Dexedrine is a psychostimulant drug primarily used to treat severe cases of ADHD and narcolepsy. The active ingredient in Dexedrine is “dextroamphetamine” which is regarded as the “right-handed” stereoisomer of the molecule amphetamine. Dextroamphetamine is considered a popular military stimulant, and has been utilized throughout history such as in World War II to offset fatigue and to help troops stay up for nighttime missions.
Amedra Pharmaceuticals began marketing Dexedrine for the treatment of attention-deficit/hyperactivity disorder in 1982 as a potent stimulant for those who didn’t respond well to methylphenidate. Years later (1996), the FDA approved a drug comprised of mixed amphetamine salts called Adderall. Adderall differed from Dexedrine in that its formulation was 75% dextroamphetamine and 25% levoamphetamine or a mixture of amphetamine salts.
Adderall and Dexedrine are considered similar drugs due to the fact that they are both comprised of amphetamine stereoisomers. However, Dexedrine can be considered to be a more potent stimulant than Adderall due to the fact that it contains 100% dextroamphetamine whereas Adderall only contains 75%. Dextroamphetamine elicits nearly three-fold more CNS stimulation than levoamphetamine.
Dexedrine vs. Adderall Comparison Chart
As you can determine from the chart below, Dexedrine and Adderall are relatively similar drugs. Dexedrine is comprised fully of dextroamphetamine, the right-handed (dextrorotatory) stereoisomer of amphetamine. Adderall is comprised of 3/4 dextroamphetamine and 1/4 levoamphetamine (the left-handed stereoisomer).
|Approved uses||ADHD. Narcolepsy.||ADHD. Narcolepsy.|
|Ingredients||Dextroamphetamine||Mixed Amphetamine Salts (75% Dextroamphetamine / 25% Levoamphetamine)|
|Formats||Spansule (Sustained-release capsule)||IR (Immediate release) or XR (Extended release)|
|Dosages||5 mg/10 mg/15 mg||IR: 5 mg/7.5 mg/10 mg/12.5 mg/15 mg/20 mg/30 mg or XR: 5 mg/10 mg/15 mg/20 mg/25 mg/30 mg|
|Manufacturer||Amedra Pharmaceuticals||Shire Pharmaceuticals|
|Legal Status||Schedule II (US)||Schedule II (US)|
|Mechanism of action||Functions by increasing levels and inhibiting reuptake of stimulatory neurotransmitters such as dopamine and norepinephrine. It acts as a potent TAAR1 agonist and VMAT2 inhibitor.||Functions by increasing levels and inhibiting reuptake of stimulatory neurotransmitters such as dopamine and norepinephrine. It acts as a TAAR1 agonist and VMAT2 inhibitor.|
|Half life||12 hours||11 to 13 hours|
|Common side effects||Appetite loss. Diarrhea. Dizziness. Dry mouth. Headache. Insomnia. Irritability. Nausea. Nervousness. Restlessness. Stomach aches. Sweating. Weight loss.||Abdominal pain. Appetite loss. Diarrhea. Dizziness. Dry mouth. Fever. Headache. Insomnia. Irritability. Nausea. Nervousness. Vomiting. Weight loss.|
|Date approved||(1982)||February 13 (1996)|
|Effect duration||8 to 10 hours||IR: 4 to 6 hours / XR: 12 hours|
|Investigational uses||Nasal congestion. Obesity. Treatment-resistant depression.||Stroke rehabilitation. Treatment-resistant depression (Read: Adderall for depression).|
Dexedrine vs. Adderall: What’s the difference?
There are a couple of notable differences between Dexedrine and Adderall. First, Dexedrine is only available in “Spansule” format (sustained-release capsules). Adderall is available in multiple formats including both IR (immediate-release) and XR (extended-release). Dexedrine was formerly available as an immediate-release tablet, but it has been discontinued from production.
