Amphetamine: Side Effects, Uses, Interactions, Warnings

Amphetamine

Generic Name: Amphetamine

Brand Names: Adzenys ER, Adzenys XR, Dyanavel XR, Evekeo, Adderall, Dexedrine

Ingredients: Amphetamine

Drug Class: CNS Stimulants

Controlled Status: Not a Controlled Substance

Availability: Prescription Medication only

What is Amphetamine? 

Amphetamine belongs to the class of drugs known as central nervous system stimulants. These substances stimulate the release of certain neurotransmitters in the brain, particularly dopamine and norepinephrine, which are responsible for various functions including attention, alertness, and mood regulation. It is a potent and commonly prescribed medication in its generic form. Known for its stimulant effects on the brain, it is primarily used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and sometimes for obesity management.

The generic form of amphetamine includes various formulations such as amphetamine sulfate, amphetamine aspartate, dextroamphetamine sulfate, and dextroamphetamine saccharate.

Amphetamine is available in various strengths depending on the formulation and the specific brand. Common brand names for amphetamine-based medications include Adderall, Dexedrine, Evekeo, Adzenys ER, Adzenys XR, Dyanavel XR and others. Dosages and strengths vary, with immediate-release and extended-release forms to suit individual needs. Amphetamine-based medications are available only through a prescription due to their controlled nature. 

Amphetamine, although notably effective, carries potential side effects encompassing common symptoms such as reduced appetite, insomnia, elevated heart rate, dry mouth, restlessness, and headaches, as well as less frequent yet severe outcomes like heightened blood pressure, heart palpitations, mood fluctuations, and in rare instances, psychotic manifestations such as hallucinations or paranoia.

What is Amphetamine Used for?

Amphetamine is used primarily in the treatment of certain medical conditions such as attention deficit hyperactivity disorder (ADHD), narcolepsy, and in some cases, obesity. It works by affecting certain neurotransmitters in the brain, helping to improve focus, attention, and impulse control in individuals with ADHD, promoting wakefulness in people with narcolepsy, and occasionally assisting in weight management for those dealing with obesity.

How does Amphetamine Work?

Amphetamine, a central nervous system stimulant, operates by augmenting the levels of dopamine, norepinephrine, and to a lesser extent, serotonin in the synaptic gap using various mechanisms. It enters the presynaptic axon terminal through diffusion or by being taken up by monoamine transporters like DAT, NET, and SERT. Inside the terminal, amphetamine boosts the levels of these neurotransmitters in the cytosol by hindering the function of the vesicular monoamine transporter 2 (VMAT2) and disrupting the electrochemical gradients required for vesicular transporter activity.

Additionally, amphetamine hampers the breakdown of monoamine neurotransmitters by inhibiting monoamine oxidase (MAO). Simultaneously, it triggers the intracellular receptor TAAR1, which prompts the internalization of DAT or the reversal of the transporter’s function. While TAAR1’s influence on DAT is evident, its effects on NET and SERT have only been indirectly observed in studies. Consequently, this process results in an increased release of dopamine into the synaptic cleft and impedes its reuptake within the cleft through DAT internalization and direct competition.

Types of Amphetamines

There exist various types of amphetamines, including:

Type	Is it legally produced?	Use
Dextroamphetamine	Yes	ADHD, narcolepsy
Levoamphetamine	Yes	ADHD, narcolepsy
Lisdexamfetamine	Yes	Obesity (binge eating disorder)
Methamphetamine	No	Recreational use
Methamphetamine hydrochloride	Yes	ADHD, obesity

Note: Methamphetamine hydrochloride is legally produced for specific medical purposes like ADHD and obesity treatment.

Amphetamine Dosage

The dosage for amphetamines varies depending on the brand and the purpose for which the drug is being used. On average, amphetamine dosage ranges from 5 to 40 milligrams (mg), taken one to three times a day and split at intervals of four to six hours. The maximum dosage for adults is typically 60 mg per day. FDA-approved amphetamines are available in different forms, including immediate-release tablets, extended-release capsules, and oral solutions. It’s important to note that amphetamine has the potential to be habit-forming. Misuse of this medication can lead to addiction, overdose, or even fatal outcomes. Store the medicine in a secure place inaccessible to others, and it is illegal to sell or distribute this medication to others. Amphetamines can be taken with or without food.

The available dosages and forms listed here might not encompass all options. The specific dose, form, and frequency of intake will rely on various factors, including:

• Your age
• The particular condition being addressed
• The severity of that condition
• Other existing medical conditions
• Your individual response to the initial dose

These aspects play a crucial role in determining the most suitable dosage, form, and frequency of medication intake that would be most effective and safe for your situation. Always consult a healthcare professional for personalized guidance regarding your medication regimen.

For the typical adult dosage, the amounts commonly prescribed for Narcolepsy, Obesity, and Attention Deficit Disorder. For the standard pediatric dosage, the typical amounts generally recommended for Narcolepsy, Obesity, and Attention Deficit Disorder in children.

What are the Side Effects of Amphetamine? 

