Adderall® (mixed amphetamine salts)

Primer

Adderall® (mixed amphetamine salts) is a stimulant medication in the amphetamine class primarily used in the treatment of attention-deficit/hyperactivity disorder (ADHD).

Formulation

  • Adderall mimics taking twice-a-day (BID) amphetamine: one part (50%) is delayed release, and the other part (other 50%) is immediate release
  • This last longer than Biphentin, which mimics BID methylphenidate
  • Lasts for 12 hours

Dosing

Comparison Table

There are many different formulations of amphetamines. These are all clinically the same basic ingredient —- there are just different delivery mechanisms of each.

Different Formulations of Amphetamine Psychostimulants

Tradename Active ingredient Immediate/Delayed (%) Duration Formulations Starting Dose Titration Notes
Adderall XR Amphetamine mixed salts 50/50 12 hours 5, 10, 15, 20, 25, 30 mg cap 5-10 mg q AM (adults can start at 10 mg) • ↑ 5-10 mg at weekly intervals
• Maximum dose/day: Children = 30 mg
• Adolescents & Adults = 20-30 mg 		• Mimics BID amphetamine dosing (one part delayed release, one part immediate release)
• It lasts longer (12 hours) than Biphentin, which mimics BID methylphenidate
• Capsules may be opened up and the beads inside sprinkled on soft foods (e.g. - apple sauce, yogurt, ice cream)
Vyvanse Lisdexamfetamine N/A 12-14 hours 10, 20, 30, 40, 50, 60, 70 mg cap 20-30 mg q AM ­• ↑­ 10-20 mg by clinical discretion at weekly intervals
• Maximum dose/day: All ages = 60 mg 		• The drug ingested is lisdexamfetamine dimesylate a pro-drug
• No abuse potential because of this mechanism
• Low abuse potential
• Capsules may be opened up and the powder inside mixed into water (taste is slightly sweet), orange juice, or yogurt
Dexedrine Dextro-amphetamine 100/0 4 hours 5 mg tab 2.5-5 mg BID ­• ↑ 5 mg at weekly intervals
­• Maximum dose/day: (q.d. or b.i.d.)
­• Children & Adolescents = 20-30 mg
­• Adults = 50 mg 		-
Dexedrine Spansule Dextro-amphetamine 50/50 Purportedly lasts 10-12 hours, but more likely 6-8 hours 10, 15 mg cap 10mg q AM ­• ↑ 5 mg at weekly intervals
­• Maximum dose/day: (q.d. or b.i.d.)
­• Children & Adolescents = 20-30 mg
­• Adults = 50 mg 		• Essentially mimics BID dexedrine tabs
• Capsule containing 2 kinds of beads (50% d-amphetamine, 50% polymer-coated d-amphetamine)
• Capsules may be opened up and the beads inside sprinkled on soft foods
* = Doses per CADDRA that are over or under product monograph maximum or minimum doses should be considered off-label use.

Psychosis Risk

Dextroamphetamine

Pearls

  • Capsules may be opened up and the beads inside sprinkled on soft foods (e.g. — apple sauce, yogurt, ice cream)