OK, I take 4 20 mg. Adderall XR's in the AM (80 mg.) then at about 3 in the afternoon I take one and one-half 20 mg. ir (30 mg.). So what should I tell the doctor I need to make the switch to Dexedrine? Thanks for the help!!

your doc should be able to tell you what dose you should start at. (edited to add the following) if your doc can't tell you, then it's probably time to find a doc with ADD (med) knowledge.

Dex is different from Adderall, and to get the best results with minimal side effects you should titrate up, no matter what you are transitioning from.

Basically it's a 1:1 conversion although some will argue that isn't true since the amount of d-amphetamine is higher in Dexedrine vs Adderall (100% vs 75%).

I still say that it's a 1:1 with a caveat. With Adderall you are trading in some of the d-amphetamine for l-amphetamine which helps give a little 'movitational' kick-in-the-butt. The total amphetamine quantity remains the same though.

Everyone responds a little differently though.

A rough dosage chart is:

5mg of Desoxyn = 10mg of Dexedrine = 10mg of Adderall = 10mg of Focalin = 20mg of Ritalin = 30mg of Vyvanse

J

I really feel there are 2 sides to these stimulant drugs focus + adrenal stimulation.

Focus translates to attention/clarity of thought.

adrenal action translates to side effects like sweating/muscle tension, but it also effects executive function (very complex) like reward valuing + improved perception + etc.

overall Adderall is more adrenal then dexedrine.

for focus 20mg of dexedrine was equiv to 30mg of adderal for me.

Adrenal stimulation via dex is around 1/3 to 2/3 as potent 20mg of dex translates to around 7-14mg of Adderall for me.

BobC

I don't think the amphetamines - ecstasy, meth, or dex - are adrenergic. Same goes for methylphenidate and cocaine.

Possibly meth at high levels, but that's it.

Stimulants tend to focus on norepinephrine, dopamine, and to a lesser degree serotonin.

Laevo-amphetamine (28% of this in Adderall, none in Dexedrine) is more noradrenergic than dextro-amphetamine (which is more dopaminergic than laevo). Perhaps this is why you feel a difference between Adderall and Dexedrine.

Norepinephrine is synthesized from dopamine (http://en.wikipedia.org/wiki/Dopamine) by dopamine β-hydroxylase (http://en.wikipedia.org/wiki/Dopamine_%CE%B2-hydroxylase).<SUP class=reference id=_ref-1>[3] (http://en.wikipedia.org/wiki/Norepinephrine#_note-1)</SUP> It is released from the adrenal medulla (http://en.wikipedia.org/wiki/Adrenal_medulla) into the blood as a hormone (http://en.wikipedia.org/wiki/Hormone), and is also a neurotransmitter (http://en.wikipedia.org/wiki/Neurotransmitter) in the central nervous system (http://en.wikipedia.org/wiki/Central_nervous_system) and sympathetic nervous system (http://en.wikipedia.org/wiki/Sympathetic_nervous_system) where it is released from noradrenergic neurons (http://en.wikipedia.org/wiki/Neuron). The actions of norepinephrine are carried out via the binding to adrenergic receptors (http://en.wikipedia.org/wiki/Adrenergic_receptor).

I'm fairly certain NE strongly effects the adrenal system. :)

L-amp is much more adrenal then D-amp possibly 2-3X more.

BobC

Let me just say that I'm probably one of very few who feels this way.... but I find Dex and Addy to be very similar mg per mg. HOWEVER, when switching different generics I can definitely tell a difference!!

Here are a couple of examples: I felt that 10mg Mallinckrodt Dex was very similar to 10mg Ranbaxy Addy. I probably could have used them interchangeably and it wouldn't have made a difference. HOWEVER... I feel that 10mg Barr Dex is actually a bit more stimulating (in a good way) than 15mg Barr Addy. I used to think that generics were all the same... but not anymore. Barr Addy is disappointing. They are 15mg tabs but they feel like I'm taking less than 10mg. :( BOO!

Norepinephrine is synthesized from dopamine (http://en.wikipedia.org/wiki/Dopamine) by dopamine β-hydroxylase (http://en.wikipedia.org/wiki/Dopamine_%CE%B2-hydroxylase).<sup class="reference" id="_ref-1">[3] (http://en.wikipedia.org/wiki/Norepinephrine#_note-1)</sup> It is released from the adrenal medulla (http://en.wikipedia.org/wiki/Adrenal_medulla) into the blood as a hormone (http://en.wikipedia.org/wiki/Hormone), and is also a neurotransmitter (http://en.wikipedia.org/wiki/Neurotransmitter) in the central nervous system (http://en.wikipedia.org/wiki/Central_nervous_system) and sympathetic nervous system (http://en.wikipedia.org/wiki/Sympathetic_nervous_system) where it is released from noradrenergic neurons (http://en.wikipedia.org/wiki/Neuron). The actions of norepinephrine are carried out via the binding to adrenergic receptors (http://en.wikipedia.org/wiki/Adrenergic_receptor).

