amphetamine/dextroamphetamine

Adjunctive therapy

Brands: ADDERALL, ADDERALL XR, MYDAYIS

Last reviewed 2025-12-29

Reviewed by PsychMed Editorial Team.

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Quick answers

What is amphetamine/dextroamphetamine?
Amphetamine/dextroamphetamine (brands include Adderall and Adderall XR) is a Schedule II stimulant used as a first-line pharmacotherapy option for ADHD. It can improve attention, initiation, and impulse control, especially when combined with structured behavioral supports.
What is ADDERALL?
ADDERALL is a brand name for amphetamine/dextroamphetamine (other brands: ADDERALL XR, MYDAYIS).
What is ADDERALL (amphetamine/dextroamphetamine) used for?
Label indications include: Attention-deficit/hyperactivity disorder (ADHD); narcolepsy (product-dependent).
What drug class is ADDERALL (amphetamine/dextroamphetamine)?
CNS stimulant; increases dopamine and norepinephrine signaling via release and reuptake inhibition.
What strengths does ADDERALL (amphetamine/dextroamphetamine) come in?
Immediate-release tablets (often dosed 1–2 times daily).
What is the maximum recommended dose of ADDERALL (amphetamine/dextroamphetamine)?
Maximum recommended dose depends on the specific product; respect the labeled maximum and reassess diagnosis, adherence, sleep, and substance use before increasing beyond typical ranges.

Snapshot

Class: Adjunctive therapy
Common US brands: ADDERALL, ADDERALL XR, MYDAYIS
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-29

Label indications

Attention-deficit/hyperactivity disorder (ADHD); narcolepsy (product-dependent).

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Clinical Highlights

Amphetamine/dextroamphetamine (brands include Adderall and Adderall XR) is a Schedule II stimulant used as a first-line pharmacotherapy option for ADHD. It can improve attention, initiation, and impulse control, especially when combined with structured behavioral supports. Compared with methylphenidate-class stimulants, amphetamine products more directly promote catecholamine release; individual response varies and switching between stimulant classes is common when the first trial is ineffective or poorly tolerated.

In serious mental illness, stimulants may be used for comorbid ADHD or disabling inattention, but they can worsen anxiety, insomnia, mania, or psychosis in vulnerable patients. Clinicians typically confirm the diagnosis and ensure mood/psychosis is stable before starting, and monitor closely for activation.
Immediate-release products emphasize flexibility (often BID dosing), while extended-release products provide once-daily morning dosing; the right duration reduces late-day rebound and avoids “stacking” sedatives.
The compare view, the amphetamine/dextroamphetamine evidence feed, and the amphetamine/dextroamphetamine print page can support shared decision-making about safe use and monitoring.

Dosing & Formulations

Immediate-release products are typically dosed 1–2 times daily; extended- release products are usually once daily in the morning. Doses are typically started low and titrated gradually based on functional improvement and tolerability; late-day dosing is usually avoided to reduce insomnia.

Typical adult total daily dosing often falls in the 5–40 mg/day range, but labeled maxima vary by product and indication.
If coverage is inadequate or rebound occurs, formulation or timing is often adjusted before dose escalation or adding sedatives.
Maximum recommended dose depends on the specific product; respect the labeled maximum and reassess diagnosis, adherence, sleep, and substance use before increasing beyond typical ranges.

Monitoring & Risks

Vital signs: blood pressure and heart rate are typically checked at baseline and periodically, especially during titration. Appetite and weight: appetite suppression and weight loss are common; track weight/BMI and meal timing.

Sleep: insomnia and delayed sleep onset are common; treat timing and formulation choice as part of the prescription.
Psychiatric activation: monitor for anxiety, agitation, mood elevation, or hallucinations; emergence of mania or psychosis warrants stopping and reassessment.
Misuse/diversion: controlled substance with high misuse potential; use safe storage counseling and consider non-stimulants when risk is high.

Drug Interactions

Contraindicated with MAO inhibitors; an adequate washout is required. Urinary pH affects exposure. Acidifying agents can reduce effect; alkalinizing agents can prolong effects and adverse reactions.

CYP2D6 inhibitors can increase exposure in some patients; monitor for insomnia, tachycardia, or agitation when combining.

Practice Notes

Titration is typically anchored to function (work/school output, fewer errors, safer driving) and reassessed after each dose adjustment. If a stimulant is needed in someone with psychosis or bipolar vulnerability, conservative dosing and close follow-up are typical, with a low threshold to stop if activation emerges.

If benefit is minimal at reasonable doses, reassess ADHD diagnosis, sleep, depression/anxiety, and substance use rather than escalating indefinitely.

References

Adderall (mixed amphetamine salts) prescribing information — DailyMed (2024)
Adderall XR (mixed Amphetamine Salts Extended Release) Prescribing Information — DailyMed (2025)
Attention deficit hyperactivity disorder (NICE guideline NG87) — NICE (2018)
Clinical Practice Guideline FOR THE Diagnosis, Evaluation, AND Treatment OF Attention Deficit/hyperactivity Disorder IN Children AND Adolescents — Pediatrics (2019)
Comparative Efficacy AND Tolerability OF Medications FOR Adhd (systematic Review AND Network Meta Analysis) — Lancet Psychiatry (2018)