The drug Dexedrine hit the market over a decade before Adderall and was commonly utilized by the military for missions demanding vigilance. Like Dexedrine, the drug Adderall is comprised of mostly dextroamphetamine (75%), but differs in that its formulation also incorporates 25% levoamphetamine. Both dextroamphetamine and levoamphetamine are considered effective for treating attentional deficits.
That said, levoamphetamine is regarded as eliciting effect on cardiovascular and peripheral functioning than dextroamphetamine. This means that Adderall is more likely to affect your cardiovascular functioning than Dexedrine. Furthermore, Dexedrine is believed to produce a slightly greater degree of CNS stimulation due to the fact that it solely contains dextroamphetamine; regarded as being more stimulatory than levoamphetamine.
Both Dexedrine and Adderall are regarded as having a high potential for abuse. Due to their high potential for abuse, they are classified as “Schedule II” controlled-substances in the United States. Schedule II classification indicates that they may be habit-forming, abused, and that users may be susceptible to psychological (or physical) dependence.
Some would argue that since Dexedrine is no longer sold in immediate-release format, that it may have less potential for abuse than Adderall, which is manufactured in both immediate-release and extended-release format. Many people resort to snorting Adderall (usually the immediate-release), whereas insufflation remains more difficult with the extended-release versions (the only format of Dexedrine). That said, the 100% dextroamphetamine within Dexedrine is believed to produce a greater stimulatory effect than the 75% dextroamphetamine within Adderall.
In any regard, both substances are capable of inducing a dopaminergic euphoria when taken in supratherapeutic doses. Users may become hooked on this stimulatory euphoria and seek out more of the drug, possibly ingesting increasingly larger doses with each successive usage as a result of tolerance. The abuse of Dexedrine and Adderall is highly appealing to individuals: seeking a mood boost, trying to lose weight, enhance academic performance, or increase productivity.
Since Adderall is the more popular drug of the two, most people have an easier time obtaining it compared to Dexedrine. That said, they are each drugs comprised of amphetamine stereoisomers and are considered extremely potent. Abuse of either drug may lead to abnormally high dopamine, which triggers stimulant psychosis. Each drug is only to be used as medically recommended for ADHD or narcolepsy.
Cost: Which is more expensive?
If you’re planning on getting the “name brand” format of either Dexedrine Spansules or Adderall, you will end up paying a significant amount of money for a 30 day supply. For the cost of “name brand” Dexedrine Spansules, the cost will be within the range of $350 to $365 for a 30 day supply. If you want to attain brand name Adderall IR (immediate-release), it’ll cost within the range of $150 and $170 for 30 tablets; if you need double the tablets, you’re looking at a cost of over $300 for a one-month supply.
Brand name Adderall XR (extended-release) is sold for over $220 at most pharmacies for a 30 day supply. Both Adderall IR and XR are cheaper than Dexedrine Spansules, making them the favorable option in terms of price. Fortunately, both Adderall and Dexedrine Spansules are available in reasonably-priced generic formats.
Generic Dexedrine Spansules (dextroamphetamine ER) cost $50 to $150 for a 30 day supply; prices are subject to variation based on the dosage – the higher the dose, the higher the cost. Adderall IR as a generic (mixed amphetamine salts) tend to cost between $25 and $40 for a one-month supply. Adderall XR (amphetamine salt combo XR) usually cost between $75 and $150 for a 30 day supply.
Comparison of the cost for generics would indicate that Adderall IR is the cheapest option, followed by Dexedrine Spansules and Adderall XR. For “brand name” options, Dexedrine Spansules may put a minor dent in your bank account.
Dosage & Formats
Adderall is manufactured in multiple formats including: “IR” (immediate-release) and “XR” (extended-release). Dexedrine is only manufactured in the form of sustained-release capsules called “Spansules.” The dosing options for Adderall are noticeably favorable over those available for Dexedrine.
