Amphetamine salts vs. dextroamphetamine is a common comparison people make while exploring ADHD and narcolepsy treatments [1]. While both are brain stimulant medications that help patients with ADHD and narcolepsy gain better control of their executive functions, the two differ in potency, long-term and short-term side effects, and, most notably, chemical compositions.
It is essential to be aware of these factors if someone wants to incorporate them into their treatment. This article provides a detailed explanation of the differences between the two, their uses, dosage, and associated risks.
What Are Amphetamine Salts?
Amphetamine salts are a unique combination of chemical compounds used in certain brain stimulant medications [2]. It activates dopamine and norepinephrine chemicals in the body and alters the brain chemistry by stimulating the central nervous system (CNS), which regulates mood, energy, and control in individuals.
For those suffering from various disorders, such as attention disorders, neurological conditions, and chronic conditions such as ADHD, narcolepsy, or binge eating disorder. It can improve impulse control, depression, focus, and executive functions (e.g., decision-making).
Amphetamine salts are made from two main components: dextroamphetamine and levoamphetamine, and are mainly sold in two notable liquid formulations. These are:
- Adderall (Mixed Amphetamine Salts): A medication that combines L-amphetamine and d-amphetamine in a 3:1 ratio, boosting physical energy and mental clarity.
- Vyvanse (Lisdexamfetamine): Medication that slowly releases d-amphetamine into the body after digestion to reduce binge eating urges.
Uses of Amphetamine Salts
In the US, the FDA has sanctioned medical uses for amphetamine salt medications only for some conditions [3]:
1. ADHD: When it comes to attention deficit hyperactivity disorder, amphetamine salts can help the prefrontal cortex recover from a dull state. Activity in this area of the brain is essential for executive function, which improves one’s decision-making skills and helps keep the brain focused
2. Narcolepsy: A sudden urge to sleep uncontrollably and randomly kicks in, a condition such as narcolepsy. Amphetamine salts combat this condition by stimulating the body to produce norepinephrine, which helps keep the mind alert, and dopamine, which enhances overall alertness and focus.
Some notable additional conditions are;
1. Binge Eating Disorder: For eating disorders, Amphetamine salt medication, such as lisdexamfetamine, is commonly sold as Vyvanse on the market. This medication has helped many individuals reduce and manage episodes of eating disorders by curbing the urge to consume food [4].
2. Mental Disorders: In some particular cases, people trying to recover from traumatic brain injuries, chronic fatigue, or manage conditions like multiple sclerosis (MS), amphetamine medications help people regain balanced mental health by encouraging control, removing brain fog, providing mental clarity, and upping their alertness.
3. Treatment-Resistant Depression: For those who do not see improvement with conventional antidepressants, amphetamine medication can provide short-term improvements. While it is temporary, it reduces symptoms of depression by boosting energy levels, motivation, and focus.
Amphetamine Dosages, Onset, and Duration
Amphetamines are taken in different dosages depending on a person’s age, conditions, and other medications [5]. Only two specific liquid formulations are prescribed: IR medications and XR medications.
IR medications: Immediate-release liquid formulations that start working within 10 to 45 minutes and last around 4 hours, on average. They are typically taken multiple times during the day.
XR medications: Formulations with extended-release properties that are taken in the early morning and can last for 12 hours, allowing the body to be medicated slowly over time.
Recommended Amphetamine Dosage
- Narcolepsy: The starting dose for narcolepsy is an extended-release XR liquid formulation, 5 to 10 mg.
- ADHD in children: It depends on the child’s tolerance, but typically given 5 to 10mg.
- ADHD in adults: Adults are typically prescribed a single daily dose of an XR formulation like Adderall XR.
- Binge Eating Disorder: In eating disorders, adults typically start with a 30mg increase weekly until a maximum of 70mg daily.
What Is Dextroamphetamine?
Dextroamphetamine is a modified version of amphetamine, capable of stimulating the brain more powerfully [6]. It is derived from amphetamine but only maintains the chemical compound, the dextro isomer, for stronger central nervous system stimulation. These stronger, targeted effects make it more suitable for adults trying to manage inattention and excessive sleepiness.
