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  • Adderall IR vs Dexadrine

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    Old 06-13-2009, 06:10 AM   #1
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    Adderall IR vs Dexadrine

    I found a recent double-blind on kids that concluded Adderall IR has no efficacy longer than plain old evil Dexadrine.

    The study was done by the state of Virginia, U.S.A.

    Bob

     
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    Old 06-13-2009, 06:35 AM   #2
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    Re: Adderall IR vs Dexadrine

    Does that mean effects of Adderall = d-amphetamine? No

    The why cause ...

    d-amphetamine mostly bumps up dopamine. l-amphetamine is heavier on the noreprinephrine circuits.

    Adderall or Dexadrine for you? Evidently it depends on the unique needs of your brain.

    Isn't that where we always end up in these discussions?

    Bob

     
    Old 06-13-2009, 11:24 AM   #3
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    Re: Adderall IR vs Dexadrine

    It took quite of bit of digging to come up with some numbers you can take to the bank:

    Adderall is 72.7% dextroamphetamine and 27.3% levoamphetamine.

    Vyvanse is 29.48% dextroamphetamine, it's only active drug. 30mg of Vyvanse has 8.844mg of d-amphetamine. The dimesylate salt slows absorbtion reducing bioavalability over time. Shire markets Vyvanse for its lower misuse potential. Why the Schedule II rating by the DEA? Why the same rating given to Dexadrine?

    Let's do a side-by-side cost comparison. I obtained the values from a Walmart in Pennsylvania today - Jun 13, 09.

    60mg Vyvanse is $156 for 30 capsules. In real life, most people would need 2 capsules of 40mg Vyvanse, one in AM and one in PM. Real life cost for a 30 day supply, 60 capsules = $312.

    To approximate the same efficacy, same person would need (4) 5mg capusules of Dexadrine. Same Walmart quoted me $34/month for (120) 5mg Dexadrine capsules.

    Boys and girls, you can have a brain for $312/month or $34/month, your choice. Or so you'd think. In the U.S., getting a prescription for Dexadrine is harder than buying it on the street.

    If you're Canadian, don't fall for Shire's bull [bad word that begins with sh and ends with it].

    If you are an American without insurance, the time it takes to find a doctor who will prescribe Dexadrine may just be the best time investment you'll ever make - assuming Dexadrine is the med that works for you.

    This is all most upsetting to me.

    Bob

     
    Old 06-13-2009, 05:18 PM   #4
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    Re: Adderall IR vs Dexadrine

    It's so hard to find dependable information on the differences between the different medications, it's nice to see it summarized.

    I'm not certain from my research that dextroamphetamine is less effective than levoamphetamine at stimulating norepinephrine, though it seems clear that l-amphetamine is less involved with dopamine, which is why it's apparently seen as having less potential for abuse. My own research (which means reading online, it's not like I'm doing science here) has highlighted that l-amphetamine has stronger physical effects, on the heart and the cardiovascular system, than does d-amphetamine.

    Unfortunately, in my case, I'm going to be stuck with just dextro, whether I like it or not, as paying for a brand name med is just not in the cards. Fortunately, Dexadrine has not been difficult for me to obtain, as it is rated lower than Methylphenidate by Health Canada (For Methylphenidate it's a triplicate prescription that has to be filled within three days, yadda yadda yadda, while dex is no different than any other standard prescription).

    Unfortunately, Bob, repackaging old medications and marking them up by thousands of percent is the standard in our neck of the woods. Couple that with the fact that everyone's for sale (*cough* doctors and politicians *cough*) and the people that have the most money get their way . . . and the drug companies have an awful lot of scratch to spread around.

    Ultimately, I'm torn as to whether I should wait until my appointment with my psych in early August, and just take the Adderall in the meantime, or seek a more immediate appointment so I can try getting a dex or Ritalin dose right before school starts. I guess I'll play it by ear.

     
    Old 06-13-2009, 07:22 PM   #5
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    Re: Adderall IR vs Dexadrine

    Quote:
    Originally Posted by Thunor View Post
    I'm not certain from my research that dextroamphetamine is less effective than levoamphetamine at stimulating norepinephrine, though it seems clear that l-amphetamine is less involved with dopamine, which is why it's apparently seen as having less potential for abuse. My own research (which means reading online, it's not like I'm doing science here) has highlighted that l-amphetamine has stronger physical effects, on the heart and the cardiovascular system, than does d-amphetamine.
    Thu,

    In your other thread you say you learn from me. Believe me, I learn from you. Most of my Adderall theory and numbers turned out way off.