I'm fairly certain NE strongly effects the adrenal system. :)

L-amp is much more adrenal then D-amp possibly 2-3X more.

BobC

Funnily, neither of us is in error, yet it appears our posts are responses to one another.

I was confusing 'adrenal' with 'adrenergic', though I am not wrong in saying stimulant medication is not adrenergic (and in fairness, you've never stated that it is).

On topic: Some people, especially those without hyperactivity symptoms, have more of a need for norepinephrine than dopamine. Not everybody has the same type of ADHD. It would be interesting to know if ADHD variations are caused by the same thing (the same genes) or not.

Tangentially, why is it that adrenaline remains unaffected by both ADHD and stimulants, especially considering noradrenaline uses the same receptors, and that adrenaline is created from noradrenaline which is created from dopamine (both substances lacking in people with ADHD)?

So, the levoamphetamine in Adderall is noradrenergic while dextroamphetamine is dopaminergic? Or are you saying that l-amp is just "more" noradrenergic than d-amp (and visa versa).

Just trying to understand this here. I guess I was thinking that l-amp and d-amp weren't *that* different... maybe l-amp produced more PNS effects than d-amp, but otherwise they acted fairly similar in the brain. btw- I'm not disputing anyone, I'm just trying to understand! :)

This is an interesting subject to me since I tend to switch back and forth between Addy and Dex. :D

So, the levoamphetamine in Adderall is noradrenergic while dextroamphetamine is dopaminergic? Or are you saying that l-amp is just "more" noradrenergic than d-amp (and visa versa).

Just trying to understand this here. I guess I was thinking that l-amp and d-amp weren't *that* different... maybe l-amp produced more PNS effects than d-amp, but otherwise they acted fairly similar in the brain. btw- I'm not disputing anyone, I'm just trying to understand! :)

This is an interesting subject to me since I tend to switch back and forth between Addy and Dex. :D

A brief run-down:
- Racemic means a drug contains left and right versions of a molecule.
- Ritalin is a racemic of methylphenidate in equal proportions. I'm not sure of the specifics of the racemic, but in methylphenidate, the dextro isomer is more noradrenergic than the laevo isomer.
- Adderall is a racemic of amphetamine in proportions roughly 3/4 dextro and 1/4 laevo. In amphetamine, the laevo isomer is more noradrenergic than the dextro isomer.
- Dopamine is essentially centrally acting (CNS only), whilst norepinephrine is centrally acting, but also a stress hormone and is said to be 'sympathetically acting' - sympathetic action is part of the PNS.

Once released, noradrenaline and adrenaline bind adrenergic receptors (http://en.wikipedia.org/wiki/Adrenergic_receptor) on peripheral tissues. Binding to adrenergic receptors causes the effects seen during the fight-or-flight response. These include pupil dilation, increased sweating, increased heart rate, occasional vomiting, and increased blood pressure.Any of these symptoms sound familiar? They should; they're side-effects of most stimulants (even coffee, because while it increases dopamine levels, it does not increase noradrenaline levels, but it does increase adrenaline levels). I'm not positive, but considering dopamine isn't peripherally active, I'd guess that such side-effects of ADHD medication are due to norepinephrine alone. Perhaps something to consider for those taking things like Strattera, which increases noradrenaline only.

All optical isomers of methylphenidate and basic amphetamine are both dopaminergic and noradrenergic (to answer your question). If I had to guess, I'd say Adderall increases norepinephrine and dopamine in a roughly 1:1 ratio, whilst dextro-amphetamine is possibly 2:3.

So what's the verdict on which is better? None. They do slightly different things, but both accomplish the same basic task. Use which ever one feels smoother and has less side-effects. I believe Adderall is only marketed in extended release form, whilst Dex I've only seen (here in Aus) in instant release form. Shame Adderall isn't legal here (due to lack of demand, not safety), or I'd try it out.

Thanks Fuse. Yeah, I knew about the isomers and what the components were but wasn't exactly sure how each performed. I always thought they were similar, since I frequently switch back and forth with generally no problems (except for certain generics, but that's another whole issue. :))

Anyway, on Adderall I do feel more PNS effects... a slight increase in heart rate being the main one.

Also, FYI: Here in the states we have the instant release Adderall, as well as the extended release version (Adderall XR).

I had very strong beta receptor stimulation from adderall.. I even tried taking propanolol to block it which worked great. Unfortunatly after about 10 days on propanolol my alpha-2 stimulation went nuts. I was sweating from my stomach even lol.

I tapered off the propanolol and it was quite painful had a migrane for the second time in my life.

I'm pretty sure D-amp is 1:1 NE/DA. D-amp switches over to 1:3 at higher dosages as the transport reverses flow and Dopamine is released from the synnapse. That spike is why illegal drug users downregulate dopamine so quickly.

I have never seen a study that lists L-amp or adderall in terms of NE/DA ratios.

I wonder how L-amp causes beta-adrenal stimulation.

Strattera is a really interesting drug it only increases NE/DA in the frotal cortex. I'm very tempted to try it, but d-amp has few side effects for me.

BobC