Why is adderall so much more widely prescribed than dexedrine for ADHD?

[JackiesBabyy]

Does l-amphetamine do anything for ADHD? Seems like l-amp just contributes to the side effects as opposed to d-amphetamine which helps with attention and focusing.

 

[Dysphoric]

Does l-amphetamine do anything for ADHD?

I would highly doubt that. I think it has to do with less abuse potential perhaps?

I actually just last week brought this up with my doc last week when I was getting my script filled. I asked why they don't use the D-isomers like Dex, Desoxyn, and Focalin over the racemic garbage. He didn't really know either. He agreed that it would make sense to use the D-isomers over racemic mixtures due to a more benign side effects.

 

[JackiesBabyy]

I would highly doubt that. I think it has to do with less abuse potential perhaps?

I actually just last week brought this up with my doc last week when I was getting my script filled. I asked why they don't use the D-isomers like Dex, Desoxyn, and Focalin over the racemic garbage. He didn't really know either. He agreed that it would make sense to use the D-isomers over racemic mixtures due to a more benign side effects.

Adderall still has plenty of abuse potential though. Desoxyn isn't as widely prescribed because it's meth and people equate it with crystal meth, even though I've heard Desoxyn basically feels exactly like dexedrine only longer lasting.

 

[Swimmingdancer]

I was wondering about this too. My doctor didn't seem to know either and thinks Dexedrine is superior and often causes less side effects. Wikipedia says:

Dextroamphetamine induces more euphoria, whereas levoamphetamine induces more depression. The overall greater potency of the dextro form to central actions suggests that this form may have a higher potential for abuse.[37]
Adderall’s inclusion of levoamphetamine provides the pharmaceutical with a quicker onset and longer clinical effect compared to pharmaceuticals formulated exclusively of dextroamphetamine.[38] Although it seems the human brain has a preference for dextroamphetamine over levoamphetamine, it has been reported that certain children have a better clinical response to levoamphetamine.[39]

So that would lead me to conclude that Adderall may be viewed as having a lower abuse potential, and that could be why it is often seen as the first line of treatment. Who knows, maybe another factor could be that Adderall has better marketing and is more well-known?

 

[THC2LSD]

Two reasons. First, Dexedrine has the stigma of being a street drug. It was quite popular in the 60's-70's. Second, marketing.

Really Adderall is an irrational combination drug. It started as Obetrol, a diet pill with a meth/amphetamine salts combo. Then it was reformulated to what Adderall is. Then Shire bought up the company that made it, dubbed it Adderall and marketed it for ADD rather than the shrinking and risky market of weight-loss.

There are some theoretical reasons for Adderall. The levo isomer has a longer half-life and since it was a weight loss pill they may have thought the body stimulation would help with weight loss. Also the different salts may have different absorption rates making for a smoother release.AFAIK none of this is proven. I can't think of one study comparing Adderall and Dexedrine head to head.

The only real benefit Adderall has over Dexedrine is it has a sweet taste. Also the XR but not the IR of Adderall is a little bit harder to abuse(snort/IV) than Dexedrine Spansules. Adderall IR is easier to abuse than IR dexies. Also it may have some advantages in manufacturing, such as purifying or racemizing. But they don't pass on the savings to the customers, dexedrine is cheaper.

Why couldn't they buy Biphetamine instead? I heard black beauties were the shit back in the day.Plus they actually lasted almost 16 hours.

 

[tricomb]

Adderall still has plenty of abuse potential though. Desoxyn isn't as widely prescribed because it's meth and people equate it with crystal meth, even though I've heard Desoxyn basically feels exactly like dexedrine only longer lasting.

Not at all, Desoxyn is much better than Dexedrine, they do not feel exactly the same, they're very different IMO. If you had to compare Desoxyn to other ADHD medications then yes it's closest to Dexedrine, but that's likely because dextro-amp is a metabolite of dextro-methamp. Desoxyn has much less side effects than Dexedrine from my experiences.

Also, Desoxyn is far superior to other ADHD medications because it doesn't force-focus, as I call it. Medications such as Adderall XR made me focus too much. Yes, there is a balance between attention deficit, and attention excess. As an example, on Adderall XR in addition to enjoying unbearable side effects, I would be so intently focused in general that I would spend too much time obsessing over irrelevant details. Writing long papers going off on tangents not answering the writing prompt. Don't get me started on methylphenidate that just made me feel like I had a pot of coffee (and I hate caffeine!) nothing but nausea, jittery, a V8 version of caffeine if you ask me. Dexedrine offers tons of improvement over Adderall in terms of having much less side effects, however due to it being the same main active ingredient in Adderall, it would also force more focus than I could benefit from.

For me, Desoxyn is a great drug. It's 100% dextro isomer, so less PNS side effects. It only comes in 5mg IR tablets but this works just fine, as the desired effects last longer than any XR ADHD medication I've tried, I've found it close to on par with Dexedrine XR in terms of duration. It does not exacerbate my severe insomnia and anxiety, no headaches, minimal dry mouth, no body-load/tension, etc. I could really go on and on.
ADHD is a very difficult condition to diagnose and treat, and medications are only so effective as the patients desire to use them to learn better skills, organization, time management, etc.