Similar to standard amphetamine, dextroamphetamine is available in many IR and XR formulations and sold under different brand names. Most notable ones are:
- Dexedrine: It is a dextroamphetamine sulfate formulation with a target effect on attention and wakefulness; Dexedrine is sold in both IR and XR liquid formulations.
- ProCentra: Dextroamphetamine in an oral liquid formulation is prescribed for dose adjustments.
- Zenzedi: For flexible dosing. It is an immediately released formulation, typically recommended for pediatric and adult ADHD cases.
Uses of Dexedrine / Dextroamphetamine
For dextroamphetamine, the FDA has given the green light for two specific medical uses with full approval.
ADHD: Attention deficit disorders make completing daily tasks a struggle due to a lack of interest in any given task. This is caused by a lack of dopamine, which runs out quickly when the “novelty” of the given task ends. In slang terms, it is called “shiny object syndrome.” Dextroamphetamine boosts dopamine to increase the ability to concentrate and reduce hyperactivity, making daily tasks more manageable.
Narcolepsy: In narcolepsy, dextroamphetamine medications fight the sudden urge to sleep, releasing norepinephrine in the brain. The results help individuals stay alert throughout the day while also ensuring better control over sudden attacks.
It is beneficial in these notable additional conditions that are not or partially approved by the FDA:
Apathy in the Elderly: In some rare cases, older adults with Alzheimer’s or Parkinson’s disease might be prescribed dextroamphetamine. Affecting up to 70% of Alzheimer’s patients, for many these diseases cripple the mind and make it less apathetic toward daily life. Dextroamphetamine sparks motivation in people by interacting with the brain’s reward system, which involves dopamine, helping apathetic individuals regain control over brain function.
Resistant Depression: When regular antidepressants do not work, people become resistant to taking the necessary medications until they see results. To help them break the cycle, under careful supervision, off-label dextroamphetamine is prescribed. It alters brain chemistry to provide a much-needed rush, lifting the mood. These short-term but effective improvements help people regain the motivation to continue treatment.
Binge Eating Disorder: Dextroamphetamine can also step in as an alternative to the usual lisdexamfetamine for managing binge eating disorder. For many, it regulates appetite and reduces episodes of sudden, compulsive eating.
Dosages of Dextroamphetamine
The dosage of dextroamphetamine is determined entirely by factors like the conditions treated, the person’s age, and specific timing [7]. For example, Dexedrine Spansules are taken early in the morning for a steady release throughout the day. Similar to amphetamine salts, the formulation is prescribed in two liquid formulations:
IR medications: Immediate-release liquid formulations; IR liquid formulation begins working in 30 minutes and can last for 6 hours.
XR medications: A formulation with extended release, where dextroamphetamine is steadily released, medicating the body for about 12 hours.
Recommended Dextroamphetamine Dosage
- Narcolepsy: extended-release versions, such as Dexedrine XR, are prescribed in doses of 5 to 10 mg.
- ADHD in children: Children are prescribed 5 mg to 10 mg of dextroamphetamine to improve focus and attention.
- ADHD in adults: Extended-release (ER) liquid formulations with doses of 5mg to 10mg are typically taken once in the morning.
- Alzheimer’s or Parkinson’s: In rare cases, 2.5 to 5 mg is prescribed to help with motivation and alertness.
- Binge-eating disorder: Under guidance, people begin with 30mg, with increasing dosages by 10mg every week until reaching 70mg.
Differences Between Amphetamine Salts and Dextroamphetamine: Dosages, Uses, and Chemical Makeup
Dosage Differences
The dosages differ in the following ways:
Amphetamine salts (Adderall) are given in an IR (immediate release) dose of 5mg once or twice daily, or under certain conditions[8].
On the other hand, Dextroamphetamine (Dexedrine) is slightly lower in dosage than amphetamine salts, starting at 2.5 to 5 mg. Similar to amphetamine, the XR (extended release) version is typically prescribed at only a 10 mg dosage due to its potent effects.
Use Differences
Amphetamine salts are one of the most prescribed formulations for many patients, and dextroamphetamine is preferred when stronger medications with more targeted effects are needed. There are six major differences:
- Weight Loss: Amphetamine can cause short-term weight loss in some individuals.
