Dextroamphetamine

Dextroamphetamine is the dextrorotatory enantiomer of the amphetamine molecule and a central nervous system stimulant. It is used clinically for attention deficit hyperactivity disorder (ADHD) and narcolepsy, and has historically been employed for weight reduction. It is marketed in various prescription forms and brand names, including Dexedrine and ProCentra, and is also a component of mixed amphetamine salt medications such as Adderall.

Mechanism of action involves increased release of catecholamines, particularly dopamine and norepinephrine, from presynaptic nerve terminals and inhibition of their reuptake. This leads to higher concentrations of these neurotransmitters in synaptic gaps, producing wakefulness, improved attention, and heightened alertness. The dextro isomer is generally more potent at central nervous system stimulation than the levo isomer.

Dextroamphetamine is typically taken orally. Onset of effects commonly occurs within 30 to 60 minutes, with a duration lasting several hours depending on the formulation. It is metabolized in the liver and excreted in the urine, with excretion rates influenced by urinary pH. In many countries, dextroamphetamine is a Schedule II controlled substance due to its potential for abuse and dependence.

Safety and regulation considerations include common adverse effects such as decreased appetite, insomnia, dry mouth, increased heart rate and blood pressure, anxiety, and potential for dependence or withdrawal. Contraindications include known hypersensitivity to amphetamines, significant cardiovascular disease, uncontrolled hypertension, hyperthyroidism, glaucoma, and use with certain monoamine oxidase inhibitors. Use during pregnancy may carry risks, and therapy requires careful medical supervision to balance benefits and safety.

Historically synthesized in the early 20th century, dextroamphetamine remains a tightly regulated pharmaceutical with monitoring to mitigate abuse and adverse effects.