    Again you give me a clearer picture. Yep, d-amphetamine kicks up the dopamine, norepinephrine, and serotonin. l-amphetamine is light on the dopamine.

    My sources are online also. A well known, free, user written, online encyclopedia, is a good starter place. For the real poop, click on their references. One of them put me in Health Canada. The rationale for banning Adderal was not as explicit as I'd hoped. My theory had l-amphetamine's heart pounding as the reason. Health Canada couldn't come up with enough data to incriminate the l-amphetamine so lifted the ban.

    I got to get a few references to support l-amphetamine's heavier impact on the cardio system. Those of us that legitimately need d-amphetamine for medical reasons get the pay through the nose and/or are forced to take a more dangerous product.

    My shrink will prescribe Dexadrine for me. He'd rather not to cover his own butt butt will. I never made an issue of it because Adderall works fairly well for me. Generic Adderall IR is about $25 more expensive than GSK's Dexadrine. I could live with that but not with the greater health risk. What fer?

    Your mission turned into my mission. Hopefully we both benefited.

    Why do we have to go through all this CRAP to get decent medical care? You'd think we lived in north and south Somalia. You explained. I already know. Cough, cough, cough.

    Bob

     
    Old 06-14-2009, 01:21 AM   #6
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    Re: Adderall IR vs Dexadrine

    OK, Mr. Chemist -- where does methylphenidat (generic Ritalin) fit into that l- and d- chart of yours?

    --Rheanna

     
    Old 06-14-2009, 02:54 AM   #7
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    Re: Adderall IR vs Dexadrine

    I can't speak for Bob, but I am most definately not a chemist! Alas, I am but a layman who is generally effective at describing science to other laypeople, because I break things down until they're simple enough for me to understand, and once they're that simple, anyone can understand them!

    So, I'll do my best with Methylphenidate. I'll start by defining a couple of terms. At the molecular level, many drugs (and I'm not sure if this holds true for all compounds, remember, not a chemist) have multiple shapes. These shapes can be described as a right twist (it's not 100% physical from what I've read, but how they refract light, but I'm simplifying), and a left twist. The right twist is called dextro- or d- after the Latin word for 'right.' The left twist version is called levo- or l- from the Latin for left. A drug that is made up exclusively of one of these versions of the molecule will be named accordingly (thus, dextroamphetamine consists of only the right twist version of amphetamine, any levoamphetamine has been removed). A pill that contains both the d- and the l- variant is called a racemic mixture.

    The difference between the right and the left twist versions of a molecule are important, because the difference in shape can lead to variations in their ability to bind to the various receptor cites in the brain and elsewhere that they are attempting to affect. If the l- version is less effective, or even unable to bind with the target receptors, it will not have the desired effect. Worse, if it binds to cites that are not intended, it can cause side effects. What we're seeing with amphetamine is that the right twist is better at binding with the desired receptors, and is less likely than the l- to bind to unintended receptors.

    Still with me (because I'm not certain that I am!)? Ok . . .

    Methyphenidate doesn't technically fit into the discussion that Bob and I were having, because although it is derived from amphetamine, it's not simply amphetamine and thus may act differently and has to be evaluated on its own. For the sake of the d- vs. l- discussion, Ritalin and its generic versions is a racemic mixture, consisting of both dextromethylphenidate and levomethylphenidate. What little reading I've done on the specifics of Methylphenidate indicates that the d- and the l- are similar in effect on the brain to their counterparts in the amphetamines, the l- being generally less effective than the d-.

    Apparently, Focalin is an example of dextromethylphenidate, a med which I'm going to have to read more about, because my knowledge of it is virtually nil.

    The lists of adverse effects for Methylphenidate are similar to those for amphetamine.

    The most important reason for understanding the d- vs. l- question is to gain an understanding of dosing. The reason one might require a larger dose of Adderall as compared to Dexedrine is that Dexedrine doesn't have the less effective l-amphetamine in the mix, and thus you can achieve the desired effect with less overall medication. As an example, let's say you need 5mg of dextroamphetamine to get the effect you're looking for. To get the result you want, you'll need to take just 5mg of Dexedrine, while you may need 7 or 8mg of Adderall to get the same effect.

    The idea that the l-amphetamine may be responsible for the lion's share of the side effects of Adderall is something I hadn't considered before. Thanks to Bob for making me think.

     
    Old 06-14-2009, 05:58 AM   #8
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    Re: Adderall IR vs Dexadrine

    Rheanna,

    Let's let Thunor speak for me. I'm sure I could have done better if I knew what I was talking about.

    So THAT is what racemic means. I'll be son-a-gun. It's the d,l-amphetamine I've been seeing, not another mysterious amphetamine no one ever talks about. They been talking about it.

