However, children are more likely to have unwanted effects (eg, weight loss, slow growth). Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do.

Amphetamine exerts analogous, yet less pronounced, effects on serotonin as on dopamine and norepinephrine. In other words, amphetamine induces competitive NET reuptake inhibition, non-competitive reuptake inhibition and efflux at phosphorylated NET via PKC activation, CAMKIIα-mediated NET efflux without internalization, and norepinephrine release from VMAT2. Subsequently, the cytosolic dopamine molecules are released from the presynaptic neuron into the synaptic cleft via reverse transport at DAT. Upon entering the presynaptic neuron, amphetamine provokes the release of Ca²⁺ from endoplasmic reticulum stores, an effect that raises intracellular calcium to levels sufficient for downstream kinase-dependent signalling. Amphetamine also inhibits monoamine oxidases at very high doses, resulting in less monoamine and trace amine metabolism and consequently higher concentrations of synaptic monoamines. When amphetamine accumulates in the presynaptic terminal, it collapses the vesicular pH gradient and releases vesicular monoamines into the neuronal cytosol.

What should I do if I forget a dose?

This medicine may cause some people to feel a false sense of well-being or to become dizzy, lightheaded, or less alert than they are normally. If your child is using this medicine, the doctor will need to keep track of your child’s height and weight to make sure your child is growing properly. This medicine may cause slow growth and weight loss. Call your doctor right away if you notice these symptoms. Check with your doctor right away if you have chest pain, fast or uneven heartbeat, trouble breathing, or fainting while using this medicine. This medicine may cause serious heart or blood vessel problems.

Symptoms of overdose may include the following:

On June 30, 2025, FDA issued a drug safety communication about a risk of weight loss in patients younger than 6 years of age taking extended-release stimulants for ADHD and will be revising the labeling for all these products to reflect this new safety information. Amphetamines produce dopamine, the neurotransmitter that causes happiness and euphoria, and feelings of reward and pleasure in the limbic reward system of the brain. The stronger the amphetamine and how regularly it is abused increases the risk of harmful side effects. Amphetamine combination drugs such as Adderall are also widely prescribed to treat ADHD. Amphetamine medications are approved to treat attention-deficit/hyperactivity disorder (ADHD), narcolepsy, obesity, and binge-eating disorder (BED). Amphetamines affect the brain’s production of dopamine, norepinephrine, and serotonin (although to a lesser extent) as well as other neurotransmitters.

Similar to dopamine, amphetamine dose-dependently increases the level of synaptic norepinephrine, the direct precursor of epinephrine. In addition to presynaptic actions that regulate DAT, TAAR1 activation exerts a somatodendritic inhibitory influence on dopamine output by reducing the firing rate of midbrain dopamine neurons via G protein-coupled inwardly-rectifying potassium channels, an effect that can attenuate amphetamine’s psychostimulant response. In certain brain regions, amphetamine increases the concentration of dopamine in the synaptic cleft by modulating DAT through several overlapping processes. Dextroamphetamine displays higher binding affinity for DAT than levoamphetamine, whereas both enantiomers share comparable affinity at NET; Consequently, dextroamphetamine produces greater CNS stimulation than levoamphetamine, roughly three to four times more, but levoamphetamine has slightly stronger cardiovascular and peripheral effects. The euphoric and locomotor-stimulating effects of amphetamine are dependent upon the magnitude and speed by which it increases synaptic dopamine and norepinephrine concentrations in the striatum.

Drug interactions

Your doctor may order certain tests to check your body’s response to amphetamine and your blood pressure. Do not flush this medication down the toilet. Place the medication in a safe location – one that is up and away and out of their sight and reach.

Along with its needed effects, a medicine may cause some unwanted effects. Use with medications that increase stomach or urine alkalinity, including sodium bicarbonate, acetazolamide, and some thiazide diuretics (water pill) should be avoided. Before you have any medical tests, tell the medical doctor in charge that you are using this medicine. Your doctor may occasionally stop treatment to check symptoms of ADHD. If you miss a dose of this medicine, take it as soon as possible.

What other medications interact with amphetamines?

Most of the research on gene regulation and addiction is based upon animal studies with intravenous amphetamine administration at very high doses. Since both natural rewards and addictive drugs induce the expression of ΔFosB (i.e., they cause the brain to produce more of it), chronic acquisition of these rewards can result in a similar pathological state of addiction. It has been implicated in addictions to alcohol, cannabinoids, cocaine, methylphenidate, nicotine, opioids, phencyclidine, propofol, and substituted amphetamines, among others.sources 11

Detection in body fluids

Supplemental magnesiumnote 15 treatment has been shown to reduce amphetamine self-administration (i.e., doses given to oneself) in humans, but it is not an effective monotherapy for amphetamine addiction. Reviews from 2015 and 2016 indicated that TAAR1-selective agonists have significant therapeutic potential as a treatment for psychostimulant addictions; however, as of February 2016,update the only compounds which are known to function as TAAR1-selective agonists are experimental drugs. Addiction is a serious risk with heavy recreational amphetamine use, but is unlikely to occur from long-term medical use at therapeutic doses; in fact, lifetime stimulant therapy for ADHD that begins during childhood reduces the risk of developing substance use disorders as an adult. At normal therapeutic doses, the most common psychological side effects of amphetamine include increased alertness, apprehension, concentration, initiative, self-confidence and sociability, mood swings (elated mood followed by mildly depressed mood), insomnia or wakefulness, and decreased sense of fatigue. Other potential physical side effects include appetite loss, blurred vision, dry mouth, excessive grinding of the teeth, nosebleed, profuse sweating, rhinitis medicamentosa (drug-induced nasal congestion), reduced seizure threshold, tics (a Amphetamine Drug Profile type of movement disorder), and weight loss.sources 6 Dangerous physical side effects are rare at typical pharmaceutical doses.