The immediate-release version of Adderall is available at dosages of 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, and 30 mg. The dosing options for the extended-release Adderall are as follows: 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg. Dexedrine is only sold under 3 dosing options that include: 5 mg, 10 mg, and 15 mg.
Due to the fact that Dexedrine is regarded as a slightly more potent drug, stimulant equivalency charts indicate that nearly 7.5 mg of a Dexedrine Spansule is equivalent to 10 mg of Adderall XR. Multiple formats of Adderall including: IR – which last 4 to 6 hours and XR – which last 12 hours may be preferred over Dexedrine which is thought to last between 8 and 10 hours.
Those attempting to titrate their dosage upwards or downwards with either drug will have a much tougher time with Dexedrine than they will with Adderall. Adderall is manufactured in smaller increments to make the titration process easier. While one could theoretically “count beads” with Dexedrine, this is impractical and not usually advised – making Adderall the superior option in both dosing and format options.
Efficacy: Which drug is more effective?
In terms of efficacy, both Dexedrine and Adderall were found to be significantly superior to a placebo in double-blind, randomized trials for both ADHD and narcolepsy. Differences in efficacy are likely subject to subjective interpretation and individual physiology. Dexedrine is the slightly more potent drug due to the fact that it contains 100% dextroamphetamine, whereas Adderall contains only 75%.
Some stimulant equivalency charts suggest that 7.5 mg of a Dexedrine Spansule is equal to 10 mg of an Adderall XR. This would suggest that Adderall may be nearly 25% less potent than Dexedrine. This interpretation is based on the fact that dextroamphetamine elicits nearly three to four-fold the CNS stimulation than levoamphetamine and is a more potent TAAR1 agonist.
If we’re comparing the 25% of the Adderall that is levoamphetamine, and it’s eliciting 3-4 less stimulation of the CNS and TAAR1 agonism, this accounts for the reduction in comparative potency. That said, potency does not always indicate efficacy – some individuals may find that Dexedrine is too potent, whereas Adderall is just potent enough to help their ADHD.
Due to the fact that Dexedrine and Adderall are extremely similar drugs, any differences in efficacy are likely a result of individual reactions to dextroamphetamine compared to a combination of dextroamphetamine and levoamphetamine. Some people may derive benefit from the levoamphetamine that they don’t get from the dextroamphetamine, while others may find the levoamphetamine to be problematic.
Mechanisms of action
The mechanisms of action for Dexedrine and Adderall are extremely similar due to the fact that they are both comprised of stereoisomers of the amphetamine molecule. Approximately 75% of Adderall consists of dextroamphetamine, the active ingredient in Dexedrine. The remaining 25% of Adderall consists of levoamphetamine, the levorotatory stereoisomer of amphetamine which elicits slightly different effects dextroamphetamine.
Both Dexedrine and Adderall act as dopamine reuptake inhibitors (DRIs) and also inhibit reuptake of norepinephrine. The reuptake inhibition increases extracellular levels of these stimulatory neurotransmitters, which increases cognitive function and arousal. In addition to inhibiting reuptake of various catecholamines, both drugs stimulate presynaptic release of dopamine and norepinephrine from presynaptic neurons.
Subtle differences in the mechanisms of action are a result of levoamphetamine within Adderall. Levoamphetamine is known to trigger more cardiovascular effects, whereas dextroamphetamine is known to increase CNS stimulation to a greater extent (nearly 3 to 4 times) and act as a more potent TAAR1 agonist. Adderall XR is comprised of 50% immediate-release beads and 50% delayed-release beads; Dexedrine Spansules are thought to be similar.
- Source: http://jad.sagepub.com/content/3/4/200.refs
- Source: http://www.ncbi.nlm.nih.gov/pubmed/22037049
- Source: http://accessmedicine.mhmedical.com/content.aspx?bookid=374§ionid=41266218&jumpsectionID=41268855
Due to the similar ingredient composition of these drugs, the approved medical uses are nearly identical. Dexedrine Spansules have been approved for the treatment of ADHD and narcolepsy, and Adderall is approved to treat the same conditions. They are commonly prescribed off-label as antidepressant augmentation strategies, with most doctors prescribing Adderall due to its increased popularity.
