DEA Schedule II Control Substance means this drug has a “high potential for abuse” that “may lead to severe psychological or physical dependence,” and the federal government sets limits on the amount that may be manufactured each year.
FDA “Black Box” Warning
The Food and Drug Administration (FDA) requires the following “black box” warning on all amphetamine drugs, including dextroamphetamine, which means that medical studies indicate dextroamphetamine carries a significant risk of serious, or even life-threatening, adverse effects.
WARNING
AMPHETAMINES HAVE A HIGH POTENTIAL FOR ABUSE.
ADMINISTRATION OF AMPHETAMINES FOR PROLONGED PERIODS OF TIME MAY LEAD TO DRUG DEPENDENCE AND MUST BE AVOIDED. PARTICULAR ATTENTION SHOULD BE PAID TO THE POSSIBILITY OF SUBJECTS OBTAINING AMPHETAMINES FOR NONTHERAPEUTIC USE OR DISTRIBUTION TO OTHERS, AND THE DRUGS SHOULD BE PRESCRIBED OR DISPENSED SPARINGLY.
MISUSE OF AMPHETAMINE MAY CAUSE SUDDEN DEATH AND SERIOUS CARDIOVASCULAR ADVERSE EVENTS.
ABOVE: FDA black box warning label appears on the manufacturer's wholesale packaging and is the strongest alert the FDA can require. (Emphasis added.)
Because dextroamphetamine can so be very effective (and addicting) it became widely popular in the middle of the last century. The psychiatric drug became famous as “uppers” and diet pills as drug-makers advertised the addictive chemical as a wonder-drug while disregarding its dangerous side-effects.
In the 1950s, drug-makers advertised Dexedrine as a “wonder-drug” while disregarding its dangerous side-effects.
“New life for the living... Dexedrine's uniquely 'smooth' antidepressant effect restores mental alertness and optimism, induces feeling of energy and well-being...
Dexedrine has the happy effect of bringing back life for the living.” (1950)
“For these lethargic overweight patients, Dexedrine offers two important benefits: effective appetite control, a renewed level of energy.” (1966)
“Does more than curb appetite...also relieves the tensions of dieting.” (1959)
“Probably the basic antidepressant... Dexedrine helps provide rapid symptomatic relief. The patient is more alert, responds more favorably to her environment.” (1950s)
ABOVE: “Dexedrine's uniquely 'smooth' antidepressant effect restores mental alertness and optimism, induces feeling of energy and well-being...
Dexedrine has the happy effect of bringing back life for the living.” (Magazine advertisement circa 1950, Smith Kline & French; GlaxoSmithKline.)
ABOVE: “Victims of overeating and underactivity: for these lethargic overweight patients, Dexedrine... offers two important benefits: 1. effective appetite control and 2. a renewed
level of energy.” (Magazine advertisement circa 1966, Smith Kline & French; GlaxoSmithKline.)
ABOVE: “Probably the basic antidepressant... Dexedrine helps provide rapid symptomatic relief. The patient is more alert, responds more favorably to her environment.” (Magazine advertisement circa 1950s, Smith Kline & French; GlaxoSmithKline.)
ABOVE: “Does more than curb appetite...also relieves the tensions of dieting.” (Magazine advertisement circa 1959, Wallace Laboratories.)
As use of the addictive chemical spread, so did its abuse, according to the U.S. Drug Enforcement Agency (DEA) in a 2005 report. Referring to dextroamphetamine, methamphetamine, and all the amphetamines, the DEA states:
In the 1960s, amphetamines became a perceived remedy for helping truckers to complete their long routes without falling asleep, for weight control, for helping athletes to perform better
and train longer, and for treating mild depression. ... With experience, it became evident that the dangers of abuse of these drugs outweighed most of their therapeutic uses.
Increased control measures were initiated in 1965 with amendments to the federal food and drug laws... Many pharmaceutical amphetamine products were removed from the market including all injectable formulations, and doctors prescribed
those that remained less freely. Recent increases in medical use of these drugs can be attributed to their use in the treatment of ADHD.
How Does Dextroamphetamine Work?
Dextroamphetamine (as with all amphetamines) works by by initiating the acute stress response (“fight or flight” response). The central nervous system prepares the body for physical action by creating physiological changes as if it were stressed or under threat. These changes include:
The release of adrenaline, raises cortisol levels and other stress hormones
Increased heart rate and blood pressure
Redirected blood flow into the muscles and away from the brain
Small doses of dextroamphetamine can banish tiredness and make the user feel alert and refreshed. However, the burst of energy comes at a price. A “speed crash” always follows the high and typically leaves the user feeling nauseous, irritable, depressed and extremely exhausted.
“The effects of amphetamines and methamphetamine are similar to cocaine, but their onset is slower and their duration is longer”
ABOVE: Drug Enforcement Administration (DEA), US Department of Justice. “Drug Fact Sheet: Amphetamines,” undated, retrieved January 15, 2013 www.justice.gov/dea/druginfo/drug_data_sheets/Amphetamines.pdf.
Abuse
Abuse of dextroamphetamine drugs have many serious potential side effects, including psychotic behavior, depression, anxiety, fatigue, paranoia, aggression, violent behavior, confusion, insomnia, auditory hallucinations, mood disturbances and delusions.
Violent and erratic behavior is frequently seen among chronic abusers of amphetamines, especially methamphetamine.
According to the DEA the effects of amphetamines are similar to cocaine but the onset is slower and the duration is longer. Chronic abuse produces a psychosis that resembles schizophrenia and is characterized by paranoia, picking at the skin, preoccupation with one’s own thoughts, and auditory and visual hallucinations. These psychotic symptoms can persist for months and even years after use of these drugs has ceased, and may be related to its neurotoxic effects.
“Amphetamine, as with cocaine, can induce symptoms similar to those seen in obsessive disorder, panic disorder, and phobic disorders.”
ABOVE: American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders as cited in Kaplan and Sadock's Synopsis of Psychiatry (2007).
What are the differences between the various Amphetamines?
Many think methylphenidate (Ritalin) is safe, or mild, because so many children use it. However, the government classifies the psychoactive drug with cocaine and morphine because it's highly addictive. [More]
Although Vyvanse is referred to as “pro-drug” of dextroamphetamine, it's still an amphetamine, meaning that it's easily abused and can cause insomnia, agitation, anxiety and sometimes psychotic symptoms like seeing things or becoming paranoid. [More]
Most people may not know that Strattera (atomoxetine) appears to cause unsatisfactory sexual function (decreased libido, ejaculatory problems and impotence). [More]
Drug Enforcement Administration, US Department of Justice. “Amphetamines,” Drugs of Abuse Publication. National Drug Intelligence Center, 2005 ed.
Drug Enforcement Administration, US Department of Justice. “Drug Fact Sheet: Amphetamines,” undated, retrieved January 15, 2013 www.justice.gov/dea/druginfo/drug_data_sheets/Amphetamines.pdf.
National Institute of Mental Health. Medications. Bethesda, MD: National Institute of Mental Health,
National Institutes of Health, US Department of Health and Human Services; NIH Publication No. 02-3929, 2007 ed. www.nimh.nih.gov/health/publications/medications/medications.pdf.
Gorman, Jack M. The Essential Guide to Psychiatric Drugs. New York, NY: St. Martin's Press, 1992.