What’s the difference between amphetamine and dextroamphetamine?

This synthetic intermediate can be transformed into amphetamine using either a Hofmann or Curtius rearrangement (method 4). In this route, allylbenzene is reacted acetonitrile in sulfuric acid to yield an organosulfate which in turn is treated with sodium hydroxide to give amphetamine via an acetamide intermediate. One example is the Friedel–Crafts alkylation of benzene by allyl chloride to yield beta chloropropylbenzene which is then reacted with ammonia to produce racemic amphetamine (method 2). A large number of alternative synthetic routes to amphetamine have been developed based on classic organic reactions.

There are a few drugs that are technically amphetamines, but have very different effects from most others. Due to the necessary conversion of lisdexamfetamine into dextroamphetamine, levels of dextroamphetamine with lisdexamfetamine peak about one hour later than with an equivalent dose of immediate-release dextroamphetamine. Although VMAT2 is recognized as a major target in amphetamine-induced monoamine release at higher doses, some reviews have challenged its relevance at therapeutic doses. Unlike amphetamine abuse, where drug tolerance necessitates escalating doses to achieve the same effect, tolerance to clinically relevant doses of amphetamine plateaus after the initial titration period, and “drug holidays” (i.e., temporary treatment discontinuation) are not required to prevent the development of tolerance. According to a 2025 review, the discontinuation of amphetamine at therapeutic doses does not typically result in withdrawal symptoms.

Other names for amphetamines

  • Lateral hypothalamic orexin neurons innervate every component of the ascending reticular activating system (ARAS), which includes noradrenergic, dopaminergic, histaminergic, and serotonergic nuclei that promote wakefulness.
  • This increase in extracellular glutamate presumably occurs via the amphetamine-induced internalization of EAAT3, a glutamate reuptake transporter, in dopamine neurons.
  • As it is a prodrug, lisdexamfetamine is structurally different from dextroamphetamine, and is inactive until it metabolizes into dextroamphetamine.

Similar to its therapeutic effect in ADHD, dextroamphetamine enhances cognitive control and may reduce impulsivity in patients with BED by enhancing the cognitive processes responsible for overriding prepotent feeding responses that precede binge eating episodes. Centrally, dextroamphetamine increases neurotransmitter activity of dopamine and norepinephrine in prefrontal cortical regions that regulate cognitive control of behavior. Reviews of magnetic resonance imaging (MRI) studies suggest that long-term treatment with amphetamine decreases abnormalities in brain structure and function found in subjects with ADHD, and improves function in several parts of the brain, such as the right caudate nucleus of the basal ganglia.

Once a tolerance to amphetamines has built up, users will feel the need to take the drug constantly to feel normal levels of happiness. This artificial production of dopamine is highly addictive and causes many to become hooked on abusing amphetamines. Depending on whether a person is abusing amphetamines in pill, powder, crystal, or liquid forms will dictate how they take the drug. Most forms of prescription amphetamines come in the form of pills or tablets but will occasionally be administered orally as a liquid.

Drug Interactions

It is sometimes prescribed off-label for its past medical indications, particularly for depression and chronic pain. Amphetamine is used to treat attention deficit hyperactivity disorder (ADHD), narcolepsy, obesity, and, in the form of lisdexamfetamine, binge eating disorder. As a member of the phenethylamine class, amphetamine is also chemically related to the naturally occurring trace amine neuromodulators, specifically phenethylamine and N-methylphenethylamine, both of which are produced within the human body.

International Patients

  • It is sometimes prescribed off-label for its past medical indications, particularly for depression and chronic pain.
  • In a normal person at therapeutic doses, this effect is usually not noticeable, but when respiration is already compromised, it may be evident.
  • The double bond and nitro group of this intermediate is reduced using either catalytic hydrogenation or by treatment with lithium aluminium hydride (method 5).
  • Remove Adzenys XR-ODT® from the blister pack by peeling back the foil, then taking the tablet out.

Very high doses can result in psychosis (e.g., hallucinations, delusions, and paranoia) which rarely occurs at therapeutic doses even during long-term use. Amphetaminenote 2 is a central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity; it is also used to treat binge eating disorder in the form of its inactive prodrug lisdexamfetamine. Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Store the extended-release orally disintegrating tablet blister packages in the rigid, plastic travel case after removal from the carton. If you are taking amphetamine for narcolepsy, your doctor will probably start you on a low dose of amphetamine and increase your dose gradually, not more often than once every week.

Chiral resolution remains the most economical method for obtaining optically pure amphetamine on a large scale. The free base is then dissolved in an organic solvent, sulfuric acid added, and amphetamine precipitates out as the sulfate salt. In the first step, a reaction between phenylacetone and formamide, either using additional formic acid or formamide itself as a reducing agent, yields N-formylamphetamine. The most common route of both legal and illicit amphetamine synthesis employs a non-metal reduction known as the Leuckart reaction (method 1).

When taken as prescribed, the risk of addiction is very low. Using them in an unprescribed way can lead to substance use disorder and addiction. Amphetamines have a big effect on your central nervous system, especially your brain. Cleveland Clinic is a non-profit academic medical center. Amphetamines are a type of stimulant drug that makes your nervous system more active.