Historically, Dexedrine was investigated for the treatment of nasal congestion, and obesity. Adderall has been studied as a drug to improve cognitive rehabilitation among stroke patients. Ingredient composition would suggest that the drugs would likely elicit very similar effects for approved conditions, off-label conditions, and investigational purposes.
Dexedrine was a popular drug before Adderall hit the market, but Adderall has surpassed nearly every ADHD medication as the undisputed favorite. Data reveals that Dexedrine no longer holds a significant portion of the market-share, even as a generic. Doctors are reluctant to prescribe Dexedrine, and generally prefer Adderall or Vyvanse.
As of 2013, nearly 38% of all psychostimulant medication prescriptions were for Adderall or its generic variation (mixed amphetamine salts). Dexedrine has been largely replaced by the drug Vyvanse, which is a prodrug that gets metabolized into l-lysine and dextroamphetamine. Doctors prefer Vyvanse over Dexedrine for its dextroamphetamine due to the fact that it has lower potential for abuse and is notably less potent.
While many people have heard of Dexedrine, it is no longer manufactured in the format of immediate-release tablets, which further reduced its popularity. These days, prescriptions for Dexedrine are seldom written due to most doctors favoring newer, less potent options. To attain a prescription, a person would likely need to respond poorly to several newer “first-line” options.
The respective side effects for Dexedrine and Adderall are nearly identical. This has to do with the fact that a majority of Adderall is comprised of dextroamphetamine (75%) and Dexedrine is fully-comprised of dextroamphetamine (100%). Common side effects associated with both medications include: appetite loss, dizziness, dry mouth, headache, insomnia, nervousness, stomach aches, and weight loss.
There may be slight variations in side effects due to the increased dextroamphetamine content in Dexedrine and the presence of levoamphetamine in Adderall. Levoamphetamine is believed to trigger slightly more cardiovascular and peripheral effects such as increased blood pressure and/or heart rate. This means that those taking Adderall may notice changes in cardiovascular function slightly more than those taking Dexedrine.
Individuals taking Dexedrine may feel slightly more stimulated at an equal dose due to the fact that there’s no levoamphetamine. The lack of levoamphetamine is also thought to result in a “cleaner focus” (with less jitters) in certain individuals by comparison. Overall there is not a significant difference in side effects between these psychostimulants.
Those attempting discontinuation from either Dexedrine or Adderall usually have a difficult time dealing with symptoms. Symptoms associated with discontinuation of both medications include: fatigue, psychomotor slowing, cognitive impairment, sleepiness, and a resurgence of ADHD symptoms. In fact, the resurgence of attentional deficits may be more severe than prior to an individual taking either drug.
It is well documented that Dexedrine withdrawal and Adderall withdrawal can be protracted in that it lasts for months (or years) before full, homeostatic recovery is established. This is due to the fact that using these drugs frequently, at high doses, and/or over a long-term mines the brain of dopamine and downregulates dopamine receptors. When either drug is discontinued, the person is left with low dopamine and feels less pleasure, motivation, and focus.
It takes time and abstinence before the brain is able to replenish receptors and increase dopamine levels following Dexedrine or Adderall usage. Due to the fact that there are less dosing increments associated with Dexedrine, and it is generally considered more potent than Adderall, it may be tougher to discontinue. Those taking Adderall should have an easier time titrating their dosage downwards prior to complete discontinuation.
Similarities (Recap): Dexedrine vs. Adderall
Below is a synopsis of the commonalities between Dexedrine and Adderall.
- Abuse potential: Both Dexedrine and Adderall are considered to have a high potential for abuse.
- Drug type: These drugs are classified as psychostimulants, and function by increasing CNS stimulation.
