Dextroamphetamine Dexedrine

The amphetamines, such as amphetamine, dextroamphetamine (Dexedrine), and metliainphetainine (Desoxyn), are sympatiiomimetic (ie, adrenergic) dru that stimulate the CNS (see Chap. 22). Their drug action results in an elevation of blood pressure, wakefulness, and an increase or decrease in pulse rate The ability of these drugs to act as anorexiants and suppress the appetite is thought to be due to their action on the appetite center in the hypothalamus. 

Dextroamphetamine (Dexedrine) Intermedia te- acting 2.5-5 mg every morning T 2.5-5 mg/day in weekly intervals 5-20 mg twice daily (40 mg/day)... 

Methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and pemoline (Cylert) are currently available in the United States. Methylphenidate has been the most widely used and is usually the first choice. Pemoline sometimes impairs liver function and is rarely used today due to the potential for toxicity. 

Dextroamphetamine (Dexedrine). Dextroamphetamine is the second most widely used stimulant and the most commonly used amphetamine in the United States. It is about twice as potent as methylphenidate and should be initiated in the treatment of ADHD at 2.5 mg taken twice daily with breakfast and lunch. Like other stimulants, the benefits of dextroamphetamine can be seen almost immediately. With weekly visits while starting treatment, the dose can be increased in 2.5-5 mg increments until the effective dose is found. Because dextroamphetamine is also slightly longer acting than methylphenidate, patients may be less likely to need an evening dose. If an after-school dose is used, then like methylphenidate it should be 25-50% of the daytime dose. 

Dextroamphetamine (Dexedrine) is commonly initiated at 5 mg taken two to three times daily before meals. Many patients will experience its benefits almost from the first day. The dose can be increased every 5-7 days until the effective dose is found. 

Stimulants. Methylphenidate (Ritalin) and dextroamphetamine (Dexedrine) are the most widely used and perhaps the most effective medications when treating post-TBI apathy. They act by enhancing the activity of dopaminergic, noradrenergic and, to a certain extent, serotonergic brain systems. Stimulants act quickly to relieve the core symptoms of apathy, and they may also improve the impairments in attention and short-term memory that often follow TBl. Please refer to Chapter 8 for more information about the stimulants. 

Dextroamphetamine Dexedrine Spansule Capsule that allows some medication release immediately and the remainder released over time... 

Amphetamines. Drugs such as amphetamine (generic), dextroamphetamine (Dexedrine, others),... 

Methylphenidate (e.g., Ritalin and Concerta ) is a stimulant drug prescribed to treat hyperactivity, impulsivity, and inattention in millions of American children. Methylphenidate was first synthesized in the mid-1940s in Europe. In the United States, it was approved by the Food and Drug Administration (FDA) in 1955. The effects of methylphenidate in the human body are almost identical to those of the amphetamines. Amphetamines—the collective name for levoamphetamine (Benzedrine), dextroamphetamine (Dexedrine ), and methamphetamine (Methedrine or speed )—are known to be potent psychomotor stimulants. 

Sustained release dextroamphetamine (Dexedrine spansule) has up to 8-hour duration of clinical action... 

There arc a number of different amphetamines, but all have the same basic effect. Plain amphetamine (Benzedrine] was the first to become popular. Dextroamphetamine (Dexedrine and methamphetamine (Methedrine] arc effective in lower doses but otherwise are similar to the parent compound. A few other drugs — methylphenidate (Ritalin), for example — resemble amphetamines in effect even though they have a different chemical stmeture. 

Medications play an important part in the treatment of ADD. Stimulants are the mainstay of the treatment of ADD methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and pemoline (Cylert). These differ in their half-lives, with Ritalin having the shortest and Cylert the longest. A warning has recently been issued about Cylert because of reports of sometimes fatal liver toxicity. Thus, it is recommended that it be used only if methylphenidate and dextroamphetamine are ineffective. There is individual variability in resporise, so that a person who does not respond to one may respond well to another. Other medications can also be effective in the treatment of ADD and may be useful, especially in residual ADD, where substance abuse may be an issue. These include tricyclic antidepressants (especially desipramine and imi-pramine) SSRIs, bupropion, venlafaxine, and clonidine. There are reports of antipsy-chotics and lithium being helpful in selected cases, as well. 

Stimulants have been used as antidepressants for many years, especially dextroamphetamine (Dexedrine) and methylphenidate (Ritalin). They have the side effects of anxiety, insomnia, agitation, and appetite suppression. They can be quite effective antidepressants but are now usually reserved for medically ill patients such as those who have had a stroke and those unresponsive to other antidepressants. 

Dextroamphetamine (dexedrine, others), with greater CNS action and less peripheral action, is FDA approved for the treatment of narcolepsy and attention-deficit/hyperactivity disorder (see below). 

Sometimes doctors prescribe methylphenidate (Ritalin) or dextroamphetamine (Dexedrine) to treat a mood disorder called dysthymia that is less severe, but more chronic, than major depression. They work more quickly than antidepressants to pep you up, increasing energy and facilitating attention and concentration. Common side effects include nervousness, insomnia, constipation, headache, and changes in heart rate. 

This study investigated the efficacy of using dextroamphetamine (Dexedrine ) as a countermeasure to deep loss during sustained operations in which it is impossible for persotmel to gain any restorative sleep for up to 40 hours. Although, previously published reports have proven that amphetamines are effective for enhancing performance and alertness (see Caldwell et al., 1994, for a review there had been no controlled aviation studies. However, there was evidence that amphetamines would effectively counter sleep loss and fotigue in aviation personnel. 

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