Amphetamine Drug Profile

What is Amphetamine?

Amphetamine is a central nervous system stimulant medication that belongs to the class of drugs known as sympathomimetic amines. It is primarily prescribed to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy, a sleep disorder characterized by excessive daytime sleepiness. Amphetamine works by increasing the activity of certain neurotransmitters in the brain that affect focus, attention, and impulse control.

Uses

Attention Deficit Hyperactivity Disorder (ADHD): The primary approved use for amphetamine is treating ADHD in children, adolescents, and adults. It helps improve focus, reduce hyperactivity, and control impulsive behaviors.

Narcolepsy: Amphetamine is prescribed to help patients with narcolepsy stay awake during the day and reduce sudden episodes of falling asleep.

Treatment-resistant depression: In some cases, amphetamine may be used as an adjunct treatment for severe depression that has not responded to other medications, though this is considered an off-label use.

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Binge eating disorder: Certain amphetamine formulations have been approved specifically for treating moderate to severe binge eating disorder in adults.

Excessive daytime sleepiness: Beyond narcolepsy, amphetamine may be prescribed for other conditions causing significant daytime sleepiness when other treatments have been ineffective.

How it works

Amphetamine increases the levels of dopamine and norepinephrine in the brain by blocking their reuptake and promoting their release from nerve terminals. These neurotransmitters play crucial roles in attention, focus, and executive function. By enhancing the activity of these chemical messengers, particularly in areas of the brain responsible for attention and impulse control, amphetamine helps improve symptoms of ADHD and maintains wakefulness in sleep disorders.

Side effects

Common side effects:

• Decreased appetite and weight loss
• Difficulty sleeping (insomnia)
• Dry mouth
• Headache
• Nervousness or anxiety
• Increased heart rate
• Stomach pain or nausea
• Mood changes or irritability

Serious side effects requiring immediate medical attention:

• Chest pain or heart palpitations
• Severe mood changes, including depression or suicidal thoughts
• Signs of psychosis, such as hallucinations or paranoia
• Severe allergic reactions with rash, swelling, or difficulty breathing
• Circulation problems in fingers and toes, including numbness or color changes

Warnings and precautions

Cardiovascular risks: Patients with heart problems, high blood pressure, or a family history of heart disease should use amphetamine with extreme caution, as it can increase heart rate and blood pressure.

Mental health considerations: Individuals with a history of psychosis, bipolar disorder, or severe anxiety may experience worsening symptoms. The medication can also unmask underlying psychiatric conditions.

Addiction potential: Amphetamine has a high potential for abuse and dependence. It is classified as a Schedule II controlled substance and should only be used under close medical supervision.

Pregnancy and breastfeeding: Amphetamine is classified as pregnancy category C, meaning potential benefits may warrant use despite potential risks. The drug passes into breast milk and may affect nursing infants.

Growth suppression: Long-term use in children may slow growth and weight gain, requiring regular monitoring by healthcare providers.

Interactions

Monoamine oxidase inhibitors (MAOIs): Can cause dangerous increases in blood pressure and should not be used within 14 days of MAOI use.

Antacids and urinary alkalinizers: May increase amphetamine absorption and effects by reducing its elimination from the body.

Tricyclic antidepressants: Can enhance cardiovascular side effects and increase the risk of irregular heart rhythms.

Blood pressure medications: Amphetamine may counteract the effects of antihypertensive drugs, potentially reducing their effectiveness.

Seizure medications: May lower the seizure threshold and reduce the effectiveness of anti-epileptic drugs.

Proton pump inhibitors: Can increase amphetamine levels in the blood by affecting stomach acidity and drug absorption.

Vitamin C (ascorbic acid): Large doses may decrease amphetamine absorption and effectiveness.

Caffeine: May increase stimulant effects and side effects when used together.

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Dosage

Dosing for amphetamine varies significantly based on the specific formulation, patient age, and medical condition being treated. For ADHD in adults, typical starting doses range from 5-10 mg once or twice daily, with gradual increases as needed and tolerated. Maximum daily doses generally do not exceed 40 mg for immediate-release formulations. For narcolepsy, doses may range from 5-60 mg daily, divided into multiple doses. Extended-release formulations allow for once-daily dosing with different dosing schedules. All dosing decisions should be made by a healthcare provider based on individual patient needs and response to treatment.

Sources: FDA DailyMed drug labels (public domain), BNF, WHO Essential Medicines List. This article is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before starting or stopping any medication.

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