Amphetamine use can result in various side effects. It’s essential to inform your doctor if any of these symptoms are persistent or become bothersome. These symptoms may include experiencing a dry mouth, nausea, diarrhea, constipation, an unpleasant taste, stomach cramps, weight loss, nosebleeds, headaches, grinding or clenching of teeth during sleep, feelings of nervousness, alterations in sex drive or performance, painful menstruation, and pain or burning sensation during urination. Keeping your healthcare provider informed about these symptoms is crucial for proper monitoring and guidance during amphetamine use.

Certain side effects associated with amphetamine can be severe. These symptoms include experiencing dizziness, weakness or numbness in an arm or leg, motor or verbal tics, having beliefs that are not based in reality, feeling unusually suspicious of others, hallucinations, or displaying signs of mania. Other severe symptoms may encompass agitation, fever, confusion, rapid heartbeat, sweating, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, diarrhea, seizures, changes in vision, blistering or peeling skin, rashes, hives, itching, or swelling of the face, throat, tongue, lips, or eyes. Additionally, any difficulty in breathing or swallowing, along with numbness, pain, or temperature sensitivity in the fingers or toes, skin color changes, or unexplained wounds appearing on fingers or toes, warrant immediate medical attention.

For more details about side effects of Amphetamine

Amphetamine dependence, tolerance and withdrawal

Tolerance to amphetamines can develop, requiring the individual to consume larger doses to achieve the same desired effect. Eventually, the body might rely on amphetamines to function normally.

Amphetamine withdrawal

Quitting amphetamines after long-term use can be difficult. Your body and mind will need time to adapt to functioning without the drug. When you choose to reduce or stop using amphetamines, you might experience withdrawal symptoms. It’s crucial to seek guidance from a healthcare professional when planning to discontinue amphetamine use. These symptoms generally emerge initially and tend to decrease within a week. Most withdrawal symptoms typically fade away within a month.

Withdrawal Symptoms Include

• Tiredness
• Anxiety, Depression And Paranoia
• Confusion And Crankiness
• Extreme Hunger
• Aches And Pains
• Sleep Problems And Nightmares

Certain individuals might undergo notably intense symptoms, commonly referred to as a ‘speed crash’ These are: 

• Nausea
• Extreme Exhaustion
• Irritability 
• Feeling Depressed

How to Use Amphetamine?

Take amphetamine strictly in accordance with your doctor’s prescription. Adhere to all instructions on your prescription label and thoroughly review all provided medication guides or instruction sheets. Your doctor might occasionally adjust your dosage. Be aware that amphetamine can be habit-forming, and misuse can result in addiction, overdose, or even fatal consequences. Store the medication in a secure place inaccessible to others. It is illegal to sell or distribute this medicine.

You can take this medication with or without food.

For the oral suspension (liquid), ensure to shake it before use. Measure your dose using the provided syringe or a proper dose-measuring device, avoiding the use of a household kitchen spoon. Allow orally disintegrating tablets to dissolve in your mouth without chewing.

If there are any changes in the brand, strength, or form of this medicine, your dosage requirements may also change. To prevent medication errors, use only the specific medicine prescribed by your doctor.

Your doctor will need to monitor your progress regularly. Inform any healthcare professional treating you that you are utilizing this medicine.

What Happens if I Miss a Dose of Amphetamine? 

If you miss a dose, take it as soon as you remember. However, if it’s nearly time for your next scheduled dose, skip the missed one and continue with your regular dosing routine. Avoid taking a double dose to compensate for the missed dose.

What Happens if I Overdose Amphetamine? 

Signs and Symptoms of overdose includes:

• Breathing difficulties
• Seizures (including fits and uncontrolled jerking)
• Chest pain or racing heartbeat
• Chills or fever
• No urine output
• Extreme agitation leading to hostility, aggression, and violence
• Paranoia, hallucinations, or delusions
• Stroke, heart attack, and potential fatality; immediate action could save a life
• Restlessness
• Confusion
• Aggressive behavior
• Tremors or shaking of a part of the body
• Fatigue or weakness
• Depression
• Rapid or irregular heartbeat
• Nausea
• Vomiting
• Diarrhea
• Stomach cramps
• Seizures
• Coma (loss of consciousness for a period of time)

In case of a medical emergency, please seek immediate medical assistance or contact the Poison Help Line at 1-800-222-1222. Information is also available online at poisonhelp.org. Nevertheless, if you are experiencing severe symptoms, please do not hesitate to dial 911 (or your Local Emergency Number) immediately or proceed to the nearest emergency room for immediate medical attention. Your safety and well-being are paramount.

Pros and Cons of Amphetamine

Pros	Cons
First-choice treatment for ADHD	Risk of misuse and dependence
Available in various dosage forms (tablets, dissolvable tablets, liquid)	Special requirements due to being a controlled substance for prescription filling
Some forms available as lower-cost generics	Orally disintegrating tablets only accessible as brand-name medication
Safe for use in children	Inconsistency among available forms, not substitutable
Rapid onset, often within an hour to alleviate ADHD symptoms	Potential risks associated with pregnancy or breastfeeding

Interaction Between Amphetamine and other Drugs

What are the Risks and Warnings for Amphetamine?