- Symptom Coverage: Amphetamine salts offer a broader range of physical energy due to the inclusion of both d- and l-isomer compounds.
- Off-label Uses: Dextroamphetamine is preferred when treating depression and cognitive fatigue, particularly in vulnerable patients, such as the elderly with apathy.
- Neurological Fatigue: Dextroamphetamine is preferred to reduce fatigue in patients with MS and brain injuries.
- Better Physical Effects: The l-amphetamine chemical compound in Amphetamine salts gives its users a boost in physical energy that is better than that of dextroamphetamine.
- Better Mental Effects: Dextroamphetamine is chosen when patients need a stronger dosage to keep the minds clear.
Chemical Makeup Differences
Chemical liquid formulation between both formulations in Amphetamine Salts vs Dextroamphetamine lies in their composition:
- Amphetamine salts: They are synthesized by blending levoamphetamine and dextroamphetamine. Called a mixed salt, they are made with a ratio of 3:1 [9].
- Dextroamphetamine: Dextroamphetamine is made by breaking down chemical compounds in amphetamine until it only contains one chemical compound called ‘d-isomer’ that remains. This gives the medication a more targeted, stronger effect.
FAQ
1. Are Dextroamphetamine and Amphetamine Salts the Same?
No. While debating amphetamine salts vs dextroamphetamine, many consider them the same. But amphetamine is an umbrella term that includes both dextroamphetamine (d-isomer) and levoamphetamine (l-isomer) chemical compounds.
2. Which Is Stronger, Adderall or Dextroamphetamine?
Dextroamphetamine is much stronger in effect than Adderall, which is a mixed amphetamine salt. This is because dextroamphetamine, containing only the d-isomer, is synthesized to target exclusively mental focus and attention disorders.
3. Why Switch from Adderall to Dexedrine?
Different switches from Adderall to Dexedrine occur for various reasons. Some individuals choose to switch from Adderall to Dexedrine cause [10]:
- Long-term side effects.
- Improvement in conditions.
- Range of effects.
4. Are Amphetamine Salts the Same as Adderall XR?
Yes, Adderall XR is a common brand name medication containing amphetamine salts. The ‘XR’ indicates that it is an extended-release medication, slowly releasing its effects throughout the day. The effects can last up to 12 hours.
5. What Are the 4 Amphetamine Salts?
The four different types of amphetamine salts are:
- Dextroamphetamine saccharate (d-isomer)
- Amphetamine aspartate monohydrate (racemic)
- Dextroamphetamine sulfate (d-isomer)
- Amphetamine sulfate (racemic)
6. Is Taking Two 10mg Adderall XR the Same as one 20mg?
While higher doses are taken to manage specific conditions, such as eating disorders, it is generally not recommended to take more than the prescribed dose without supervision. Amphetamine salts and dextroamphetamine carry a high potential for misuse and abuse.
Let Alliance Recovery Help You Out
If you’re concerned about how medications like amphetamine salts or dextroamphetamine are affecting your life or someone close to you, confidential support is available.
Alliance Recovery offers guidance and evidence-based care for individuals navigating prescription stimulant use.
We offer:
- Outpatient and day treatment programs
- Individual and group therapy
- Support from professionals with lived recovery experience
Call our treatment team at (844) 287-8506 to get started.
Sources
[1] https://pubmed.ncbi.nlm.nih.gov/11483144/
[2] https://www.ncbi.nlm.nih.gov/books/NBK556103/
[3] https://www.medicalnewstoday.com/articles/221211
[4] https://pubmed.ncbi.nlm.nih.gov/29134566/
[5] https://www.healthline.com/health/drugs/amphetamine-oral-tablet
[6]http://ncbi.nlm.nih.gov/books/NBK507808/
[7]https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/dexamphetamine
[8]https://www.nepho.org/wp-content/uploads/2023/02/ADHD-Medication-Conversion-Chart.pdf
[9]https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=288dafc4-fe6e-4891-832f-511022c87445&type=display
[10]https://clarityxdna.com/blog/med-vs-med/dexedrine-vs-adderall-unveiling-key-differences/
