ADHD/ Amphetamines

Central Nervous System Agents

Dextroamphetamine

• ADHD: first-line therapy for patients ≥ 6 years of age

• Other indications: narcolepsy, binge eating disorder

indirect and central sympathomimetic activity → increased release and blocked reuptake of norepinephrine and dopamine (minor effect on serotonin) → increased concentration in the synaptic cleft

• Increased mental performance: improved concentration, cognition (learning, remembering, combining), short-term memory, and fine motor skills

• Reduced potential for conflict

• Adverse sympathomimetic effects

  • Anxiety, agitation, restlessness, bruxism, tics

  • Difficulties falling asleep (insomnia)

  • Reduced appetite, nausea, vomiting (causes weight loss)

  • Increased arterial blood pressure, tachycardia

• Epileptogenic potential: reduces the threshold for seizures and tics

• Decreased growth rate (reversible if medication is stopped)

• Euphoria

• Rarely, priapism

Contraindicated in patients with hypersensitivity or idiosyncrasy to the sympathomimetic amines,  symptomatic cardiovascular disease, hyperthyroidism,  moderate to severe hypertension, glaucoma, or advanced arteriosclerosis; within 14 days of MAO inhibitor therapy;  and in agitated patients.