Overview
Adderall contains amphetamine and dextroamphetamine, which are stimulants. This drug is used to:

1. Improve a patient's attention span.
2. Increase his ability to follow directions.
3. Decrease distractibility among children ages three and older.
4. Decrease impulsivity, stubbornness and aggression.

An advantage of Adderall is that it is effective for most patients when taken once or twice a day. This makes it convenient for patients, parents and caregivers. Adderall may help some patients for whom other medications, such as Ritalin have not been effective. The effects of Adderall can be felt after a few doses. It may take additional time to achieve the full effect and this may require adjusting dosages. Most people can achieve maximum benefit in 3 to 4 weeks.

Why is this drug prescribed?
Adderall is used to treat Attention Deficit Disorder with Hyperactivity (ADHD). It is prescribed for the following symptoms in children:

1. Moderate to severe distractibility
2. Short attention span
3. Hyperactivity
4. Mood swings
5. Impulsiveness

When these symptoms first appear, other factors should be considered, such as neurological signs, learning disability, abnormal EEG and central nervous system dysfunction.

Warnings and Precautions
Amphetamines have a high potential for abuse. Administration of amphetamines for prolonged periods may lead to drug dependence. There is a danger of obtaining amphetamines for non-therapeutic use or distribution to others.

Clinical experience suggests that in psychotic children, amphetamines may exacerbate symptoms of behavior disturbance and thought disorder. Chronic administration of amphetamines may be associated with growth inhibition. Therefore, growth should be monitored during treatment.

The least amount feasible should be dispensed at one time, in order to minimize the possibility of over dosage.

Amphetamines may impair the ability of the patient to engage in potentially hazardous activities, such as operating machinery or vehicles.

For Nursing Mothers: Amphetamines are excreted in human milk. Mothers taking amphetamines should refrain from nursing.

Contraindications
Adderall should Not be used for people who have:

1. Advanced arteriosclerosis.
2. Symptomatic cardiovascular disease.
3. Moderate to severe hypertension, hyperthyroidism, or are hypersensitive to nervous stimulation.
4. A history of drug abuse or agitated states.

Adverse Reactions
Amphetamines may cause the following reactions:

1. Heart palpitations, tachycardia (racing heart), elevation of blood pressure. There have been isolated reports of heart disease associated with chronic amphetamine use.
2. Psychotic episodes at recommended doses (rare), overstimulation, restlessness, dizziness, insomnia, euphoria, depression, dyskinesia (loss of motor control), tremor, headache, and exacerbation of motor and speech problems, including Tourette's syndrome.
3. Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances. Anorexia and weight loss may occur.
4. Hives.
5. Impotence and changes in libido.

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Adderall include:

1. Gastrointestinal acidifying agents, such as guanethidine, reserpine, glutamic acid HCI, ascorbic acid, fruit juices, etc. These lower the absorption of amphetamines.
2. Urinary acidifying agents, such as ammonium chloride, and sodium acid phosphate. These may increase the concentration of amphetamines.
3. Adrenergic blockers - Adrenergic blockers are inhibited by amphetamines.
4. Akalinizing agents, such as sodium bicarbonate, increase the effect of amphetamines.
5. Antidepressants, tricyclic, combined with amphetamines may cause amphetamines to increase in the brain. The combination of these two drugs may also affect cardiovascular functions.
6. M.A.O. inhibitor antidepressants combined with amphetamines can cause headaches and other signs of hypertensive crisis. A variety of neurological toxic effects can occur, sometimes with fatal results.
7. Antihistamines' sedative effect can be counteracted by amphetamines.
8. Antihypertensives' effects can be offset by amphetamines.
9. Chlorpromazine inhibits central stimulant effects of amphetamines and can be used to treat amphetamine poisoning.
10. Ethosuximide's intestinal absorption may be delayed by amphetamines.
11. Haloperidol inhibits the central stimulant effects of amphetamines.
12. Lithium carbonate may inhibit the stimulatory effects of amphetamines.
13. Meperidine's analgesic effect may be inhibited by amphetamines
14. Methenamine therapy may reduce the effect of amphetamines.
15. Norepinephrine combined with amphetamines can increase adrenalin.
16. Phenobarbital and amphetamines combined may produce a synergistic anticonvulsant action. Amphetamine may delay intestinal absorption of phenobarbital.
17. Phenytoin - Amphetamines may delay intestinal absorption of phenytoin. Combining phenytoin and amphetamines may produce a synergistic anticonvulsant action.
18. Propoxyphene over dose combined with amphetamines can cause fatal convulsions.
19. Veratrum alkaloids' hypotensive effect can be inhibited by amphetamines.

Sources:

http://www.rxlist.com

http://www.rx.com/cgi/weight/amphet_ids.htm

http://site.health-center.com/pharmacy/meds/adderall.htm

http://www.healthtouch.com

http://www.healthtouch.com//bin/EContent_HT/showUSPLfts.asp?fname=use0025.htm&
title=Adderall&cid=HT

Newman, Laura, MA, "Single Daily Dose of Adderall May Work as Well as Two Ritalin Doses for Children With ADHD," WebMD Medical News," Nov.16, 1999. http://my.webmd.com/content/article/1728.50571.