    I get the salt bit too - I think. Free base amphetamine is attached to a salt. The d-amphetamine and d,l-amphetamine in Adderall is attached to aspartate monohydrate, saccharide and sulfate. The missing salt (pose to be 4) isn't missing. d-amphetamine sulfate is one, d,l-amphetamine sulfate is the other.

    Thu,

    Your writting is so clear, lucid, and understandable because:

    1. You clearly understand your material.
    2. You express complex thoughts simply.

    I can't tell you how many times I said "now I get it" when reading you.

    You got a monster brain in your cranium. Intelligence, in my book, is the ability to put the pieces together. You can do whatever you want - not just write. You put the pieces together so easily.

    Get THE bug under control, my friend, and no one or no thing will be able to hold you back.

    Bob

     
    Old 06-14-2009, 07:22 AM   #9
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    Re: Adderall IR vs Dexadrine

    Some people do better on Adderall than on Dexadrine. Adderall is a different drug than Dexedrine. I suspect that some who do not respond well to Adderall, are reacting adversely to the levoamphetamine. What option does the second group have? If unable to afford Vyvanse, they're screwed.

    Some with severe ADHD are unable to beat the pavement long and hard enough to get the meds needed. So they resort to self-medication.

    I think I may do better on Dexedrine. No one will know for sure until I try it. For two reasons, I'm switching, at least temporarily, to Dexedrine. My first reason is already stated. My second reason is on the principle.

    The sons-a-guns disturb me to no end.

    Doing it. Done with it.

    Bob

     
    Old 06-14-2009, 09:46 AM   #10
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    Re: Adderall IR vs Dexadrine

    Bob,

    I hope the change works out for you, I'll be interested to hear how you react with the Dexedrine as opposed to the Adderall you've been on for so long.

    I'm going to slap a caveat on my 'scientific' writing by noting that I'm expressing my understanding of the material, and that I am simplifying, possibly to the point of oversimplification. I'm satisfied that my understanding is sufficient for my own purposes, because it's not like I'll be doing the science, I'm simply trying to make sense of how it applies to me. I will also give credit where it's due, and it was Dr. Michael Colgan's descriptions of keys and locks that taught me the difference between d- and l- and the important distinction separating racemic vs. non-racemic in regards to how compounds work in the body (although he was discussing vitamins rather than amphetamines).

     
    Old 06-17-2009, 06:03 AM   #11
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    Re: Adderall IR vs Dexadrine

    Thu,

    Today - 11:30 got an appt. with shrink.

    I clipping out some of the info this thread to review with my pdoc. Frankly, he ain't interested in the chemistry. He is very interested in how I'm responding to the chemistry.

    You worry about over-simplification. Of course, you over-simplified, you had to. That does not mean inaccurate. About three months ago I had one of the most difficult problems I can remember. It looked so simple. Identify an external hard drive on a USB port. You don't want the details, do you? I spent the better part of a week getting the details. You do want the point. When a HD is connected to a USB port the logical drive letter is NOT consistent. Heck, "it" can go from non-existent to existent to another logical drive letter within a session because the user the unplugged the HD, plugged in another device and then re-plugged in the HD. You name it, it can happen on a USB port. Whereas the drives stuck in the box stay put. C drivie is always C drive, ain't it?

    Our lives are plugged into USB ports. Everytime our environment variables change significantly, so does our ADHD and our response to the meds. Environment variables complicate the heck out programming and out of ADHD medication management.

    So does dextroamphetamine account for 75% and levoamphetamin 25% of the effects that Adderall has? Very, very, very unlikely that the chemical ratios equate to effects on the brain. The l-amphetamine might be responsible for better than 50% of the effects in my case. I base that on my response curve under current environment variables drawn from daily charts I've been keeping. The devil is in the environmental details. Change them and the dang response curve changes too.

    Research enables me to talk semi-intelligently with my shrink. Accuracy and over-simplication would be a problem if I were prescribing the meds. Don't worry. Be happy. I'm not prescribing my meds. I enjoy being alive too much at least most of time.

    Bob

     
    Old 06-17-2009, 11:56 AM   #12
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    Re: Adderall IR vs Dexadrine

    Let's wrap this up with stuff I got from my shrink mixed with a little of my own interpolations I think are fairly sound:

    Adderall is a different medication than Dexedrine. As we discussed, Adderall is a mixture (not a compound) of 4 amphetamine salts. Adderall contains 1 part Dexedrine - brand name for dextroamphetamine sulfate, 1 part dextroamphetamine saccharide, 1 part d,l-amphetamine aspartate monohydrate and 1 part d,l-amphetamine sulfate.