- Efficacy: Both drugs are clinically effective for ADHD and narcolepsy; there is no evidence to suggest superior efficacy for one over the other.
- Generic availability: Dexedrine Spansules are available as generics under “dextroamphetamine ER” and Adderall is sold generically as “mixed amphetamine salts.”
- Half-life: The estimated elimination half-life of Dexedrine is 12 hours, while that of Adderall is estimated to range between 11 and 13 hours.
- Legal status: The U.S. legal system has classified Dexedrine and Adderall as “Schedule II” controlled-substances. They are legal to possess and use when prescribed to treat a medical condition, but are illegal if used outside medical constraints.
- Mechanisms of action: Each of these drugs inhibits reuptake of stimulatory neurotransmitters like dopamine and norepinephrine. They also elicit further presynaptic activity, stimulating increased release of these neurotransmitters.
- Medical uses: Medically, Dexedrine and Adderall can be used to treat ADHD and/or narcolepsy.
- Side effects: The side effect profiles of these drugs is nearly identical, with subtle differences as a result of the presence of levoamphetamine in Adderall.
- Withdrawal: Discontinuation of either psychostimulant is a difficult endeavor, characterized by severe fatigue, psychomotor slowing, and sleepiness.
Differences (Recap): Dexedrine vs. Adderall
Below are some differences between Dexedrine and Adderall.
- Cost: Brand name Dexedrine costs over $350, Adderall XR costs over $220, and Adderall IR costs over $150 (for a 30 day supply). Dexedrine is the most expensive brand name option, whereas the generic Dexedrine is actually slightly cheaper than generic Adderall XR.
- Duration of effect: Dexedrine Spansules are thought to elicit an effect for 8 to 10 hours, whereas Adderall XR lasts up to 12 hours. Adderall IR is shorter-acting than Dexedrine Spansules with an effect of 4 to 6 hours.
- Formats: Dexedrine Spansules and Adderall XR are very similar in that they are capsules filled with “beads.” Adderall is available as an IR format in the form of tablets, whereas Dexedrine is not.
- Ingredients: The active ingredient in Dexedrine is dextroamphetamine, whereas Adderall contains both dextroamphetamine (75%) and levoamphetamine 25%.
- Investigational uses: Adderall has been investigated for cognitive rehabilitation among stroke patients, whereas Dexedrine has been investigated for the treatment of nasal congestion.
- Manufacturers: Dexedrine is manufactured by Amedra Pharmaceuticals, whereas Adderall is manufactured by Shire Pharmaceuticals.
- Popularity: The popularity of Dexedrine is virtually nonexistent when compared to Adderall – which is still the single most popular psychostimulant in generic format.
- Potency: The potency of Dexedrine is thought to be slightly higher than Adderall due to the fact that it is 100% dextroamphetamine, whereas Adderall is only 75% dextroamphetamine.
Which drug is better for ADHD? Dexedrine vs. Adderall.
Those searching for a drug to treat their ADHD or narcolepsy will likely stumble upon the options of Adderall and Dexedrine. Everyone wants to know whether one drug is more effective than the other for the treatment of these conditions and for other off-label purposes such as studying, academics, weight loss, and business performance. The truth is that the drugs are so similar, that differences in efficacy are largely subject to individual variation.
When choosing a drug, you should work closely with your doctor (or psychiatrist) and determine which one gives you the least side effects and greatest symptomatic reduction. Some people may find that they experience a cleaner focus with 100% pure dextroamphetamine (Dexedrine), whereas others may find benefit in the 25% levoamphetamine within Adderall. It can take some trial and error before you find the optimal drug for your condition.
Which drug do you prefer? Dexedrine or Adderall?
If you’ve tried Dexedrine Spansules and Adderall, how do they compare? Feel free to leave a comment below and discuss any similarities and/or differences (e.g. side effects, efficacy, duration of effect) that you noticed between the two drugs. If you preferred to use one drug over the other for ADHD, narcolepsy, or an off-label condition, mention why.