Medication Treatments for ADHD - Adderall for ADHD

Written by Lewis Mehl-Madrona, MD, PhD

Adderall for ADHD

Adderall is made by Richwood Pharmaceuticals, and was previously known as 'Obetral'. The dosage of Adderall is roughly equivalent to a comparable dose of Dexedrine.

Adderall tablets consist of equal amounts of Amphetamine and Dextroamphetamine, with both short and long-acting preparations. The therapeutic effect is apparently more subtle and smooth than other preparations and the length of action is 6-9 hours.

Important points to note when prescribing or taking Adderall:

1. It provides therapeutic cover for a full school or working day.
2. Adderall has been used for 'impulse-control.
3. Adderall has a distinct anorexic effect and therefore management of diet, especially in children, is essential.
4. Because Adderall has a slow onset of action and a sloped drop-off of action, anxiety induced at the onset of action and rebound at drop-off is reduced over other stimulants

Summary Drug Monograph for Adderall:

Clinical Pharmacology:

Amphetamines are non-catecholamine sympathomimetic amines with CNS stimulant activity. Peripheral actions include elevation of systolic and diastolic blood pressures and weak bronchodilator and respiratory stimulant action.

There is neither specific evidence which clearly establishes the mechanism whereby amphetamine produces mental and behavioral effects in children, nor conclusive evidence regarding how these effects relate to the condition of the central nervous system.

Dosage and Aministration:

Regard less of indication, amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted. Late evening doses should be avoided because of the resulting insomnia.

Attention Deficit Disorder with Hyperactivity; Not recommended for children under 3 years of age. In children from 3 to 5 years of age, start with 2.5 mg daily; daily dosage may be raised in increments of 2.5 mg at weekly intervals until optimal response is obtained.

In children 6 years of age and older, start with 5 mg once or twice daily; daily dosage may be raised in increments of 5 mg at weekly intervals until optimal response is obtained. Only in rare cases will it be necessary to exceed a total of 40 mg per day. Give first dose on awakening; additional doses (1 or 2) at intervals of 4 to 6 hours.

Where possible, drug administration should be interrupted occasionally to determine if there is a recurrence of behavioral symptoms sufficient to require continued therapy.

Warnings:

Clinical experience suggests that in psychotic children, administration of amphetamine may exacerbate symptoms of behavior disturbance and thought disorder. Data are inadequate to determine whether chronic administration of amphetamine may be associated with growth inhibition; therefore, growth should be monitored during treatment.

Drug Interactions:

Acidifying agents - Gastrointestinal acidifying agents (guanethidine,reserpine, glutamic acid HCl,ascorbic acid, fruit juices, etc.) lower absorption of amphetamines.

Urinary acidifying agents -(ammonium chloride, sodium acid phosphate, etc.) Increase the concentration of the ionized species of the amphetamine.

Primary excretion - Both Groups of agents lower blood levels and efficacy of amphetamines.

Adrenergic blockers - Adrenergic blockers are inhibited by amphetamines.