    50% dextroamphetamine and 50% Benzedrine (brand name for d,l-amphetamine) is another valid Adderall abstraction. To the best of my knowledge, Benzedrine is no longer available as a stand-alone. It's Schedule II rating evidently brought about it's demise.

    What we need to know:

    Adderall has different properties than Dexedrine and Adderall has greater toxicity.

    Adderall works better for ADHD folk who need relatively more norepinephrine than dopamine to balance the scales. Dexedrine works better for those who need both in equal measure. Over-simplified in the extreme. Hopefully conceptually correct.

    Some meds such as Strattera that target only norephinephrine work well for those who are short on norephinephrine alone. We all know how it works for those short on dopamine too. It SUCKS.

    Dexedrine works as a norephinephrine and dopamine reuptake inhibitor at therapeutic doses. At high doses it busts open the receptors and floods the brain with dopamine and norpehinephrine and seratonin. Unfortuneately for us ADHDers, that feels too good, which makes Dexedrine evil and hard to get in the U.S.

    The Canadians evidently assume a different posture. Dexedrine at therapeutic doses is the least likely stimulant to cause adverse side-effects. Therefore it is the least likely stimulant to be abused because of self-medication. Maybe we are dumb Americans afterall.

    My shrink converted my 40mg of Adderall to 30mg of Dexedrine today. I wanted less than he prescribed. He reasoned I'm used to it so won't get buzzed and he feared less would not be enough to control my ADHD at this time. As soon as Walmart get's it in, I'll switch. May be a week wait. They have no Dexedrine in stock. It's too dangerous. They do have tons of Vyvanse though. Good thing that Vyvanse Dexedrine is safe and GSK's Dexedrine is dangerous. </sarcasm> Damn Shire anyway. Dangerous to their bottom line.

    It all depends on the unique needs of our brains and the golden rule. "He who has the gold makes the rules." SUCKS.

     
    Old 06-17-2009, 07:19 PM   #13
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    Re: Adderall IR vs Dexadrine

    I really can't add anything to that post, it sums things up perfectly.

    In my experience, Canada loves Concerta above all. Any doctor I've consulted with, the first thing out of their mouths when we discuss medication is Concerta. I've tried it three times now and have no use for it whatsoever. Ironic, because I respond well to generic Methylphenidate; maybe my metabolism just doesn't break down Concerta properly, because despite having been on doses as high as 54mg, I've never had any positive effect from it.

    One thing Bob, don't close the book on this line of discussion quite yet, I'm very interested to hear how you respond to the Dexedrine, as compared to the Adderall.

     
    Old 06-18-2009, 02:20 AM   #14
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    Re: Adderall IR vs Dexadrine

    Bob and Thunor,

    Thank you both for the descriptions of the left and right thingies. I now have a better visual image than just the vague "different meds work different for different folks".

    It is clear that we all have a different balance of receptors in our brains. No one has demonstrated that ADD is caused by one particular imbalance of these receptors (too many of one or not enough of another). So it is frustrating that so many doctors assume that one particular med is appropriate for their patients who have ADD. And so many threads on here indicate that folks have difficulties with whatever meds their doctors start them off on.

    The fact that methylphenidate is a mixture of both l- and r- (racemic -- oooh a new word!) explains a possible reason why different manufacturers of generic Ritalin produce different effects in my brain. I have now learned to insist on getting my prescription filled with Brand A. Brand B produces more spacey, almost halucinogenic effects. I don't like it. They presumably both have whatever l- and d- twisty thingies that Ritalin does, but in different balances, and perhaps even different other extra thingies as well. My pharmacist says they are both the same because "they have the same active ingredient". My brain receptors say they cannot possibly be the same because they have markedly different effects when I take them.

    Thank you both for sharing your research with us.

    And do keep us posted on your search for an appropriate med for YOUR brain receptors.

    --Rheanna

     
    Old 06-18-2009, 06:05 AM   #15
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    Re: Adderall IR vs Dexadrine

    Rheanna,

    I'm really bad right now. I should be working. I just got to tell you how correct you are about differences in presumably the same meds made by different manufacturers.

    FDA or DEA or whoever is suppose to guard the chicken coop, doesn't. Manufacturer "must prove" bioavailability is +- 20% or within 80 to 120 percent of the brand name. Proof is on the "honor system." The fox guards the coop.

    The mother of all oxymoron's: Pharmaceutical company + "honor system."

    Barrrrrrrrrrrrrrrrrrrrrrrrrrffff.

    Bob

     
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