetamine. Adderall contains four specific amphetamine salts:
- Dextroamphetamine saccharate
- Amphetamine aspartate
- Dextroamphetamine sulfate
- Amphetamine sulfate
Dexedrine, another common medication, primarily contains only the d-amphetamine isomer. Lisdexamfetamine (Vyvanse) is a prodrug, meaning it is inactive until converted into d-amphetamine within the body. This conversion occurs through enzymatic hydrolysis in red blood cells after oral ingestion, allowing for a slower and more controlled release of the active stimulant.
How They Work in the Body
Amphetamine salts primarily exert their effects by increasing the levels of certain neurotransmitters in the brain, particularly dopamine and norepinephrine. These chemical messengers play significant roles in regulating mood, attention, and energy levels. Amphetamine achieves this by promoting the release of these neurotransmitters from their storage sites within neurons.
The medications also block the reuptake of dopamine and norepinephrine, allowing these neurotransmitters to remain in the synaptic cleft for longer durations. This prolonged presence amplifies their signaling, leading to increased activity in affected neural pathways. The overall result is an enhancement of central nervous system activity, contributing to effects like improved focus and wakefulness. Some research also indicates a lesser effect on serotonin levels.
Medical Applications
Amphetamine salts are widely prescribed for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in both children and adults. They help manage core ADHD symptoms such as inattention, hyperactivity, and impulsivity.
Another primary medical application for amphetamine salts is narcolepsy, a chronic neurological condition characterized by overwhelming daytime sleepiness. The stimulant properties of these medications help to promote wakefulness and counteract excessive somnolence in affected individuals. Lisdexamfetamine, a specific amphetamine prodrug, is also approved for the treatment of moderate to severe binge eating disorder in adults.
Potential Effects and Safety Considerations
When used as prescribed, amphetamine salts can lead to therapeutic effects such as increased alertness, improved concentration, and enhanced cognitive control. These medications can also reduce fatigue and enhance wakefulness, particularly in those with narcolepsy.
Amphetamine salts are associated with a range of potential adverse effects. Common side effects include insomnia, decreased appetite, dry mouth, and an increase in heart rate and blood pressure. Some individuals may also experience anxiety, restlessness, or mood swings. Serious cardiovascular issues, including sudden death, heart problems, and significant hypertension, have been reported, especially in individuals with pre-existing heart conditions.
There is a potential for misuse, abuse, and dependence with amphetamine salts, particularly when not used under medical supervision or at higher than prescribed doses. Misuse can lead to severe adverse outcomes, including psychosis, paranoia, hallucinations, and aggression. These medications are contraindicated in individuals with a history of substance abuse, severe agitation, or certain cardiovascular diseases like advanced arteriosclerosis or uncontrolled hypertension. They should also be avoided by those with glaucoma or hyperthyroidism, or by individuals taking monoamine oxidase inhibitors (MAOIs) due to the risk of a hypertensive crisis.