$0.02 YMMV

 

[kokaino]

Methylphenidate is the most scripted ADHD med hands down. However, Adderall is far more widely prescribed than Dexedrine is. However, I'm lucky enough to get Dexedrine. I've heard from people who have tried both Desoxyn and Dexedrine claim that Dexedrine is not only the better ADHD drug, but it is the more recreational of the two. In fact, it was people on this very forum. Many seemed to agree with that too.

I personally think that as far ADHD goes, they are likely equally effective. Recreationally, I cannot personally judge as I have not tried Desoxyn but I have done crystal methamphetamine which I find to be more euphoric than Dexedrine. But Dexoxyn is not ice and that's a big difference. My psychiatrist has actually told me that Dexedrine is associated with a higher incident of side effects, but Desoxyn is much more expensive.

According to this one study, d-amp was more effective than d-methamp.

 

[88brenno]

Down under I don't get the option to try Desoxyn but the lack of Adderall makes up for it I guess from what I read. Dexies are only fun for a short while then they just keep you awake, but they are good at treating symptoms quite well. As for Ritalin, I have only used it a handful of times and it was of no use in controlling the ADD, just made me feel a little high for 2 hours then came down like a ton of bricks.

@kokaino more study is required

 

[kokaino]

Another study here comparing the abuse potential for methamphetamine and dextroamphetamine. Apparently, the abuse liability of the two are equal.

 

[88brenno]

Well the second study = A randomized, double-blind, placebo-controlled, cross-over study,

but in the findings it says: Both drugs increased cardiovascular activity and 'positive' mood, although methamphetamine produced more prominent effects on some measures (e.g. heart rate and ratings of 'high').

Still inconclusive

 

[88brenno]

Here is a little table found while scrounging the net.

Interesting.

http://www.bluelight.ru/vb/threads/...ll-Dextroamphetamine-vs-dextromethamphetamine

 

[kokaino]

Well the second study = A randomized, double-blind, placebo-controlled, cross-over study,

but in the findings it says: Both drugs increased cardiovascular activity and 'positive' mood, although methamphetamine produced more prominent effects on some measures (e.g. heart rate and ratings of 'high').

Still inconclusive

I'd say that dextroamphetamine and methamphetamine are about equal in efficacy for the treatment of ADHD and as far as abuse potential, I think they are also equal. D-amp might produce less peripheral side effects than meth (less tachycardia, tremors, etc), so it might be more desirable for some.

 

[Psychonauticunt]

I would highly doubt that. I think it has to do with less abuse potential perhaps?

It would kind of make sense, if levoamphetamine was just like dex, except with less abuse potential and better pharmacokinetical characteristics (faster absorption, slightly longer half-life of the levorotatory isomer). Why, then, would they not ban Dexedrine? I mean I guess it's not easy banning products left, right and center, but if the product contains a hard drug and a better, less abusable version exists?
Also, from personal experience, and friends' opinions (I've only had Adderall three times, most countries only have Dexedrine), the scale of recreational value/euphoria, from least intense to most, goes Dexedrine>Adderall>racemic street amphetamine.
Dexedrine is not euphoric in the slightest for me - just clean stimulation. Adderall feels like there's unnecessary peripheral stimulation... The kind that goes over the top with street speed. Bad effects for a functional stimulant, but much more recreational; kind of like Ritalin is more recreational and gets you more "high" than Dex or Adderall. I'd take street speed over Dexedrine if I was going to a party. In fact, I'd take nothing over dex to go to a party, because then at least I'd get drunk.

But the presence of levoamphetamine should logically have some sort of stimulant effect which is clinically significant - otherwise they'd leave it out, like Desoxyn leaves levomethamphetamine - it may be a nasal decongestant but that's pretty much all it does. Some kids responding to it better could be one good reason, but not for the situation where Adderall is the norm and Dexedrine the anomaly. I personally feel that the l-isomer mainly adds PNS stimulation which is unwanted, and I don't think I'm part of a tiny minority either, so I suspect that the reason may be less medical and more socio-economic. That's not to say a certain percentage of levo couldn't be better for someone, of course.

I'd say that dextroamphetamine and methamphetamine are about equal in efficacy for the treatment of ADHD and as far as abuse potential, I think they are also equal. D-amp might produce less peripheral side effects than meth (less tachycardia, tremors, etc), so it might be more desirable for some.

I have heard both from reputable-looking sources - that methamphetamine produces comparable CNS stimulation to other common psychostimulants with fewer peripheral side effects; and that compared to dextroamphetamine there are more peripheral side effects.

I have not tried Desoxyn, but if I may kind of crudely extrapolate that it is to meth what Dexedrine is to street speed. If I'm not too far off, I would probably find I enjoy Dexedrine more, with less "forced focus" as you say, with fewer peripheral side effects. Assuming that peripheral side effects are mostly due to the levorotatory isomer and cutting agents, the stimulation should be quite clean, but I still have issues with the way meth makes me focus - quite the opposite of what amphetamine (even off the street) does. Quite like you described, on METH I get this inexorable working mode, with stimulation, energy and euphoria aplenty, but the intensity of the stimulation makes it more suitable for physical than mental labour. After a few hours that wears off, but then while I am still stimulated, I begin to feel instantly less useful, and want to redose. Even with smaller doses, it's too powerful of a stimulant for me. Maybe I'd change my mind with Desoxyn, but I somehow think I'd prefer Dexedrine.