Adderall
Adderall is a brand-name pharmaceutical psychostimulant composed of mixed amphetamine salts, which is thought to work by increasing the amount of norepinephrine and dopamine in the brain. Adderall is widely reported to increase alertness, concentration and overall cognitive performance while decreasing user fatigue. It is available in two formulations: immediate release and extended release (XR).
Specifically, Adderall XR is composed of the following proportions of active ingredients:
- 1/4 dextroamphetamine saccharate
- 1/4 dextroamphetamine sulfate
- 1/4 (racemic dextro/levo-amphetamine) aspartate monohydrate
- 1/4 (racemic dextro/levo-amphetamine) sulfate
These four salts are metabolized at different rates and possess diverse half lives, therefore resulting in a less dramatic onset and termination of therapeutic action, as compared to single-salt amphetamine preparations.
The average elimination half-life in adults for dextroamphetamine and levoamphetamine is 10 hours and 13 hours respectively. Breakdown rates are affected by many factors including urinary and stomach pH, weight, gender, other medications being taken, and age. Alkalinity increases bioavailability and acidity causes the drugs to be excreted sooner. Manufacturers claim that the mixture of salts in Adderall XR makes its effects smoother (that is, makes softer highs and lows); however, there is little support for this claim.
Urinary and stomach pH levels can have the strongest effect on DL-amphetamine excretion and absorption. Co-administration of acidic substances (e.g. citric acid) causes an accelerated excretion of DL-amphetamine while co-administration of alkaline agents (e.g. antacids) causes a marked increase in both retention and absorption of amphetamines potentially resulting in dangerously high serum amphetamine levels.
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Performance-enhancing use
Adderall is also reportedly widely used as a "study drug" at many American universities. Adderall is reported to help focus energy and concentration to a much higher level than normal. It enables the user to focus and stay awake. Stories of students writing papers continuously for an unusually long time, or "cramming" all night for an exam with no loss of energy or concentration are common. However, the user reportedly can suffer from drastic side effects the following day if Adderall was used to avoid a normal sleep pattern. "In extreme cases, the drug can cause paranoia, hallucinations and heart attacks." William Frankenberger, psychology professor at University of Wisconsin at Eau Claire, led at a study at the university in 2004 that reported 14% of the campus had abused some form of ADHD drugs, including Adderall.. College campuses known to be highly competitive or have a high rate of binge drinking had up to 25% of students who misused an ADHD medication within one year, a survey of students at 119 colleges across the country concluded.
Due to side effects including appetite suppression and weight loss, Adderall has also been used as an off-label drug for obesity.
Dosing and administration
Adderall is marketed as either an immediate-release tablet, Adderall, or an extended-release capsule, Adderall XR. Doses of immediate-release Adderall are available in 5, 7.5, 10, 12.5, 15, 20, and 30 mg. Adderall XR is available in 5, 10, 15, 20, 25, and 30 mg doses.
Adderall XR utilizes the Microtrol extended-release delivery system, incorporating two types of beads. The first dissolves immediately, releasing half of the medication, while the second type dissolves much more slowly releasing the remaining medication four hours later. Maximum plasma concentration is achieved in seven hours, compared to instant-release Adderall, which reaches maximum plasma concentration within three hours. As a result of its high bioavailability, Adderall XR's effectiveness is not altered by food absorption in the gastrointestinal tract. However, mean plasma concentration is prolonged by 2.5 hours (using a 900 calorie standard high-fat meal as the control). Medications that alter urinary pH will cause variations in amount and method of excretion and usage should be monitored when taken concurrently with Adderall.
Side effects
Adderall Prolonged Use
Tolerance, extreme psychological dependence, and severe social disability can occur when amphetamines are abused. The manufacturer warns against exceeding the prescribed dosage, injecting the drug, or insufflation of the drug. Prolonged high doses of amphetamines followed by an abrupt cessation can result in extreme fatigue and mental depression. Chronic abuse of amphetamines can result in the manifestation of amphetamine psychosis.
Stop using Adderall if you experience any of these serious side effects:
- fast, pounding, or uneven heartbeats;
- feeling light-headed, fainting;
- increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure); or
- tremor, restlessness, hallucinations, unusual behavior, or motor tics (muscle twitches).
Less serious side effects may include:
- headache or dizziness;
- sleep problems (insomnia);
- dry mouth or an unpleasant taste in your mouth;
- diarrhea, constipation;
- loss of appetite, weight loss; or
- loss of interest in sex, impotence, or difficulty having an orgasm.
Contraindications, interactions, and precautions
The following provides only general guidelines and is not comprehensive. Please refer to a more comprehensive list for further information regarding co-administration of amphetamine with other substances.
SSRIs (selective serotonin reuptake inhibitors, e.g., Fluoxetine, Citalopram, Paroxetine, etc.) While rare, the possibility for serotonin syndrome exists with this combination. Use only when it is directed.
NRIs (norepinephrine reuptake inhibitors, e.g., Atomoxetine, Strattera, etc.) NRI medications and amphetamine both enhance noradrenergic activity. Possible augmentation/potentiation of effects. Use only when directed.
SNRIs (selective serotonin-norepinephrine reuptake inhibitors).