Amphetamine and Allergy Warning

Seek immediate medical assistance if you experience any indications of an allergic reaction to amphetamine, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.

Amphetamine and Alcohol Warning

Combining amphetamine with alcohol can heighten the possibility of cardiovascular side effects like an elevated heart rate, chest pain, or fluctuations in blood pressure. It is advised to refrain from or minimize alcohol consumption while undergoing amphetamine treatment. If you encounter severe or recurring headaches, chest pain, or a rapid or pounding heartbeat, inform your doctor promptly. It’s crucial to disclose all medications, including vitamins and herbal supplements, to your doctor. Refrain from discontinuing any medications without consulting your doctor beforehand.

Warning with People with Certain Health Conditions

• For individuals with heart issues: Those with severe heart conditions face a risk of sudden death when taking standard doses of this medication. It is strongly advised that they avoid using this drug.
• For individuals with psychiatric disorders: If you or your child currently suffers from a psychotic disorder and uses this medication, it may exacerbate symptoms of behavioral issues and thought disorders.

For individuals with bipolar disorder, there’s an increased risk of experiencing mixed or manic episodes while taking this drug.

• For individuals with anxiety or agitation: If you or your child commonly experiences high levels of anxiety, tension, or agitation, it’s advised not to use this drug as it might intensify these symptoms.
• For individuals with a history of drug abuse: Those with a history of substance abuse should avoid using this drug due to its high potential for addiction.
• For individuals with a history of seizures: If you or your child has a background of seizures, using this drug may heighten the risk of experiencing a seizure.
• For individuals with circulation issues: Conditions such as peripheral vasculopathy and Raynaud’s phenomenon may be aggravated by amphetamine, leading to potential tissue damage in fingers and toes. It could result in sensations of numbness, pain, or cold, accompanied by changes in finger and toe color. Close monitoring by you and your doctor is crucial for any development of these symptoms. Should symptoms worsen, adjustments in dosage, discontinuation of the medication, or referral to a specialist may be considered.
• For individuals with hyperthyroidism: Those diagnosed with an overactive thyroid (hyperthyroidism) should avoid taking this drug as it can exacerbate the condition, resulting in symptoms such as irregular or increased heartbeat.

Warning with other Groups

Amphetamine and Pregnancy

This medication is classified as a category C pregnancy drug. This categorization indicates two significant points:

• Studies conducted on animals have demonstrated adverse effects on the fetus when the mother takes the drug. 
• Insufficient research has been performed in humans to ascertain the potential impact of the drug on the fetus. 

Infants born to mothers dependent on amphetamine during pregnancy have displayed an increased risk of being born prematurely, having a low birth weight, or exhibiting withdrawal symptoms.

If you are pregnant or planning to conceive, it’s crucial to have a discussion with your doctor. The use of this drug during pregnancy should only be considered if the potential benefits outweigh the potential risks.

Amphetamine and Breastfeeding

This medication can pass into breast milk, potentially causing side effects in a breastfed child. It is important to inform your doctor if you are breastfeeding. A decision may be necessary to either discontinue breastfeeding or cease taking this medication. Breastfeeding while using this drug is not recommended.

Amphetamine and Pediatric

This medication is considered safe and efficient for children aged 3 to 17 years when utilized for attention deficit hyperactivity disorder (ADHD). However, the long-term safety and effectiveness of this drug in children have not been thoroughly established.

Expiration, Storage and Disposal

The expiration date signifies the last day until which the manufacturer assures the full effectiveness and safety of a medication. Most medication labels, whether for prescription, over-the-counter (OTC), or dietary supplements, include drug expiration dates. In the United States, pharmaceutical manufacturers are legally obliged to indicate expiration dates on prescription products before their release into the market. Please ensure to check the expiration date before using the medicine.

Store this medication in its original container, securely closed and in a place inaccessible to children. The orally disintegrating tablet blister packages should be kept in the plastic sleeves provided, while the extended-release orally disintegrating tablet blister packages should be stored in the sturdy, plastic travel case after removing them from the box. Maintain the medication at room temperature, away from light, excess heat, and moisture (avoid storing it in the bathroom).

It’s crucial to ensure all medications are kept out of sight and reach of children, as many containers, like weekly pill organizers or those for eye drops, creams, patches, and inhalers, might not be child-resistant, making them easy for young children to open. To prevent accidental poisoning, always secure safety caps and promptly store medication in a secure location—up, away, and out of their sight and reach. Visit http://www.upandaway.org for detailed information on safety precautions.

Dispose of any unnecessary medications in a way that prevents access by pets, children, or others. However, avoid flushing this medication down the toilet. The recommended method for disposal is through a medicine take-back program. Consult your pharmacist or contact your local waste disposal department to inquire about available take-back programs in your area. If a take-back program is not accessible, refer to the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for further guidance.

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What are the Alternatives of Amphetamine?

• Adderall XR.
• Concerta.
• Methylphenidate.
• Azstarys.
• Strattera.
• Dexedrine.

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