Bupropion (Zyban, Wellbutrin IR)Both bupropion and amphetamine have noradrengic and dopaminergic activity. Possible augmentation/potentiation of effects. Bupropion has pro-convulsant properties that may be enhanced or cumulatively potentiated by amphetamine. Use only when directed.
MAOIs (monoamine oxidase inhibitors, e.g., Phenelzine, Nardil, Selegiline, Emsam, Iproniazid, Iprozid, etc.) Do not administer amphetamines for a minimum of two weeks after last use of MAOI type drugs. Possible hypertensive crises, dangerously elevated amphetamine levels. Preliminary trials of low dose amphetamine and MAOIs being administered together are in progress. However, this is to only be done under strict supervision of the prescribing parties.
Tricyclics and related compounds (tricyclic antidepressants, e.g., Imipramine, Tofranil, Janamine; as well as related compounds including Cyclobenzaprine). Possible potentiation of 5ht (serotonin), dopamine and norepinephrine related drug effects. The combination of tricyclic and amphetamine compounds / other direct acting sympathomimetics has been associated with increased sympathetic action. Adjustments to dose may be required. Concurrent use not generally recommended due to interaction between direct acting sympathomimetics such as amphetamines and tricyclics. Indirect acting sympathomimetics may have decreased efficacy when combined with tricyclics (tricyclic blockade may inhibit the action of some indirect acting sympathomimetics).
CYP2D6 (liver enzyme) inhibitors, e.g., most SSRIs such as escitalopram, fluoxetine, paroxetine, etc. Some anti-psychotics such as thioridazine, haloperidol, and, levomepromazine. The stimulant cocaine. Methadone, a opioid analgesic and anti-addictive. There are additional drugs that inhibit CYP2D6, it is important to find out if any medication or drug that is being taken is a CYP2D6 inhibitor. Taking a CYP2D6 inhibiting drug along with Adderall (amphetamines in general) will lead to a elevated level of Adderall in the system and the drugs will also remain longer in the body, this can lead to undesired or possibly serious side effects.

Ephedrine HCL
Ephedrine HCL is the synthetic equavilant to natural Ephedra found in plants such as Sida Cordifolia and is used as a stimulant, appetite suppressant, fat burner, concentration aid, decongestant, and to treat hypotension associated with anaesthesia.
Guide to taking Ephedrine
Ephedrine should only be taken by individuals who are healthy and do not have any serious health conditions. Before beginning to take this, always read the warnings on the label to acquaint yourself with the possible complications that could result. If you develop any symptoms then it is smart to either decrease your dosage or stop taking it altogether. It is important to note that the negative claims regarding Ephedrine have been greatly blown out of proportion.
If you are new to Ephedrine, you should start with the smallest dosage possible which for most individuals is 8 to12 mg. Start by taking it once a day or split it up into two portions.
The stimulant properties of Ephedrine are incredible but you must figure out how much your system can handle at first. A full dose of ephedrine is 24 mg and that is too high to start with. Starting with a low dose of Ephedrine allows your body time to gradually get used to it.
As time goes by you can increase the dosage but do not go overboard and think that if a little is good then a lot would be even better. It is wise to consume no more than 72 mg on a daily basis that are broken up into three equal servings.
Ephedrine can make a person feel restless. If this is the case, simple go for a quick walk or jog to work off the nervous energy. Alternatively, reduce the amount you are taking.
If you take it too late in the day it can affect your sleep patterns so in the beginning it is not recommended that you take it any time after 2pm.
Your body will become accustomed to Ephedrine rather swiftly so in order to make it as effective as possible for yourself, keep taking it for no more than 6 weeks at a time. Then take 2 to 4 weeks off and go back to it after that time. On a weekly basis, take it 5 days and then give your body a rest for two. It is worth noting that some manufacturers of Ephedrine advise their customers to take the product for as long as 12 weeks before breaking. For first timers this is most likely too long a period.
Possible side effects of Ephedrine:
Most common side effects (if used incorrectly) include:
Headache, sweating, sleeplessness
Less common side effects include:
Dizziness; nausea; nervousness; restlessness; stomach irritation.
Rare side effects include:
Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating, heat stroke, heart attack, hypertension, stroke.
Do NOT use Ephedrine if:
- you are taking furazolidone or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) in the last 14 days
- you have severe high blood pressure, severe heart blood vessel disease, a rapid heartbeat, or severe heart problems
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you have a history of heart problems, diabetes, glaucoma, an enlarged prostate or other prostate problems, adrenal gland problems, high blood pressure, seizures, stroke, blood vessel problems, an overactive thyroid, or severe asthma
Be cautious about taking Ephedrine if you are using any of the following medicines:
- Rauwolfia derivatives (eg, reserpine) because the effectiveness of Ephedrine may be decreased
- Beta-blockers (eg, propranolol), cocaine, furazolidone, indomethacin, methyldopa, MAO inhibitors (eg, phenelzine), oxytocic medicines (eg, oxytocin), rauwolfia derivatives (eg, reserpine), or tricyclic antidepressants (eg, amitriptyline) because the actions and side effects of Ephedrine may be increased
- Bromocriptine, catechol-O-methyltransferase (COMT) inhibitors (eg, entacapone), digoxin, or droxidopa because the actions and side effects of these medicines may be increased
- Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because its effectiveness may be decreased by Ephedrine